基于肠道菌群探讨先天之本与后天之本在糖尿病发病与治疗中的作用

Role of“the Congenital Foundation and the Foundation of Acquired Constitution”in the Pathogenesis and Treatment of Diabetes Mellitus Based on Intestinal Flora

肠道微生态的改变影响着宿主能量代谢,参与糖尿病的发生。从中医角度分析肠道菌群在消渴发病机制中的作用,一方面认为生理上先天之本与后天之本参与了肠道菌群的形成与分布;另一方面,肠道菌群在功能上助肾推动脏腑气化,决定人之禀赋、助脾运化升清,助胃通降,因而,病理状态下,肾虚、胃强脾弱可诱发肠道菌群紊乱而病发消渴之症。在治疗方面,无论是具有滋阴补肾、清热健脾作用的中药或复方,还是低热量的饮食观念,不仅经现代研究证实可以通过调节肠道菌群结构改善葡萄糖稳态,还与中医学认识的消渴病机相契合,表明以肠道菌群为靶点,从先天之本与后天之本着手治疗糖尿病具有潜在的应用价值及发展前景。

Changes of intestinal microecology affect the host energy metabolism to participate in the occurrence of diabetes.This paper analyzes the role of intestinal flora in the pathogenesis of diabetes from the perspective of traditional Chinese medicine,and holds that“the congenital foundation and the foundation of acquired constitution”involves in the formation and distribution of intestinal flora.On the other hand,the intestinal flora functionally helps the kidney to promote the gasification,determines one′s endowment,helps the spleen to transport and ascend clear and and helps the stomach to propell food downward.Therefore,in the pathological state,kidney deficiency,stomach excess,and spleen weakness can lead to diabetes by inducing intestinal flora disorders.In terms of treatment,whether it is the single herb or compound prescription with the function of enriching yin and nourishing kidney,clearing heat and invigorating spleen,or the concept of low-calorie diet,it is not only confirmed by modern research that it can improve glucose homeostasis by regulating the structure of intestinal flora,but also in accordance with the pathogenesis of diabetes recognized by traditional Chinese medicine,indicating that it has potential application value and development prospect to treat diabetes with intestinal flora as the target from“the congenital foundation and the foundation of acquired constitution”.