基于肝-肠-脑轴探讨中医药防治肝性脑病研究进展  

Research Progress on the Prevention and Treatment of Hepatic Encephalopathy with Traditional Chinese Medicine Based on the Liver-Gut-Brain Axis

作　　者：刘文钒 赖嘉文 叶志豪 王馨莹 吕建林[2] LIU Wenfan;LAI Jiawen;YE Zhihao;WANG Xinying;LYU Jianlin(Guangxi University of Chinese Medicine,Nanning,Guangxi,China,530299;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning,Guangxi,China,530022)

机构地区：[1]广西中医药大学,广西南宁530299 [2]广西中医药大学第一附属医院,广西南宁530022

出　　处：《河南中医》2025年第4期617-622,共6页Henan Traditional Chinese Medicine

基　　金：中国博士后科学基金项目(2023MD734157);广西自然科学基金项目(2022GXNSFAA035446);广西中医药适宜技术开发与推广项目(GZSY2024016);广西中医药大学博士引进科研启动基金项目(2022BS032)。

摘　　要：肝性脑病发病病位在肝、脑,其发病与肠道功能紊乱及肠道微生物群失调密切相关。肠肝失调是始动因素,毒损脑络是病理基础,中医药可通过调节肝-肠-脑轴治疗肝性脑病,但目前的研究尚有以下不足:(1)当前中医药治疗肝性脑病的机制研究主要是动物实验研究,但当前的动物模型难以表现出中医的临床病症特点及其证候特征;(2)目前的研究虽已证明中西医结合治疗比单纯的西医治疗效果更好,但临床研究尚停留在临床疗效观察方面,且样本量小,对远期疗效和不良反应观察得较少。今后,应在当前动物模型的基础上,建立出更符合中医病症特点的动物模型;开展大样本、多中心、观察周期较长的临床研究。The onset of hepatic encephalopathy(HE) involves the liver and brain,and its occurrence is closely related to intestinal dysfunction and dysbiosis of the intestinal microbiota.Intestinal-liver imbalance is the initiating factor,and toxic damage to the brain vessels is the pathological basis.TCM can treat HE by regulating the liver-intestine-brain axis.However,current research still has the following deficiencies:(1)The current mechanism research on the treatment of HE with TCM mainly focuses on animal experiments,but the current animal models are difficult to reflect the clinical symptoms and syndrome characteristics of TCM.(2)Although current research has proved that combined treatment with traditional Chinese and Western medicine is more effective than Western medicine alone,clinical research is still limited to clinical efficacy observation,with small sample sizes and less observation on long-term efficacy and adverse reactions.In the future,on the basis of the current animal models,animal models that better reflect the characteristics of TCM symptoms should be established and large-scale,multi-center,and long-term clinical studies should be carried out.

关 键 词：肝性脑病 肝-肠-脑轴 肠肝失调 毒损脑络 

分 类 号：R259.747.9[医药卫生—中西医结合]