摘要
随着高通量微生物16S核糖体RNA(16S rRNA)基因测序技术的进步,呼吸道、肠道菌群的研究成为近年来国内外的研究热点。目前研究已经发现肠道菌群与肺部囊性纤维化、慢性阻塞性肺疾病(COPD)、哮喘、肺部感染等多种呼吸系统疾病密切相关,其中COPD与肠道菌群的相关性研究仍处于探索阶段,两者的因果关系尚未被阐明。临床上COPD发病过程通常伴随着厌食、腹胀、便秘等胃肠功能紊乱症状及营养不良的表现,这与肠道菌群失衡密切相关。现代医学认为肠道微生态群主要通过“共同黏膜免疫系统”参与宿主营养能量代谢、免疫防御机制等参与疾病的过程,同时肠道菌群代谢产物也可通过远端器官的免疫调节,介导肺部免疫受损,引起肺肠微生态失调,影响COPD的发生发展。COPD在中医上属于“肺胀”范畴,COPD微生态失调的病机与肺、脾、肠密切相关,尤其在水谷精微物质的运化、抵御外邪方面与现代医学关于COPD肠道菌群紊乱的部分机制阐述颇有相通之处。深刻挖掘中医基础理论发现,从肺与大肠相表里,脾与小肠相通,肺脾太阴同气相求这3个方面可以更好地诠释COPD微生态失调的中医内涵。该文借鉴现代医学关于肺肠道菌群的部分研究成果,探讨其与COPD微生态失调的中医内涵的关联。笔者认为基于“肺-脾-肠”的中医模式可以为COPD微生态失调提供新的研究思路,探索通过调控肺肠道菌群微生态失衡进一步防治COPD。
Owing to the advancement of high-throughput microbial 16S ribosomal RNA(16S rRNA gene sequencing,respiratory and intestinal flora has become a research hotspot in China and abroad in recent years.At the moment,it has been verified that intestinal flora is closely related to various respiratory diseases such as cystic fibrosis,chronic obstructive pulmonary disease(COPD),asthma,and lung infection.The causal relationship between COPD and intestinal flora is still unclear.In clinical settings,COPD is characterized by gastrointestinal disorders such as anorexia,abdominal distension,and constipation,and malnutrition,which are closely related to the imbalance of intestinal flora.According to modern medicine,intestinal microbiota participates in the metabolism of energy and nutrients and immune defense in the host through the common mucosal immune system,thereby involving the progression of diseases.In addition,metabolites of intestinal flora mediate lung immune dysfunction through the immunoregulation of remote organs,causing pulmonary and intestinal microdysbiosis and affecting the occurrence and development of COPD.COPD belongs to the category of"lung distension"in traditional Chinese medicine(TCM).The pathogenesis of microdysbiosis in COPD is closely related to the lung,spleen,and intestine.Particularly the transportation and transformation of water and grains and the defense against external pathogens in TCM are consistent with the mechanisms of intestinal flora disturbance in COPD in modern medicine.The interior-exterior relationship between lung and large intestine,linkage between spleen and small intestine,and lung and spleen in the meridian of taiyin in TCM can well explain the microdysbiosis in COPD.Based on available research outcomes in modern medicine,this paper discusses the relationship between the flora in lung and intestine and microdysbiosis in COPD in TCM.The author believes that the"lung-spleen-intestine"mode in TCM is a new perspective for the research on microdysbiosis in COPD,which is conducive to
作者
张晓虹
王培屹
张诗晓
陶旺
孙杰
ZHANG Xiaohong;WANG Peiyi;ZHANG Shixiao;TAO Wang;SUN Jie(Guangzhou University of Chinese Medicine,Guangzhou 510000,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510000,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2023年第3期170-177,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(81360539)。
