|
|
基于“心与小肠相表里”探讨肠道菌群与冠心病血瘀证的关系
|
Abstract:
血瘀证是冠心病发病的主要因素之一，肠道菌群可以影响冠心病血瘀证的发生与发展。“心与小肠相表里”是《黄帝内经》对二者关系的总结概括，小肠代谢失常，导致津液输布障碍，成痰成瘀，痹阻心脉可以导致胸痹的发生。活血化瘀药物的应用对其有显著疗效，防止冠心病血瘀证的进一步发展，也使小肠的生理功能恢复正常。该文旨在从“心与小肠相表里”视角探讨心脏、小肠和冠心病血瘀证的相关性，为防治冠心病血瘀证提供理论基础和新的思路方法。
Blood stasis is one of the main factors in the development of coronary heart disease, and intestinal flora can affect the occurrence and development of blood stasis in coronary heart disease. “The heart and the small intestine are mutually exclusive” is the “Huangdi Neijing” on the relationship between the two summarized, the small intestine metabolic disorders, resulting in fluid distribution obstacles, into phlegm into blood stasis, paralysis of the cardiac veins can lead to the occurrence of thoracic paralysis. The application of drugs to activate blood circulation and eliminate blood stasis can have significant therapeutic effects, preventing the further development of blood stasis in coronary heart disease and restoring the physiological function of the small intestine to normal. The aim of this article is to discuss the correlation between heart, small intestine and coronary blood stasis from the perspective of “heart and small intestine are mutually exclusive”, so as to provide theoretical basis and new ideas and methods for the prevention and treatment of coronary blood stasis.
| [1] | 国家心血管病中心. 《中国心血管健康与疾病报告》2020[J]. 心肺血管病杂志, 2021, 40(10): 1005-1009. |
| [2] | 韩梦影, 肖海娟. 基于肠道菌群探讨益气健脾法对恶性肿瘤免疫治疗的影响[J]. 辽宁中医药大学学报, 2024, 8(8): 1-9. |
| [3] | 于树娜. 常规疗法联合硝酸酯类药物治疗慢性肺源性心脏病合并冠心病的临床效果分析[J]. 中国社区医师, 2023, 39(26): 50-52. |
| [4] | 崔雨婷, 张方圆, 许伟明, 等. 基于肠道菌群与冠心病的关系探讨“阴火”科学内涵[J]. 世界中医药, 2024, 19(9): 1279-1285. |
| [5] | Kamo, T., Akazawa, H., Suzuki, J. and Komuro, I. (2017) Novel Concept of a Heart-Gut Axis in the Pathophysiology of Heart Failure. Korean Circulation Journal, 47, 663. https://doi.org/10.4070/kcj.2017.0028 |
| [6] | 朱文, 谢凤群, 程洁, 冯其茂. 基于“心与小肠相表里”理论探讨肠道菌群与高血压的关系[J]. 上海中医药杂志, 2023, 57(8): 57-62. |
| [7] | 王焘. 外台秘要[M]. 北京: 人民卫生出版社, 1955. |
| [8] | 南京中医学院. 诸病源候论校释[M]. 北京: 人民卫生出版社, 2009. |
| [9] | 程艳, 张苗苗, 国嵩, 刘佳卉, 魏秀楠, 孙大娟, 迟莉丽. “心与小肠相表里”理论的历史源流及发展脉络[J]. 中医杂志, 2023, 64(13): 1302-1307. |
| [10] | 曲华, 姜众会, 杨巧宁, 等. 基于心合小肠\"论动脉粥样硬化与肠道微环境的关系[J]. 中医杂志, 2018, 59(23): 2009-2012. |
| [11] | 周艳, 高洁, 柴艺汇, 等. 基于“心与小肠相表里”理论的肠道菌群对动脉粥样硬化性心血管疾病的影响探讨[J]. 时珍国医国药, 2021, 32(1): 154-156. |
| [12] | 李斌, 杨旭, 叶建中, 等. 男性不育患者精液中金黄色葡萄球菌及其毒力基因对精子制动活性研究[J]. 中华男科学杂志, 2015, 21(10): 881-886. |
| [13] | 毕颖斐, 王贤良, 赵志强, 等. 冠心病现代中医证候特征的临床流行病学调查[J]. 中医杂志, 2017, 58(23): 2013-2019. |
| [14] | 冠心病稳定型心绞痛中医诊疗指南[J]. 中医杂志, 2019, 60(21): 1880-1890. |
| [15] | 郭丛丛, 黄力, 董建军, 等. 冠状动脉粥样硬化性心脏病血瘀证与冠脉病变程度及血管内皮功能的相关性研究 [J]. 上海中医药杂志, 2018, 52(9): 15-18. |
| [16] | 吴旸, 金刚, 崔杰, 等. 冠心病中医证候特点的回归分析[J]. 中医药学报, 2008(4): 4-6. |
| [17] | 周曼丽, 周霞辉, 张宜帆, 等. 基于“心主血脉”理论探讨冠心病血瘀证形成机制[J]. 实用心脑肺血管病杂志, 2023, 31(2): 105-107. |
| [18] | 徐晨曦, 鹿小燕, 于龄华, 等. 心率变异性与冠心病血瘀证、冠状动脉狭窄程度的相关性[J]. 中日友好医院学报, 2023, 37(2): 90-92+96. |
| [19] | 项耀祖. 中西医结合防治冠心病[J]. 中国科学: 生命科学, 2022, 52(6): 832-839. |
| [20] | 葛均波, 徐永建, 王衬. 内科学[M]. 第九版. 北京: 人民卫生出版社, 2018: 214. |
| [21] | 刘培, 俞赟丰, 杨欣雨, 等. 基于“痰、瘀、毒”理论探讨冠心病炎症机制和中药干预策略[J]. 中国实验方剂学杂志, 2023, 29(12): 185-191. |
| [22] | Hansson, G.K. and Hermansson, A. (2011) The Immune System in Atherosclerosis. Nature Immunology, 12, 204-212. https://doi.org/10.1038/ni.2001 |
| [23] | 谭宇. 肠道微生物代谢产物氧化三甲胺与急性心肌梗死斑块病理特征及预后的研究[D]: [博士学位论文]. 北京: 北京协和医学院, 2019. |
| [24] | Li, J., Tan, Y., Zhou, P., Liu, C., Zhao, H., Song, L., et al. (2021) Association of Trimethylamine N-Oxide Levels and Calcification in Culprit Lesion Segments in Patients with ST-Segment—Elevation Myocardial Infarction Evaluated by Optical Coherence Tomography. Frontiers in Cardiovascular Medicine, 8, Article ID: 628471. https://doi.org/10.3389/fcvm.2021.628471 |
| [25] | Zhang, H., Jing, L., Zhai, C., Xiang, Q., Tian, H. and Hu, H. (2022) The Intestinal Flora Metabolite Trimethylamine Oxide Is Inextricably Linked to Coronary Heart Disease. Journal of Cardiovascular Pharmacology, 81, 175-182. https://doi.org/10.1097/fjc.0000000000001387 |
| [26] | Peng, Y., Zhang, N., Li, W.J., et al. (2020) Correlations of Changes in Inflammatory Factors, Glucose and Lipid Metabolism Indicators and Adiponectin with Alterations in Intestinal Flora in Rats with Coronary Heart Disease. European Review for Medical and Pharmacological Sciences, 24, 10118-10125. |
| [27] | Zheng, X., Li, J., Gou, Y., et al. (2023) Changes in Intestinal Flora from Chronic Renal Failure Complicated with Coronary Heart Disease and its Correlation with Arterial Stiffness Index. Alternative Therapies in Health and Medicine, 29, 252-257. |
| [28] | 王亚丽, 程艳丽, 商丽华. 肠道菌群在冠心病发病机制中的研究进展[J]. 中国研究型医院, 2023, 10(1): 59-62. |
| [29] | Cui, L., Zhao, T., Hu, H., Zhang, W. and Hua, X. (2017) Association Study of Gut Flora in Coronary Heart Disease through High-Throughput Sequencing. BioMed Research International, 2017, Article ID: 3796359. https://doi.org/10.1155/2017/3796359 |
| [30] | Pokrzywnicka, P. and Gumprecht, J. (2017) Intestinal Microbiota and Its Relationship with Diabetes and Obesity. Clinical Diabetology, 5, 164-172. https://doi.org/10.5603/dk.2016.0029 |
| [31] | Yan, X., Jin, J., Su, X., Yin, X., Gao, J., Wang, X., et al. (2020) Intestinal Flora Modulates Blood Pressure by Regulating the Synthesis of Intestinal-Derived Corticosterone in High Salt-Induced Hypertension. Circulation Research, 126, 839-853. https://doi.org/10.1161/circresaha.119.316394 |
| [32] | Hold, G.L. and Hansen, R. (2019) Impact of the Gastrointestinal Microbiome in Health and Disease: Co-Evolution with the Host Immune System. In: Backert, S., Ed., Molecular Mechanisms of Inflammation: Induction, Resolution and Escape by Helicobacter pylori, Springer International Publishing, Berlin, 303-318. https://doi.org/10.1007/978-3-030-15138-6_12 |
| [33] | 王勇, 郭淑贞, 李春, 啜文静, 余俊达, 赵慧辉, 陈建新, 王伟. 小型猪血瘀证模型炎症因子与心功能[J]. 中华中医药杂志, 2010, 25(10): 1563-1565. |
| [34] | Libby, P. (2002) Inflammation in Atherosclerosis. Nature, 420, 868-874. |
| [35] | Sun, Y., Wu, D., Zeng, W., Chen, Y., Guo, M., Lu, B., et al. (2021) The Role of Intestinal Dysbacteriosis Induced Arachidonic Acid Metabolism Disorder in Inflammaging in Atherosclerosis. Frontiers in Cellular and Infection Microbiology, 11, Article ID: 618265. https://doi.org/10.3389/fcimb.2021.618265 |
| [36] | Li, X. and Li, C. (2018) Analysis of Changes in Intestinal Flora and Intravascular Inflammation and Coronary Heart Disease in Obese Patients. Experimental and Therapeutic Medicine, 15, 4538-4542. https://doi.org/10.3892/etm.2018.5987 |
| [37] | 张书萌, 陈伶利, 于子璇, 等. 肠道微生态与DNA甲基化对话对冠心病血瘀证的影响及中药干预研究[J]. 中华中医药杂志, 2023, 38(2): 722-726. |
| [38] | 张铌雪, 姚魁武, 段锦龙. 活血化瘀法对肠道菌群结构及肠屏障功能影响的研究[J]. 中国微生态学杂志, 2018, 30(12): 1479-1482. |
| [39] | 程芳, 胡坤敏, 朱珊. 活血化瘀类中药抗炎机制研究进展[J]. 中国医药导报, 2023, 20(8): 46-49+65. |
| [40] | 王诗, 刘垠杏, 张书萌, 等. 养心通脉方对冠心病血瘀证大鼠小肠黏膜菌群和血清炎症因子、内毒素的影响及相关性分析[J]. 中华中医药杂志, 2024, 39(1): 360-366. |
| [41] | 刘垠杏, 陈子君, 王以琴, 等. 基于血浆非靶向代谢组学和肠道菌群16S rRNA测序技术探讨养心通脉方干预冠心病血瘀证大鼠的作用机制(英文) [J]. 数字中医药, 2023, 6(2): 198-209. |
| [42] | 马梅. 基于肠道菌群和尿液代谢组学探讨血府逐瘀胶囊治疗冠心病心绞痛气滞血瘀证患者的作用机制研究[D]: [硕士学位论文]. 天津: 天津中医药大学, 2023. |
