基于“心-脾-肠”轴探讨肠道菌群紊乱与代谢性心血管病的关系  

Relationship Between Gut Microbiota Dysbiosis and Cardiometabolic Diseases Based on"Heart-spleen-intestine"Axis

作　　者：徐茜 王文婷 李逸雯 崔京 朱梦梦 刘艳飞[1] 刘玥[1] XU Qian;WANG Wenting;LI Yiwen;CUI Jing;ZHU Mengmeng;LIU Yanfei;LIU Yue(National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Experimental Research Center,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院西苑医院,国家中医心血管病临床医学研究中心,北京100091 [2]中国中医科学院医学实验中心,北京100700

出　　处：《中国实验方剂学杂志》2024年第20期203-211,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82374290)。

摘　　要：代谢性心血管病是一类代谢异常与心血管损害之间存在因果关系的临床综合征,其全球患病率及相关死亡率持续上升,已成为全球共同关注的重大健康问题。肠道菌群及其代谢产物在心血管代谢健康中的作用受到广泛关注,菌群紊乱被视为促进代谢性心血管病发展的关键因素。肠道菌群紊乱破坏了“心-脾-肠”轴的平衡,导致脾肠失健,引发代谢紊乱,加快代谢性心血管病的进展。心脏功能异常亦可对脾肠功能产生负面影响,心脾失调、气血失和,加剧代谢异常和肠道菌群紊乱,形成恶性循环。从现代生物学视角出发,肠道菌群及其代谢产物可能通过影响炎症反应和免疫失衡,引起内皮功能障碍和代谢紊乱,从而增加代谢性心血管病的风险。同时,笔者还提出调节肠道菌群改善代谢性心血管病的中西医防治策略,中医药治疗从肠道菌群出发,以“心-脾-肠”轴为中介,调节心血管代谢健康,突出中医药在靶向肠道菌群治疗代谢性心血管病中的独特优势。该文基于中医理论提出的“心-脾-肠”轴为切入点,围绕该轴在肠道菌群紊乱与代谢性心血管病发展中扮演的关键角色展开探讨,以期为代谢性心血管病的中西医结合研究提供新的视角,为改善代谢性心血管病患者的预后和生活质量提供科学依据和实践指导。Cardiometabolic disease is a clinical syndrome with a causal relationship between metabolic abnormalities and cardiovascular damage.With its global incidence and related mortality rates continually rising,it has become a major health concern worldwide.The role of the gut microbiome and its metabolic products in cardiovascular metabolic health has received widespread attention,with gut microbiota dysbiosis considered a key factor in promoting the development of cardiometabolic disease.Dysbiosis disrupts the balance of the"heartspleen-intestine"axis,leading to dysfunction of the spleen and intestines,which triggers metabolic disorders and accelerates the progression of cardiometabolic disease.Cardiac dysfunction can also negatively affect spleen and intestinal function,leading to imbalances in the heart and spleen,disharmony in Qi and blood,and exacerbating metabolic anomalies and further dysbiosis,thus forming a vicious cycle.From a modern biological perspective,the gut microbiome and its metabolic products can influence disease progression by modulating inflammatory responses and immune imbalances,leading to endothelial dysfunction and metabolic disorders,thereby increasing the risk of cardiometabolic disease.Additionally,the article proposes strategies for managing cardiometabolic disease by regulating the gut microbiome through a combination of Chinese and western medicine approaches.Traditional Chinese medicine(TCM)treatment starts from the gut microbiome,using the"heart-spleen-intestine"axis as a mediator to regulate cardiovascular metabolic health,highlighting the unique advantages of TCM in targeting the gut microbiome to treat cardiometabolic disease.This article takes the TCM theory of the"heart-spleen-intestine"axis as a starting point,discusses the pivotal role played by this axis in the connection between gut microbiome dysbiosis and the development of cardiometabolic disease,aiming to provide a new perspective for the integrated traditional Chinese and western medical research on cardiometabolic disea

关 键 词：代谢性心血管病 肠道菌群 “心-脾-肠”轴 中医药(TCM) 中西医结合 代谢调节 

分 类 号：R22[医药卫生—中医基础理论] R825.4[医药卫生—中医学] R28[生物学—微生物学] Q939.121