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湖南中医药大学,长沙 410208
Received:08 April 2021,
Published Online:23 June 2021,
Published:20 August 2021
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李玉丽,袁振仪,谭周进.泄泻证候相关肠道菌群的研究进展[J].中国实验方剂学杂志,2021,27(16):209-217.
LI Yu-li,YUAN Zhen-yi,TAN Zhou-jin.Correlation Between Intestinal Flora and Traditional Chinese Medicine Syndromes of Diarrhea: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(16):209-217.
李玉丽,袁振仪,谭周进.泄泻证候相关肠道菌群的研究进展[J].中国实验方剂学杂志,2021,27(16):209-217. DOI: 10.13422/j.cnki.syfjx.20211698.
LI Yu-li,YUAN Zhen-yi,TAN Zhou-jin.Correlation Between Intestinal Flora and Traditional Chinese Medicine Syndromes of Diarrhea: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(16):209-217. DOI: 10.13422/j.cnki.syfjx.20211698.
泄泻是一种以大便次数增多,粪质稀薄,甚至清稀如水为主证的中医病证,现代研究已证实其发生发展与肠道菌群失调密切相关。中医治疗泄泻尤其注重把握证候的准确性。泄泻证候研究对制订泄泻中医临床诊疗方案具有重要的指导意义,且与其临床疗效密切相关。基于中医理论与微生态理论存在许多共同的认知基础,以及随着肠道菌群研究的深入,肠道菌群在中医证候研究中的意义益加凸显。肠道菌群与泄泻发生发展密切相关,证候相关肠道菌群研究为“以菌测证、以菌施方”探究提供了思路。该文总结了泄泻中医证候与免疫反应、神经递质、脑肠肽和蛋白质等微观指标的联系,着重梳理了泄泻6种常见中医证候相关肠道菌群特征的最新研究进展,同时基于中医“以方测证”理论,即依据方剂的功效或其组成药物的功效,反证其对应证候的属性,从而间接探究泄泻中医证候与肠道菌群的相关性,以期归纳提出今后证候相关肠道菌群的研究方向。众多研究表明泄泻中医证候的物质基础与炎症细胞因子、神经递质和蛋白质等微观指标有高度的相关性。证候和菌群失调都是致病因素作用于机体的表现,从不同的角度归纳了疾病的表现。不同的中医证候对应特异的肠道菌群客观指标。肠道菌群是未来揭示泄泻证候的内在物质基础的一个有力结合点。
Diarrhea is characterized by increased bowel movements and loose and even watery stools. Its occurrence and development have been proved by modern research to be closely related to the imbalance of intestinal flora. Traditional Chinese medicine (TCM) pays a special attention to syndrome differentiation in treating diarrhea. Exploring the TCM syndromes of diarrhea is of great significance to the formulation of TCM diagnosis and treatment scheme of diarrhea and the improvement of clinical curative effects. There exist many similarities between TCM theory and micro-ecological theory concerning diarrhea. With the deepening of intestinal flora research, the significance of intestinal flora in TCM syndrome research has been increasingly highlighted. The close correlation of intestinal flora with the occurrence and development of diarrhea has provided new ideas of deducing syndrome and selecting prescription based on intestinal flora. This paper summarized the relationship between TCM syndromes of diarrhea and microscopic indexes such as immune response, neurotransmitters, brain-gut peptide, and proteins and analyzed the intestinal flora characteristics related to six common TCM syndromes of diarrhea. Meanwhile, based on the theory of deducing syndrome by prescription, namely deducing the syndrome by the efficacy of prescription or its medicinal components, the correlation between TCM syndromes of diarrhea and intestinal flora was indirectly verified, so as to identify the research direction of correlation between intestinal flora and TCM syndromes in the future. Numerous studies have shown that the TCM syndromes of diarrhea were highly correlated with the microscopic indexes such as inflammatory cytokines, neurotransmitters, and proteins. Syndromes and dysbacteriosis both resulted from pathogenic factors acting on the body, which were summarized from different angles. Different TCM syndromes corresponded to specific objective indicators of intestinal flora. Intestinal flora has the potential of being an internal material basis for powerfully revealing the TCM syndromes of diarrhea in the future.
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