基于“胆汁酸-肠菌轴”讨论疏肝健脾法在结直肠腺瘤中的作用机制  

The mechanism of method of soothing liver and strengthening spleen in colorectal adenomas based on"bile acid-gut microbiota axis"

作　　者：徐晓雯 陈婉珍[1] 张一丁 王震凯 XU Xiaowen;CHEN Wanzhen;ZHANG Yiding;WANG Zhenkai(Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing,210022,China)

机构地区：[1]南京中医药大学附属南京中医院,南京210022

出　　处：《中国中西医结合消化杂志》2025年第2期178-182,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家自然科学基金(No:82205014);镇江市中医脾胃病临床医学研究中心开放课题(No:SSPW2022-KF07)。

摘　　要：胆汁酸-肠菌轴的失调是引发结直肠腺瘤的一个重要因素,结直肠腺瘤是结直肠癌的主要癌前病变。目前西医对结直肠腺瘤以内镜下治疗为主,但存在并发症和一定的复发率。结合中医经典理论和现代医学研究发现,胆汁酸失调对应中医的“肝郁”,肠道菌群紊乱对应中医“脾虚”的范畴,故疏肝健脾法为中医治疗结直肠腺瘤的基本法之一,旨在恢复胆汁酸和微生物之间的稳态,抑制腺瘤的发生与癌变,为临床治疗结直肠腺瘤提供参考思路。The imbalance of the bile acid-gut microbiota axis is an important factor in the development of colorectal adenomas,which are the main precancerous lesions of colorectal cancer.Current Western medical treatments for colorectal adenomas rely mainly on endoscopic interventions,but these are associated with complications and a certain recurrence rate.Integrating traditional Chinese medicine(TCM)theory with modern medical research reveals that bile acid dysregulation corresponds to TCM's concept of"liver qi stagnation",while gut microbiota imbalance aligns with the TCM category of"spleen deficiency".Thus,the liver-soothing and spleen-strengthening method serves as a fundamental TCM approach to treating colorectal adenomas.This method aims to restore homeostasis between bile acids and gut microbiota,thereby inhibiting the occurrence and malignant transformation of adenomas.It offers a valuable reference framework for the clinical management of colorectal adenomas.

关 键 词：胆汁酸 肠道菌群 中医 结直肠腺瘤 

分 类 号：R735.3[医药卫生—肿瘤]