摘要
腹泻是胃肠肿瘤术后常见并发症之一,病理基础与肠道菌群失调密切相关,发病因素涉及肿瘤、营养状况、手术、围术期治疗等方面。胃肠肿瘤术后腹泻发病之本在于脾虚,治疗应注重脾脏的调和培补,调节脾的功能状态,即“实脾”。“实脾”出自张仲景《金匮要略》“见肝之病,知肝传脾,当先实脾”,从整体观五脏相克的角度论治肝病当先实脾以防传变;笔者认为“实脾”其本意是指使脾脏充盛,保持健运的功能状态,“实脾”非仅针对肝病传脾,而是对于以脾土虚弱为发病之本的疾病而言,可为脾病或他病。藏象脾与肠道菌群在生理、病理上具有相通性,具体体现在消化代谢及免疫防御功能方面。该文兹从肠道菌群、中医“实脾”、胃肠肿瘤术后腹泻探讨三者间的相关性,以期为中医药论治该疾病提供新的理论依据。
Diarrhea is one of the common postoperative complications of gastrointestinal tumor.The pathological basis is related to gut microbiota disorder.The pathogenesis factors include tumor,nutritional status,operation,perioperative treatment and so on.The origin of diarrhea after gastrointestinal tumor operation lies in spleen deficiency,and the treatment should pay attention to the harmonization and training of spleen,regulate the functional state of spleen,namely“strengthening spleen”.“Strengthening spleen”comes from Synopsis of the Golden Chamber by ZHANG Zhongjing,“seeing the disease of the liver,knowing the liver to spread the spleen,firming the spleen first”.The author thinks that its original intention is to strengthen spleen and maintain the functional state of health.“Strengthening spleen”is not only for liver disease to spread the spleen,but for diseases based on the weakness of the spleen,spleen disease or other diseases.The physiological and pathological characteristics of visceral manifestation spleen is similar to gut microbiota,specially reflected in digestion metabolism and immune defense function.This paper discusses the correlation between gut microbiota,TCM“strengthening spleen”and postoperative diarrhea of gastrointestinal tumor,in order to provide a new theoretical basis for TCM treatment of this disease.
作者
张若宣
王玥慧
李越
高磊
李泉旺
ZHANG Ruoxuan;WANG Yuehui;LI Yue;GAO Lei;LI Quanwang(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)
出处
《辽宁中医药大学学报》
CAS
2023年第4期64-67,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金项目(82174458)
北京市科学技术委员会首都特色课题项目(z121107001012076)
北京中医药大学重点攻关项目(2020-JYB-ZDGG-127)。
关键词
肠道菌群
实脾
胃肠肿瘤术后腹泻
理论探讨
gut microbiota
strengthening spleen
postoperative diarrhea of gastrointestinal tumor
theoretical study
