基于脑-肠轴学说探讨中医学防治阿尔茨海默病的理论基础

Exploration of the theoretical basis of TCM prevention and treatment of Alzheimer′s disease based on brain-gut axis theory

阿尔茨海默病(AD)作为一种进展性脑部疾病,目前无法治愈,随着时间的推移,病情会逐渐加重。AD发病率日益增加,导致当今社会人们生活质量严重下降,患者及其家属的幸福感降低。现代医学从脑-肠轴理论出发,提示微生物-脑-肠轴是大脑与胃肠的双向调节通道,为中枢神经系统的治疗打开了一个新的突破口。脑-肠轴是一个由脑、肠、肠道微生物构成的双向通路,主要由神经、免疫、内分泌和肠道菌群等上行通路介导肠道对脑进行调节作用。大脑与胃肠道的关系日益密切,许多学者将现代医学的脑-肠轴学说与中医的脑肠相通理论相结合,越来越多地应用到临床治疗之中。通过脑-肠轴学说,从阐述胃肠道和中枢神经系统的生理、病理、经络循行、气血运化等角度出发,在中医经典理论中梳理挖掘出AD与各脏腑之间脑肠相通的理论内涵,为临床治疗提供理论依据。

As a progressive brain disease,Alzheimer's disease(AD)has no cure at present,and it will gradually worsen over time.The increasing incidence of AD has led to a serious decline in the quality of life of people in today's society,and the happiness of patients and their families has been reduced.Based on the theory of brain-gut axis,modern medicine suggests that microbes-brain-gut axis is a bidirectional regulatory channel between brain and gastrointestine,which opens a new breakthrough for the treatment of central nervous system.The brain-gut axis is a bidirectional pathway composed of brain,gut and enteric microorganism,and the intestinal tract regulates the brain mainly through ascending pathways such as nerve,immune,endocrine and intestinal flora.The relationship between brain and gastrointestinal tract is increasingly close.Many scholars combine the theory of brain-gut axis in modern medicine with the theory of brain-gut communication in traditional Chinese medicine,and apply it to clinical treatment more and more.Based on the theory of braingut axis,this paper elaborates the physiology,pathology,meridian circulation,Qi-blood transportation and transformation and other aspects of the gastrointestinal tract and central nervous system,and explores the theoretical connotation of braingut communication between AD and various viscera from the classical theories of traditional Chinese medicine,which can provide theoretical basis for clinical treatment.