首页|肠道微生态:中医药治疗冠脉微循环障碍的潜在靶点

肠道微生态:中医药治疗冠脉微循环障碍的潜在靶点

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阐述了肠道菌群及其代谢产物,总结了冠脉微循环障碍(CMD)患者肠道菌群的变化,阐明肠道屏障损伤和细菌易位诱导炎症反应和免疫反应,加重CMD,肠道菌群的改变影响包括氧化三甲胺(TMAO)、短链脂肪酸(SCFA)和胆汁酸(BA)途径在内的多种代谢途径,导致CMD。综述肠道菌群结构失调与CMD之间的关联、中医药对肠道菌群的调节作用以及基于菌群的治疗方案,提示中医药可能通过靶向调控肠道菌群及其代谢产物,如TMAO、SCFA、BA,影响炎症反应及免疫反应,发挥改善动脉粥样硬化、稳定易损斑块,改善微血管内皮功能障碍及干预冠脉微循环障碍的危险因素,进而改善CMD。以心与小肠相表里为切入点,深入探讨中医药在调控肠道微生态在冠脉微循环障碍发生、发展中扮演的关键角色,以期为冠脉微循环障碍的中西医结合治疗提供新的思路与策略。
Intestinal Microbiota:Potential Targets for the Treatment of Coronary Microcirculatory Disorders with Traditional Chinese Medicine
This review discussed the gut microbiota and its metabolic products,summarized changes in the gut microbiota of pa-tients with coronary microcirculatory disorder(CMD),and clarified how intestinal barrier damage and bacterial translocation in-duced inflammatory and immune responses that exacerbated CMD.Changes in the gut microbiota affect various metabolic pathways,including those involving trimethylamine N-oxide(TMAO),short-chain fatty acids(SCFA),and bile acids(BA),contributing to CMD.The review highlighted the association between dysbiosis of the gut microbiota and CMD,the regulatory effects of traditional Chinese medicine(TCM)on gut microbiota,and treatment protocols based on gut microbiota.The results suggest that TCM may in-fluence inflammatory and immune responses by targeting and modulating gut microbiota and its metabolic products,such as TMAO,SCFA,and BA.This action may improve atherosclerosis,stabilize vulnerable plaques,enhance microvascular endothelial dysfunc-tion,and intervene in risk factors for CMD,ultimately improving CMD.Using the internal-external relationship between the heart and small intestine as a starting point,the review delved into the critical role of TCM in regulating gut microecology during the onset and progression of CMD,aiming to provide new insights and strategies for the combined treatment of CMD through both Western medicine and TCM.

Coronary microcirculatory disorderIntestinal microecologyTraditional Chinese medicineMetabolitesImmune re-sponseInflammatory responseEndothelial functionTrimethylamine N-oxideShort-chain fatty acidBile acid

葛昭、杨志华、任思霖、王贤良

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天津中医药大学第一附属医院/国家中医针灸临床医学研究中心,天津,300381

天津中医药大学研究生院,天津,301617

冠脉微循环障碍 肠道微生态 中医药 代谢产物 免疫反应 炎症反应 内皮功能 氧化三甲胺 短链脂肪酸 胆汁酸

2024

世界中医药
世界中医药学会联合会

世界中医药

CSTPCDCHSSCD北大核心
影响因子:1.266
ISSN:1673-7202
年,卷(期):2024.19(20)