Prescription for NAFLD Based on Relationship Between Intestinal Microecology and Spleen-stomach's Ascending and Descending Theory

Kai-zhou HUANG; Kai-ping JIANG; Jian-hong LI; Xiao-ai MO; Hong-tao HU; Lei ZHANG

doi:10.13422/j.cnki.syfjx.20190430

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Prescription for NAFLD Based on Relationship Between Intestinal Microecology and Spleen-stomach's Ascending and Descending Theory

Topic on TCM Clinical Exploration of Non-alcoholic Fatty Liver Disease | 更新时间：2021-02-09

- Prescription for NAFLD Based on Relationship Between Intestinal Microecology and Spleen-stomach's Ascending and Descending Theory
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 3, Pages: 43-52(2020)
- 作者机构：
  
  1.广州中医药大学　附属佛山中医院，广东佛山　 528000
  2.广州中医药大学，广州　 512000
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20190430
  CLC： R22; R242; R2-031; R285.5; R287
- Received：29 June 2018，
  
  Published Online：05 November 2018，
  
  Published：05 February 2020
- 稿件说明：
移动端阅览
Kai-zhou HUANG, Kai-ping JIANG, Jian-hong LI, et al. Prescription for NAFLD Based on Relationship Between Intestinal Microecology and Spleen-stomach's Ascending and Descending Theory[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(3): 43-52.
DOI：

Kai-zhou HUANG, Kai-ping JIANG, Jian-hong LI, et al. Prescription for NAFLD Based on Relationship Between Intestinal Microecology and Spleen-stomach's Ascending and Descending Theory[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(3): 43-52. DOI： 10.13422/j.cnki.syfjx.20190430.

摘要

非酒精性脂肪性肝病(NAFLD)是一种代谢应激性肝损伤，已成为我国乃至全世界最常见的慢性肝病之一。因此，NAFLD的发生发展过程及其防治都越来越受到人们的重视，而肠道微生态特别是肠道菌群发生紊乱就是导致NAFLD的重要因素之一。NAFLD中医病证溯源、病因病机与脾胃升降失调相关，NAFLD治疗获益有赖脾胃升降。肠道是中医脾胃实现功能的主要部位，肠道菌群是饮食影响宿主代谢状态的调节因子，符合中医学脾胃升降原理的生物学内涵。脾胃气机升降失常所表现的症状与肠道菌群失调时表现的症状具有一致性，故肠道菌群与中医脾胃升降有着密切联系。该文基于现代肠道微生态系统阐述了从中医脾胃升降关系论治NAFLD的理论基础，并据此提出了NAFLD的组方用药思路，主要包括健脾益气升清、行气和胃降浊、化痰活血消积，突出脾胃升降与肠道微生态协调在NAFLD论治中的主导作用；疏肝理气、宣降肺气、升清降浊、温肾助阳，顾及NAFLD发病协同因素，助力脾胃升降，从肠道微生态靶点考量治疗效应；中药保留灌肠激活大肠传导功能而助力胃气通降、协调脾胃气机升降，结合肠道菌群及其代谢的理论，从16s rDNA基因路径关注中药肠道给药途径干预NAFLD的肠道微生态机制。随着肠道菌群研究领域的深入推进，其与脾胃升降和NAFLD的关系将进一步揭示，既承接了我国从古至今运用脾胃升降理论治疗肝病的悠久历史，也将拓展调节肠道微生态(肠道菌群)治疗NAFLD的新视野。

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a kind of metabolic stress liver injury

which has become one of most common chronic liver diseases in China and even world. Therefore

the occurrence and development of NAFLD and its prevention and treatment have been attracted more and more attention. The disturbance of intestinal microecology

especially intestinal flora

is one of important factors leading to NAFLD. The syndrome traceability

etiology and pathogenesis of nafld in traditional Chinese medicine (TCM) are related to imbalance of spleen-stomach's ascending and descending. The effect of NAFLD treatment depends on spleen-stomach's ascending and descending. The intestinal tract is main part for realizing spleen-stomach function according to principle of TCM. Intestinal flora is a regulation factor affecting host metabolism

which is consistent with biological connotation of TCM principle of spleen-stomach's ascending and descending. Because spleen-stomach's ascending and descending disorder is consistent with symptoms of intestinal flora imbalance

intestinal flora is closely related to spleen-stomach's ascending and descending in TCM. Based on modern intestinal micro-ecosystem

this paper expounds theoretical basis for treatment of NAFLD based on relationship between spleen-stomach's ascending and descending in TCM

and on that basis

ideas of prescription and medication for NAFLD were put forward

mainly including: invigorating spleen and replenishing Qi and ascending clearity

regulating Qi-flowing and regulating stomach and descending turbidity

resolving phlegm

activating blood circulation and dissipating accumulation

and dominant role in coordinating spleen-stomach's ascending and descending and intestinal microecology is highlighted in treatment of NAFLD. Soothing liver and regulating Qi

dispersing and descending lung-Qi

ascending clearity and descending turbidity

and warming and activating kidney-Yang

synergistic factors for onset of NAFLD were taken into account to promote spleen-stomach's ascending and descending functions

and therapeutic effect shall be considered from perspective of intestinal microecology. After retention enema with Chinese herbs

transporting function of large intestine might be activated to help stomach-Qi descending and coordinate spleen-stomach's ascending and descending

and intestinal microecological mechanism of drug delivery channel intervening NAFLD may be studied based on 16s rDNA gene pathway. With deepening of research on intestinal flora

relationship between it and spleen-stomach's ascending and descending and NAFLD will be further revealed

which not only inherits China's long history of applying spleen-stomach's ascending and descending to treat liver diseases

but also expand perspective of regulating intestinal microecolog(intestinal flora) in treatment of NAFLD.

关键词

Keywords

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Related Author

ZHAO Jie

SHI Wei

HUANG Guodong

MO Chao

Hao-yue FENG

Hui LI

Tian-yi LIU

Chen-yi XU

Related Institution

Graduate School， Guangxi University of Chinese Medicine

The First Affiliated Hospital of Guangxi University of Chinese Medicine

Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine

Graduate School， Hunan University of Chinese Medicine

Hospital of Chengdu University of Traditional Chinese Medicine （TCM）

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