抽动障碍从脾胃论治  

Treating Tic Disorders from the Perspective of the Spleen and Stomach

作　　者：张永莹 许洪义 徐曼曼 ZHANG Yongying;XU Hongyi;XU Manman(Shandong University of Traditional Chinese Medicine,Jinan,Shandong,China,250014;Heze Hospital of Traditional Chinese Medicine,Heze,Shandong,China,274000)

机构地区：[1]山东中医药大学,山东济南250014 [2]菏泽市中医医院,山东菏泽274000

出　　处：《河南中医》2024年第12期1827-1830,共4页Henan Traditional Chinese Medicine

基　　金：山东省中医药科技面上项目(2020M200)。

摘　　要：抽动障碍的发病机制主要为皮质-基底神经节-丘脑-皮质环路神经递质紊乱,肠道微生物群可通过免疫、内分泌、神经等途径实现与中枢神经系统的相互沟通,在辅助胃肠消化及参与糖类、脂质、蛋白质的代谢过程中,产生诸多对机体有益的营养物质。生理状态下,清阳出上窍,浊阴出下窍,阳主气,阴成形,清阳升、浊阴降是机体正常运行的重要前提。肠道菌群代谢产生的糖、脂肪、蛋白质等精微物质为“清”,而免疫炎症因子、吲哚酚硫酸盐等神经毒性代谢产物、失衡神经递质为“浊”。脾之升清、胃之降浊的功能与肠道菌群稳态及其正常功能的发挥具有重要的关联性,故从脾胃论治抽动障碍可调节肠道菌群,改善皮质-基底神经节-丘脑-皮质环路神经递质紊乱,从而改善症状。The pathogenesis of tic disorders is primarily associated with neurotransmitter dysregulation in the cortico-basal ganglia-thalamo-cortical circuit.Gut microbiota can communicate bidirectionally with the central nervous system through immune,endocrine,and neural pathways,exerting regulatory effects.According to TCM,the main pathogenesis of tic disorders is considered to be weakness of the spleen and stomach leading to wind,with weakness of the spleen and stomach as the root and wind manifestations as the symptoms.The intestinal microbiome plays a role in assisting digestion in the gastrointestinal tract and participating in the metabolism of carbohydrates,lipids,and proteins,producing numerous nutrients beneficial to the body.In physiological state,the clear yang rises to the upper orifices,while the turbid yin descends to the lower orifices.Yang governs the function of qi,while yin forms the body.The most important principle is"inhaling the clear and exhaling the turbid."The"clear"substances such as sugar,fat,and protein produced by the gut microbiota metabolism serve as nourishment for the body,while the"turbid"substances such as immune and inflammatory factors,indole-3-phosphate sulfate,and imbalanced neurotransmitters are neurotoxic metabolites that disrupt the brain-stem-thalamus-cortex circuit.The healthy functioning of the spleen′s"raising the clear"and stomach′s"descending the turbid"functions is closely related to the stability of the gut microbiota and its normal function.Therefore,treating tic disorders from the perspective of the spleen and stomach can regulate the gut microbiota and improve the dysfunction of the cortex-basal ganglia-thalamus-cortex circuit,thereby exerting its therapeutic effects.

关 键 词：抽动障碍 肠道菌群 从脾胃论治 脑-肠轴理论 

分 类 号：R277.748[医药卫生—中医学]