中西医通过调节肠道菌群防治慢性肾脏病研究进展  

Research Progress on the Prevention and Treatment of Chronic Kidney Disease by Regulating Intestinal Flora with Traditional Chinese and Western Medicine

作　　者：梁素娜 赵晰[1,2] 王耀光 LIANG Suna;ZHAO Xi;WANG Yaoguang(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,China,300381;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin,China,300381)

机构地区：[1]天津中医药大学第一附属医院,天津300381 [2]国家中医针灸临床医学研究中心,天津300381

出　　处：《河南中医》2025年第2期317-324,共8页Henan Traditional Chinese Medicine

基　　金：王耀光全国名老中医药专家传承工作室项目(978022);王耀光天津市名中医传承工作室项目(883022)。

摘　　要：基于“肠-肾轴”理论,肾脏疾病与肠道菌群的关系可以概括为慢性肾脏病发生发展过程中肠道菌群的破坏,包括肠道菌群改变、肠源性尿毒症毒素增多、肠道屏障功能障碍和内毒素水平升高。西医常用微生态制剂、吸附剂、缓泻剂、粪菌移植调整肠道菌群,增加尿毒症毒素的排泄,修复肠道黏膜及降低内毒素水平。中医认为,肾脏疾病的核心病机为脾肾亏虚,浊毒内蕴,补益脾肾法可调节菌群改变,通腑泄浊法可清除肠源性尿毒症毒素,活血化浊解毒法可降低内毒素水平。诸法合用,整体调节人体内环境,显著改善患者的肠道菌群情况,缓解临床症状。但目前治疗方案尚不完善,作用机制研究还不深入,之后可完善治疗方案,深入研究其作用机制和具体的作用通路与靶点,为中西医通过调节肠道菌群治疗慢性肾脏病提供客观依据。Based on the"intestine-kidney axis"theory,the relationship between kidney diseases and intestinal flora can be summarized as the disruption of intestinal flora during the occurrence and development of chronic kidney disease,including changes in intestinal flora,an increase in intestinal uremic toxins,intestinal barrier dysfunction,and elevated endotoxin levels.Western medicine commonly uses microecological preparations,adsorbents,laxatives,and fecal microbiota transplantation to adjust the changes in intestinal flora,increase the excretion of GUTs,repair intestinal mucosa,and reduce endotoxin levels.According to TCM,the core pathogenesis of kidney diseases is the deficiency of the spleen and kidney and the accumulation of turbid toxins.The method of tonifying the spleen and kidney can regulate the changes of the flora;the method of purging the bowels and eliminating turbidity can remove the toxins of uremia from the intestine,and the method of promoting blood circulation,eliminating turbidity and detoxifying can reduce the level of endotoxins.The combination of these methods can comprehensively regulate the internal environment of the human body,significantly improve the intestinal flora of patients,and alleviate clinical symptoms.However,the current treatment plan is still not perfect,and the research on its mechanism of action is not yet in-depth.In the future,the treatment plan can be improved,and the mechanism of action and specific pathways and targets can be studied in depth to provide an objective basis for the treatment of CKD through regulating the intestinal flora by integrating traditional Chinese and Western medicine.

关 键 词：慢性肾脏病 “肠-肾轴” 微生态制剂 吸附剂 缓泻剂 粪菌移植 补益脾肾法 通腑泄浊法 活血化浊解毒法 肠道菌群 中西医结合疗法 

分 类 号：R259.926[医药卫生—中西医结合]