基于肠道菌群-炎症反应探讨糖尿病前期脾虚痰湿的病机内涵  

Pathogenetic Connotation of Spleen Deficiency Induced Phlegm-Dampness in Prediabetic State Based on Intestinal Flora-Inflammatory Response Theory

作　　者：杨星 郑承红[1,2] 丁念[2] 邹秀淇 YANG Xing;ZHENG Chenghong;DING Nian;ZOU Xiuqi(Hubei University of Chinese Medicine,Wuhan Hubei China 430065;Wuhan Hospital of Traditional Chinese Medicine,Wuhan Hubei China 430050)

机构地区：[1]湖北中医药大学,湖北武汉430065 [2]武汉市中医医院,湖北武汉430050

出　　处：《中医学报》2025年第4期735-739,共5页Acta Chinese Medicine

基　　金：湖北省中医药管理局中医药指导性项目(ZY2023F053);武汉市科技局知识创新专项项目(2022020801010582);武汉市中医药科研项目(WZ22C56,WZ24Q23)。

摘　　要：肠道菌群紊乱诱导的炎症级联反应及免疫失衡,与糖尿病前期的发病密切相关。中医认为,脾虚与痰湿是糖尿病前期重要的致病因素,也是关键病机。高脂高热量饮食摄入扰乱肠道微生物群及其代谢产物,破坏肠道屏障,影响免疫细胞平衡,导致一系列的炎症反应和机体代谢功能障碍,诱发胰岛素抵抗并演变为糖尿病。结合现代分子生物学与中医学理论研究可知,肠道菌群紊乱是糖尿病前期脾虚痰湿的病理基础,慢性炎症是脾虚痰湿的微观表现,炎症诱发的免疫失衡是脾虚痰湿的重要环节。故菌群平衡是“脾主运化”的物质基石,运用培脾化痰法治疗糖尿病前期,可有效调节肠道微生物群,缓解炎症反应及免疫失衡状态。Inflammatory cascade response and immune imbalance induced by intestinal flora disorders are closely related to the pathogenesis of prediabetic state.According to traditional Chinese medicine(TCM),Spleen deficiency induced Phlegm-Dampness are important pathogenic factors and key disease mechanisms in prediabetes.High-fat and high-calorie diet disrupts the intestinal microbiota and its metabolites,destroys the intestinal barrier,and affects the balance of immune cells,leading to a series of inflammatory reactions and metabolic dysfunction,which induces insulin resistance and evolves into diabetes.Combined with modern molecular biology and Chinese medicine theory,intestinal flora disorders are the pathological basis of Spleen deficiency induced Phlegm-Dampness in prediabetic state,chronic inflammation is the microscopic manifestation of Spleen deficiency induced Phlegm-Dampness,and inflammation-induced immune imbalance is an important part of Spleen deficiency induced Phlegm-Dampness.Therefore,the balance of bacterial flora is the material cornerstone of"Spleen is the master of transportation and digestion",and the treatment of prediabetic state with the method of cultivating the Spleen and Phlegm resolving can effectively regulate the intestinal microbiota and alleviate the inflammatory reaction and immune imbalance.

关 键 词：糖尿病前期 脾虚痰湿 肠道菌群 炎症反应 菌群失调 免疫失衡 培脾化痰法 病机 

分 类 号：R255.4[医药卫生—中医内科学]