基于“肠道菌群-胆汁酸互作”探讨代谢相关脂肪性肝病“土壅木郁”的生物学内涵

Discussion on the biological connotation of“earth stagnation and wood constraint”in metabolic associated fatty liver disease based on“intestinal microbiota-bile acid interaction”

中医学认为“土壅木郁”是代谢相关脂肪性肝病的主要病机。结合中医病机理论与现代医学研究发现,肠道菌群失调极有可能是“土壅”(脾失健运)的重要生物学基础,胆汁酸代谢失衡则可能是“木郁”(肝失疏泄)的微观表现。西医视角下“肠道菌群-胆汁酸互作”失衡导致代谢相关脂肪性肝病发生发展与中医视角下代谢相关脂肪性肝病以“土壅木郁”为主要病机相契合。本文基于肠道菌群与胆汁酸互作的角度初步探讨代谢相关脂肪性肝病“土壅木郁”病机的生物学内涵,以期为研究“土壅木郁”的病机实质及推进中医药防治代谢相关脂肪性肝病提供新的思路。

Traditional Chinese medicine believes that“earth stagnation and wood constraint”is the main pathogenesis of metabolic associated fatty liver disease.Combined with the pathogenesis theory of traditional Chinese medicine and modern medical research,it is found that the dysregulation of intestinal microbiota is very likely to be an important biological basis of“earth stagnation”(dysfunction of spleen in transportation),and the imbalance of bile acid metabolism may be the microscopic manifestation of“wood constraint”(dysfunction of liver in conveyance and dispersion).The occurrence and development of metabolic associated fatty liver disease caused by the imbalance of“intestinal microbiota-bile acid interaction”from the perspective of western medicine is consistent with the main pathogenesis of“earth stagnation and wood constraint”from the perspective of traditional Chinese medicine.Based on the interaction between intestinal microbiota and bile acids,this paper preliminarily explores the biological connotation of the pathogenesis of“earth stagnation and wood constraint”in metabolic associated fatty liver disease,to provide new ideas for studying the pathogenesis of“earth stagnation and wood constraint”and promoting the prevention and treatment of metabolic associated fatty liver disease with traditional Chinese medicine。