基于肠道菌群探讨冠心病心脾同治的科学内涵

Scientific connotation of combinative treatment of heart and spleen for coronary heart disease based on gut microbiota

中医认为心主血脉,火土相生,心脾相关,而脾失健运,聚湿成痰,痰瘀互结,心脾同病,而成胸痹。临床运用心脾同治法治疗冠心病取得显著疗效。肠道菌群参与人体消化、吸收、免疫防御等,这与中医脾胃为后天之本、化生气血、实肺卫之气以御邪等功能密切相关;肠道菌群还可通过氧化三甲胺等代谢产物作用于远端器官,参与冠心病发生发展的病理过程,这与胸痹心脾同病、痰瘀互结等中医理论相似。肠道菌群与心脾同治相碰带来了新的思路,冠心病心脾同治法具有更为前沿的科学内涵。

In traditional Chinese medicine, the heart which related to the spleen dominates the blood and vessel. The malfunction of spleen could result in sputum and stasis, leading to coronary heart disease(CHD). The combinative treatment of heart and spleen(CTHS) has a significant effect on CHD in clinical practice. The function of gut microbiota taking part in human’s absorption and immune defense is related to the TCM’s theory that the spleen is the acquired foundation, the origin of qi and blood and strengthen the qi of lung could protect body. The imbalance of gut microbiota could influence pathological process of CHD through trimethylamine oxide, and other metabolites. It’s similar to the TCM’s theory about the disorder of heart and spleen. And the characteristics of comprehensive and multi-target of TCM is closely related to the extremely complex mechanism of gut microbiota. The collision between gut microbiota and CTHS could bring a new opportunity of CHD treatment.