首页|基于肠道菌群-胆汁酸代谢轴探讨T2DM"土壅木郁"病机的生物学内涵

基于肠道菌群-胆汁酸代谢轴探讨T2DM"土壅木郁"病机的生物学内涵

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2型糖尿病(Type 2 diabetes mellitus,T2DM)是一种患病率较高的慢性代谢性疾病,主要由胰岛素抵抗和/或胰岛素分泌不足引起的慢性高血糖为特征,常合并高血压、高血脂等代谢异常性疾病。近年来,肠道菌群、胆汁酸和T2DM之间的关联为临床研究的热点。中医学认为,脾胃属土,肝胆属木,脾土壅滞,土壅内热,影响肝木之疏泄;肝木郁结,气机氤氲,阻遏中焦,最终壅滞脾土,此乃"土壅木郁"之象。土壅与木郁互为因果,为消渴病发生发展的理论基础,土壅不能运化水谷以滋养肝木,肝失濡养,致使肝气失于疏泄,气郁化火伤阴,上灼肺津,中劫胃液,下耗肾水,诱发消渴。从现代医学及生物技术角度来讲,以肠道菌群-胆汁酸代谢轴为切入点,阐释土壅木郁理论的科学内涵。肠道菌群失调是土壅的重要生物学基础,脾土壅滞,水谷不化,影响机体消化、免疫、脂质等方面,致使肠道菌群紊乱。胆汁酸代谢异常是木郁的重要微观体现,肝失疏泄,气机升降失常,致使胆气郁滞,胆汁酸代谢分泌异常。肠道菌群-胆汁酸代谢轴通过影响T2DM患者体内肠道菌群的结构组成和多样性、胆汁酸池组成等一系列变化来调节葡萄糖代谢和糖稳态进而影响糖尿病发展进程。因此,本文从肠道菌群-胆汁酸代谢轴角度探讨T2DM"土壅木郁"的生物学内涵,更好地阐释T2DM土壅木郁机制的科学性,为防治T2DM提供新的临床思路及理论依据。
Based on the Theory of"Earth stagnation,Wood Depression",the Mechanism Connotation of Intestinal Flora-Bile Acid Metabolism Axis of Type 2 Diabetes Mellitus was Discussed
Type 2 diabetes mellitus(T2DM)is a chronic metabolic disease with a high prevalence of high prevalence,mainly manifested by hyperglycemia,insulin secretion or insulin resistance,often complicated by hypertension,hyperlipidemia and other metabolic abnormalities.In recent years,the association between intestinal flora,bile acids and T2DM has been a hot topic in clinical research.Traditional Chinese medicine believes that the spleen and stomach belong to soil,liver and gallbladder belong to wood,spleen soil stagnation,soil internal heat,affecting the drainage of liver wood;The liver wood is staggered,Liver qi stagnation,the middle scorch is suppressed,and finally the spleen is stagnant,which is the image of"earth stagnation,wood depression".Earth stagnation and wood depression are the cause and effect of each other,which is the theoretical basis for the occurrence and development of T2DM,and earth stagnation cannot transport water valley to nourish liver wood,and the liver loses nourishment,resulting in liver qi loss in drainage,qi depression and fire injury yin,burning lungs,robbing gastric juice,consuming kidney water,and inducing thirst quenching.From the perspective of modern medicine and biotechnology,the intestinal flora-bile acid metabolic axis is used as the starting point to explain the scientific connotation of the theory of soil wood.Intestinal flora disorder is an important biological basis of the soil,the spleen and soil are stagnant,the water valley does not change,affecting the body's digestion,immunity,lipids and other aspects,resulting in intestinal flora disorders.Abnormal bile acid metabolism is an important microscopic embodiment of wood depression,liver loss and drainage,gas engine lifting and lowering abnormalities,resulting in bile depression,bile acid metabolism secretion abnormal.The intestinal microbiota-bile acid metabolism axis regulates glucose metabolism and glucose homeostasis by affecting the structural composition and diversity of intestinal flora and bile acid pool composition in T2DM patients,thereby affecting the development process of diabetes.Therefore,this paper discusses the biological connotation of T2DM"earth stagnation,wood depression"from the perspective of intestinal microbiota-bile acid metabolic axis,better explains the scientific nature of T2DM soil woody depression mechanism,and provides new clinical ideas and theoretical basis for the prevention and treatment of T2DM.

Intestinal floraBile acidsT2DMEarth stagnation wood depressionRestraining wood and hilling earth

张爽、李品、安继仁、杨宇峰、石岩

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辽宁中医药大学 沈阳 110847

辽宁中医药大学附属医院 沈阳 110847

肠道菌群 胆汁酸 2型糖尿病 土壅木郁 抑木扶土

2024

世界科学技术-中医药现代化
中科院科技政策与管理科学研究所,中国高技术产业发展促进会

世界科学技术-中医药现代化

CSTPCD北大核心
影响因子:1.175
ISSN:1674-3849
年,卷(期):2024.26(10)