[1]王瑜慧,曲 淼.基于“肠道菌群-炎症反应”探讨胃与广泛性焦虑障碍的中医药治疗[J].陕西中医,2025,46(5):668-671.[doi:DOI:10.3969/j.issn.1000-7369.2025.05.020]
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基于“肠道菌群-炎症反应”探讨胃与广泛性焦虑障碍的中医药治疗
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年5期
页码:
668-671
栏目:
学术探讨
出版日期:
2025-05-05

文章信息/Info

作者:
王瑜慧12曲 淼3
(1.北京中医药大学,北京 100029; 2.北京中医药大学第三附属医院,北京 100029; 3.首都医科大学宣武医院,北京 100053)
关键词:
广泛性焦虑障碍 肠道菌群 炎症反应 肝脾 痰、火 整体观念
分类号:
R 277.7
DOI:
DOI:10.3969/j.issn.1000-7369.2025.05.020
文献标志码:
A
摘要:
肠道菌群失衡诱导的炎症反应与广泛性焦虑障碍(GAD)密切相关。中医学认为,肝脾相关,二者为GAD重要病位,痰、火为GAD的重要病理因素,肝失疏泄,脾失健运,脑不调神为GAD关键病机。现代分子生物学及中医学理论研究可知,肠道菌群平衡是“肝主疏泄、脾主运化”的物质基础,菌群失衡及炎症反应是痰、火等GAD相关病理因素的表现形式之一,而痰、火亦与肝、脾密切相关。因此,疏肝养肝、健脾益气对于治疗GAD十分关键。治疗时,应多配伍辛散之品,疏达肝气,伴随病程进展同时补以养肝阴、肝血之品,养血柔肝。GAD患者多伴有肝郁,见肝之病,知肝传脾,当先实脾,在治肝的同时,防止进一步伤及菌群微环境,需顾护脾土。对肠道菌群紊乱的患者首先要注重健脾,益气补血,防止向炎症发展,从肠道菌群角度提前预防有助于顾护脾土,减慢证候的进一步扩展,对高炎症状态患者,要注意泻火热、化痰湿。

参考文献/References:

[1] 陆林.沈渔邨精神病学[M].6版.北京:人民卫生出版社,2018:430-432.
[2] HUANG Y,WANG Y,WANG H,et al.Prevalence of mental disorders in China:A cross-sectional epidemiological study[J].Lancet Psychiatry,2019,6(3):211-224.
[3] CHEN Y H,BAI J,WU D,et al.Association between fecal microbiota and generalized anxiety disorder:Severity and early treatment response[J].J Affect Disord,2019,259:56-66.
[4] CHENG Y,WANG Y,ZHANG W,et al.Relationship between intestinal flora,inflammation,BDNF gene polymorphism and generalized anxiety disorder:A clinical investigation[J].Medicine(Baltimore),2022,101(29):e28910.
[5] LEE Y,KIM Y K.Understanding the Connection between the gut-brain axis and stress/anxiety disorders[J].Curr Psychiatry Rep,2021,23(5):22.
[6] 曾忠花,刘容容,汤俐,等.肠道菌群与胆汁酸代谢的互相作用[J].中国微生态学杂志,2021,33(7):849-856.
[7] ALBILLOS A,DE GOTTARDI A,RESCIGNO M.The gut-liver axis in liver disease:Pathophysiological basis for therapy[J].J Hepatol,2020,72(3):558-577.
[8] CIESIELSKA A,MATYJEK M,KWIATKOWSKA K.TLR4 and CD14 trafficking and its influence on LPS-induced pro-inflammatory signaling[J].Cell Mol Life Sci,2021,78(4):1233-1261.
[9] GORALCZYK-BIKOWSKA A,SZMAJDA-KRYGIER D,KOZLOWSKA E.The microbiota-gut-brain axis in psychiatric disorders[J].Int J Mol Sci,2022,23(19):11245.
[10] PEIRCE J M,ALVINA K.The role of inflammation and the gut microbiome in depression and anxiety[J].J Neurosci Res,2019,97(10):1223-1241.
[11] 赵文艳,胡营营,周玉亮,等.慢性低度炎症与焦虑、抑郁状态的相关性分析[J].联勤军事医学,2023,37(10):866-870.
[12] RUTSCH A,KANTSJO J B,RONCHI F.The Gut-brain axis:How microbiota and host inflammasome influence brain physiology and pathology[J].Front Immunol,2020,11:604179.
[13] VALDES A M,WALTER J,SEGAL E,et al.Role of the gut microbiota in nutrition and health[J].BMJ.2018,361:k2179.
[14] CHEN Y,ZHOU J,WANG L.Role and mechanism of gut microbiota in human disease[J].Front Cell Infect Microbiol,2021,11:625913.
[15] 邵铁娟,李海昌,谢志军,等.基于脾主运化理论探讨脾虚湿困与肠道菌群紊乱的关系[J].中华中医药杂志,2014,29(12):3762-3765.
[16] 郑昊龙,陈丝,宋囡,等.脾虚模型大鼠肠道菌群分布及时效性研究[J].中医杂志,2020,61(14):1262-1267.
[17] 许亚辉,吴佳佳,李杰,等.肝郁脾虚证与肠道菌群相关研究[J].世界科学技术-中医药现代化,2018,20(11):1958-1963.
[18] CANAKIS A,HAROON M,WEBER H C.Irritable bowel syndrome and gut microbiota[J].Curr Opin Endocrinol Diabetes Obes,2020,27(1):28-35.
[19] TILG H,ADOLPH T E,DUDEK M,et al.Non-alcoholic fatty liver disease:The interplay between metabolism,microbes and immunity[J].Nat Metab,2021,3(12):1596-1607.
[20] KIRPICH I A,SOLOVIEVA N V,LEIKHTER S N,et al.Probiotics restore bowel flora and improve liver enzymes in human alcohol-induced liver injury:A pilot study[J].Alcohol,2008,42:675-682.
[21] 刘完素.素问病机气宜保命集[M].北京:人民卫生出版社,2005:123-126.
[22] 景彩,肖宁,张昕,等.基于16S rDNA测序技术研究痰湿质受试者肠道菌群的组成及丰度[J].中医杂志,2019,60(23):2045-2049.
[23] 郑璐玉,杨玲玲,李玲孺,等.液相芯片技术检测痰湿体质人群TNF-α、IL-6、CRP及MCP-1的表达研究[J].中国中西医结合杂志,2013,33(7):920-923.
[24] 翟昌明,鲁放,马重阳,等.试述肝火证、炎症反应、高血压三者之关系[J].环球中医药,2019,12(12):1858-1861.
[25] 黎杏群,张海男,金益强,等.肝火上炎证的病理生理学基础研究[J].中医杂志,2002,43(1):54-56.
[26] 赵振武,郭蓉娟,顾丽佳,等.焦虑症肝郁化火的动物实验炎症机制研究[J].中华中医药杂志,2020,35(4):2010-2013.
[27] 董烁,尹冬青,贾竑晓.广泛性焦虑障碍中医湿、热证素研究[J].中华中医药杂志,2018,33(8):3671-3675.
[28] 徐硕,唐启盛,赵瑞珍,等.疏肝清热健脾法治疗广泛性焦虑症的探讨[J].北京中医药,2014,33(7):514-516.
[29] 许欣跃,孙庆,张玮.孙庆运用“疏肝行气,调神解郁”腹部推拿法治疗广泛性焦虑症的经验[J].辽宁中医杂志,2015,42(7):1200-1202.
[30] 胡海,曹云松,胡博,等.孙文垣三焦论痰法学术思想特色探赜[J].陕西中医,2023,44(9):1259-1264.
[31] 张洁洁,孟伟.名中医郭维琴基于“脏-神-气”论治心系疾病郁证经验[J].陕西中医,2023,44(7):933-935,940.
[32] LI X J,MA Q Y,JIANG Y M,et al.Xiaoyaosan exerts anxiolytic-like effects by down-regulating the TNF-α/JAK2-STAT3 pathway in the rat hippocampus[J].Sci Rep,2017,7(1):353.
[33] 李小黎,刘晓梅,邵珺,等.丹栀逍遥散干预社区肝郁化火型广泛性焦虑症患者的临床疗效分析[J].北京中医药,2017,36(4):359-361.
[34] 刘尚智,张志强,李昇锦.丹栀逍遥散对D-氨基半乳糖/脂多糖诱导的大鼠急性肝损伤保护作用机制研究[J].实用肝脏病杂志,2022,25(2):179-182.
[35] 张丹丹,叶晓川.基于肠道菌群和代谢组学探讨茯苓水提物健脾的作用机制[J].中华中医药杂志,2021,36(7):3994-4001.
[36] 沈王明,俞琦,孙蕾.温胆汤配合针刺治疗痰湿体质广泛性焦虑症患者的临床效果[J].健康研究,2022,42(4):473-476.
[37] 周芹.温胆汤对广泛性焦虑障碍小鼠的调节作用与机制研究[D].北京:北京中医药大学,2021.

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备注/Memo

备注/Memo:
[基金项目]国家自然科学基金资助项目(8197150201); 首都卫生发展科研专项课题(2020-1-2011)
更新日期/Last Update: 2025-05-08