基于脑肠轴学说探讨中医调节肠道菌群治疗胃癌伴抑郁研究进展

Research Progress of TCM for Regulating Intestinal Microbiota in the Treatment of Gastric Cancer with Depression Based on the Theory of Brain-Gut Axis

生理状态下,脑与肠道上下相通、互为滋养;病理状态下,脑与肠道相互影响,促使疾病发生、发展。中医药可通过调控肠道菌群治疗胃癌伴抑郁,其作用机制可能为通过调控脑肠肽水平、调节肠道菌群从而发挥作用。胃癌伴抑郁的常用治疗方法有单药及其高纯度提取物、中药复方、针灸、穴位贴敷、腧穴艾灸、针药结合等,均取得较好疗效,但目前的研究还存在以下不足:(1)当前用于探索中医治疗胃癌疗效的动物模型多基于单一疾病模型,未能充分融合中医辨证论治的独特理念,这可能限制了对胃癌相关生物学变化的全面理解;(2)对中药复方和单体成分的物质基础研究缺乏深入研究,各种药效之间的内在联系以及单体成分在机制中的具体贡献与协调机制不明确。今后,需开发结合病证特点的现代化动物模型,更能准确反映临床实际,满足现代中医药研究的科技需求。此外,还需要制定更为严格的中药质量把控标准,加深对中药复方和单体成分的物质基础研究,明确各种药效关系。

In a physiological state,the brain and intestines are interconnected and mutually nourishing.In pathological conditions,the brain and intestines interact with each other,promoting the occurrence and development of diseases.TCM can treat gastric cancer with depression by regulating intestinal microbiota,and its mechanism of action may be through regulating brain gut peptide levels and intestinal microbiota.Common treatment methods of gastric caner with depression include single medicine and its high-purity extract,Chinese medicinal compound formulas,acupuncture and moxibustion,acupoint application,acupoint moxibustion,combination of acupuncture and medicine,etc.,all of which have achieved good efficacy,but the current research still has the following shortcomings:(1)The current animal models used to explore the efficacy of TCM in treating gastric cancer are mostly based on a single disease model,fail to fully integrate the unique concept of TCM syndrome differentiation and treatment,which may limit the comprehensive understanding of biological changes related to gastric cancer.(2)There is a lack of in-depth research on the material basis of Chinese medicinal compound formulas and monomer components,and the internal connections between various pharmacological effects,as well as the specific contributions and coordination mechanisms of monomer components in the mechanism,are not clear.In the future,it is necessary to develop modern animal models that combine the characteristics of diseases and syndromes,which can more accurately reflect clinical practice and meet the technological needs of modern TCM research.In addition,it is necessary to establish stricter quality control standards for Chinese medicinals,deepen the research on the material basis of Chinese medicinal compound formulas and monomer components,and clarify various medicine-efficacy relationships.