基于“脾为之卫”理论以肠道菌群为靶点探讨2型糖尿病的防治

Prevention and Treatment of type 2 Diabetes with Intestinal Flora As Target Based on Theory of"Pi Wei Zhi Wei"

“脾为之卫”理论涵盖了脾主运化、脾主升清、藏营主意等生理功能,而肠道菌群与中医学“脾为之卫”职能有极大的相似性。肠道菌群可通过多种途径参与2型糖尿病(diabetes mellitus type 2,T2DM)的发生过程,其作用机制与代谢产物、激素分泌、免疫反应及细菌-肠-脑轴密切相关。调控肠道菌群中有益菌的数量、种类等,或直接调节短链脂肪酸、脂多糖、胆汁酸等代谢产物的合成与分泌,激活肠道L细胞调节胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)和内分泌调节肽的分泌量,维持葡萄糖稳态,并促进B细胞增殖,增加胰岛素分泌、减弱肠上皮内淋巴细胞炎症反应,提高固有层淋巴细胞活性,从而缓解炎症反应,减轻胰岛素抵抗。

The theory of"pi wei zhi wei"in traditional Chinese medicine covers physiological functions such as Spleen governing transport,Spleen governing ascending Qi,and Spleen hiding Ying and managing ideas.The function of intestinal flora is very similar to that.Intestinal flora can participate in the occurrence of type 2 diabetes mellitus(T2DM)in many ways,and its mechanism is closely related to metabolites,hormone secretion,immune response and bacterial-intestinal-brain axis.By regulating the number and species of beneficial bacteria in the intestinal flora,or directly regulating the synthesis and secretion of metabolites such as short-chain fatty acids,lipopolysaccharide,bile acids,etc.,L cells in the intestine can be activated to regulate the secretion of glucagon-like peptide-1(GLP-1)and endocrine-regulating peptide,maintain glucose homeostasis,promote the proliferation ofβcells,increase insulin secretion,and weaken the inflammatory reaction of lymphocytes in the intestinal epithelium.