从肝脾失调探讨胆汁酸-菌群轴对慢性萎缩性胃炎伴肠上皮化生的影响  

Effect of Bile Acid-Flora Axis on Chronic Atrophic Gastritis with Intestinal Metaplasia from Liver and Spleen Disorders

作　　者：王文秀 王玉娟[2] 于丽丽[2] 李秀丽[2] 柏世界 贾天睿 WANG Wenxiu;WANG Yujuan;YU Lili;LI Xiuli;BAI Shijie;JIA Tianrui(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Department of Spleen,Stomach and Hepatobiliary Diseases,Jinan Hospital of Traditional Chinese Medicine,Jinan 250012,China;Department of Internal Medicine I,Chongqing Wulong District Hospital of Traditional Chinese Medicine,Chongqing 408500,China;College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250014 [2]济南市中医医院脾胃肝胆科,山东济南250012 [3]重庆市武隆区中医医院内一科,重庆408500 [4]山东中医药大学中医学院,山东济南250355

出　　处：《山东中医杂志》2025年第4期405-409,415,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技项目重点项目(编号:2020Z28)。

摘　　要：慢性萎缩性胃炎(CAG)是临床常见消化系统疾病之一,肠上皮化生(IM)是指胃黏膜上皮细胞被肠型上皮细胞取代的病理改变。胆汁酸与肠道菌群共同维持胃肠道的稳态,胆汁酸-菌群轴异常与CAG伴IM的发生发展密切相关;胆汁酸-菌群轴与中医肝脾功能关系密切,是其正常发挥的物质基础,胆汁酸与肠道菌群的相互影响也体现了肝脾相关理论;肝失疏泄、脾失健运,肝脾失调是CAG伴IM的重要病机。故本文基于肝脾失调探讨胆汁酸-菌群轴对CAG伴IM的影响,以期为中西医结合防治CAG伴IM提供新的思考。Chronic atrophic gastritis(CAG)is one of the common digestive diseases in clinical practice.Intestinal metaplasia(IM)refers to the pathological changes in which gastric mucosal epithelial cells are replaced by intestinal epithelial cells.Bile acids and intestinal flora axis maintain gastrointestinal homeostasis together,and bile acid-flora axis abnormalities are closely related to the occurrence and development of CAG with IM.Bile acid-flora axis is closely related to traditional Chinese medicine(TCM)liver and spleen function,and is the material basis for its normal function.The interaction between bile acid and intestinal flora also reflects the theory of liver and spleen correlation.Meanwhile,the dysfunction of liver and spleen is an important pathogenesis of CAG with IM.Therefore,this paper discusses the effect of bile acid-flora axis on CAG with IM based on liver and spleen disorders,in order to provide new thinking for the prevention and treatment of CAG with IM by combining TCM and western medicine.

关 键 词：慢性萎缩性胃炎 肠上皮化生 肝脾失调 胆汁酸代谢 肠道菌群 胆汁酸-菌群轴 

分 类 号：R259.733.2[医药卫生—中西医结合]