Biological Connotation of Pathogenesis of Ulcerative Colitis with Liver Depression and Spleen Deficiency Based on Bile Acid-intestinal Flora Axis

CHANG Yi; ZHANG Xiangan; GUO Haixia; LIU Jing; MI Liuyue; XU Yuting; AN Jingwen

doi:10.13422/j.cnki.syfjx.202201730

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Biological Connotation of Pathogenesis of Ulcerative Colitis with Liver Depression and Spleen Deficiency Based on Bile Acid-intestinal Flora Axis

更新时间：2023-05-17

- Biological Connotation of Pathogenesis of Ulcerative Colitis with Liver Depression and Spleen Deficiency Based on Bile Acid-intestinal Flora Axis
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 29, Issue 8, Pages: 229-236(2023)
- 作者机构：
  
  1.河南中医药大学，郑州 450046
  2.河南中医药大学第一附属医院，郑州 450000
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.202201730
  CLC： R22;R242;R2-031;R287
- Published：20 April 2023，
  
  Published Online：21 July 2022，
  
  Received：07 May 2022，
- 稿件说明：
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常艺,张相安,郭海霞等.基于胆汁酸-肠道菌群轴探讨溃疡性结肠炎肝郁脾虚病机的生物学内涵[J].中国实验方剂学杂志,2023,29(08):229-236.

CHANG Yi,ZHANG Xiangan,GUO Haixia,et al.Biological Connotation of Pathogenesis of Ulcerative Colitis with Liver Depression and Spleen Deficiency Based on Bile Acid-intestinal Flora Axis[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(08):229-236.
常艺,张相安,郭海霞等.基于胆汁酸-肠道菌群轴探讨溃疡性结肠炎肝郁脾虚病机的生物学内涵[J].中国实验方剂学杂志,2023,29(08):229-236. DOI： 10.13422/j.cnki.syfjx.202201730.

CHANG Yi,ZHANG Xiangan,GUO Haixia,et al.Biological Connotation of Pathogenesis of Ulcerative Colitis with Liver Depression and Spleen Deficiency Based on Bile Acid-intestinal Flora Axis[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(08):229-236. DOI： 10.13422/j.cnki.syfjx.202201730.

摘要

溃疡性结肠炎（UC）是以腹痛、腹泻、黏液脓血便为主症的慢性难治性炎症性肠病之一。近年来随着人类生活方式的改变及诊断水平的提高，UC的发病率及患病率不断升高。UC的发病机制与肠黏膜免疫功能异常、肠道菌群紊乱、胆汁酸分泌异常等密切相关。UC患者存在胆汁酸分泌异常及肠道菌群失调。查阅大量文献发现胆汁酸分泌异常抑制免疫功能、影响信号转导、破坏肠黏膜屏障；肠道菌群紊乱，在炎症的发生发展、免疫稳态及应激方面具有重要影响。胆汁酸间接或直接影响肠道菌群的结构及功能，同时在肠道菌群的修饰下又可产生次级胆汁酸，并经过肠肝循环进入肝脏，故胆汁酸-肠道菌群轴之间复杂的对话机制与UC发生发展密切相关。基于中医基础理论及临床研究，发现情志是诱发该病的重要因素，脾胃虚弱为致病之本，肝郁脾虚是UC的关键病机。结合现代医学及分子生物学研究，认为胆汁酸异常分泌是中医肝郁的微观体现，肠道菌群紊乱为脾虚的生物学基础，并且在UC发病过程中，胆汁酸-肠道菌群轴失衡与中医的肝郁脾病机相契合。从胆汁酸-肠道菌群轴角度探讨UC肝郁脾虚病机的生物学内涵，更好地阐释UC肝郁脾虚发病机制的科学性，对于研究UC肝郁脾虚的病机实质及代表组方防治此病提供新的临床思路及可靠的理论依据。

Abstract

Ulcerative colitis （UC） is one of the chronic refractory inflammatory bowel diseases characterized by abdominal pain， diarrhea， and mucus， pus and blood in the stool. In recent years， with changes in human life style and improvements of the diagnosis， the incidence and prevalence of UC have been increasing. The pathogenesis of UC is closely related to intestinal mucosal immune dysfunction， intestinal flora disturbance， and abnormal bile acid secretion. Patients with UC have abnormal bile acid secretion and intestinal flora imbalance. A large number of studies have found that abnormal bile acid secretion inhibits immune function， affects signal transduction， and destroys the intestinal mucosal barrier. Intestinal flora disturbance has an important impact on the occurrence and development of inflammation， immune homeostasis， and stress. Bile acids indirectly or directly affect the structure and function of intestinal flora， and at the same time， they produce secondary bile acids under the modification of intestinal flora， entering the liver through enterohepatic circulation. Therefore， the complex dialogue mechanism of bile acid-intestinal flora axis is closely related to the occurrence and development of UC. Based on the basic theory of traditional Chinese medicine（TCM） and clinical research， it is found that emotion is an important factor that induces this disease， spleen and stomach weakness is the root of the disease， and liver depression and spleen deficiency are the key pathogenesis of UC. Combined with modern medicine and molecular biology research， it is believed that abnormal secretion of bile acids is a microscopic manifestation of liver depression in TCM， and intestinal flora disturbance is the biological basis of spleen deficiency. In the pathogenesis of UC， the imbalanced bile acid-intestinal flora axis is consistent with the pathogenesis of liver depression and spleen in TCM. The exploration of the biological connotation of the pathogenesis of UC with liver depression and spleen deficiency from the perspective of bile acid-intestinal flora axis can better explain the scientific nature of its pathogenesis， which provides new clinical solutions and reliable references for studying the pathogenesis of UC with liver depression and spleen deficiency and finding representative prescriptions to prevent and treat this disease.

关键词

胆汁酸-肠道菌群轴溃疡性结肠炎肝郁脾虚生物学内涵

Keywords

bile acid-intestinal flora axisulcerative colitisliver depression and spleen deficiencybiological connotation

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