基于“肠脑-肝脾相关”理论探讨肠道菌群失调与慢性疲劳综合征发病的相关性  

Exploring the Correlation Between Intestinal Microbiota Dysbiosis and the Onset of Chronic Fatigue Syndrome Based on the"Gut-Brain and Liver-Spleen Correlation"Theory

作　　者：张思宁 马紫慧 张晓蕾 马国海 商洪涛[1] ZHANG Sining;MA Zihui;ZHANG Xiaolei;MA Guohai;SHANG Hongtao(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中医药信息》2024年第11期40-47,共8页Information on Traditional Chinese Medicine

基　　金：江苏省老年健康科研项目(LD2021004)。

摘　　要：慢性疲劳综合征(CFS)是一种以疲劳为主症,同时伴有焦虑、抑郁、排便习惯改变等不适的多系统疾病,其发病率逐年升高。“脑-肠轴”的中医学理论基础是肝脾相关,肝脾不调在CFS患者中最常见,结合“脏腑别通”理论中“肝与大肠相通,脾与小肠相通”,可以将“脑-肠轴”与肝脾不调在CFS发病中的作用相互关联。本文以肠道菌群为切入点,系统阐述CFS发病中“脑-肠轴”通路的失控、肠黏膜屏障的破坏、免疫炎症反应的异常和线粒体代谢障碍等病理变化,创新地提出“肠脑-肝脾相关”理论,用现代医学语言揭示CFS肝郁脾虚病机的生物学内涵,并总结疏肝健脾疗法对CFS患者肠道菌群和免疫功能的改善效果,为CFS的治疗提供新思路,促进中医理论的继承、创新和发展。Chronic fatigue syndrome(CFS)is a multi-system disorder primarily characterized by fatigue,accompanied by symptoms such as anxiety,depression,and changes in bowel habits,with an increasing prevalence each year.The theoretical basis of the"brain-gut axis"in Chinese medicine is rooted in the relationship between the liver and spleen,where liver-spleen disharmony is commonly observed in CFS patients.According to the"Organ Interconnection"theory,which posits that the liver is connected to the large intestine and the spleen to the small intestine,the roles of the"brain-gut axis"and liver-spleen disharmony in CFS onset are interrelated.This article uses intestinal microbiota as a point of entry to systematically elucidate the pathological changes in CFS,including the dysregulation of the brain-gut axis pathway,disruption of the intestinal mucosal barrier,abnormalities in immune-inflammatory responses,and mitochondrial metabolic dysfunction.The innovative"gut-brain and liver-spleen correlation"theory is proposed here to reveal the biological basis of liver qi stagnation and spleen deficiency in CFS through the lens of modern medicine.Additionally,the efficacy of liver-soothing and spleen-strengthening therapies on improving intestinal microbiota and immune function in CFS patients is summarized,providing new perspectives for CFS treatment and promoting the inheritance,innovation,and development of Chinese medicine theory.

关 键 词：慢性疲劳综合征 “脑-肠轴” 肝脾相关 肠道菌群 “肠脑-肝脾相关”理论 

分 类 号：R259[医药卫生—中西医结合]