基于“肠-甲状腺”轴探讨中医药调节肠道菌群治疗甲状腺疾病的研究进展

Traditional Chinese Medicine Regulates Gut Microbiota in Treatment of Thyroid Diseases via Gut-thyroid Axis:A Review

甲状腺疾病是临床常见的内分泌疾病,具有较高的发病率。该病与遗传因素、激素水平等密切相关,现代医学治疗虽取得一定疗效,但诸多的药物不良反应影响临床治疗。近年来,研究发现,肠道微生物群是影响甲状腺疾病的重要因素,越来越多的研究将肠道和甲状腺之间的双向信息交互系统称为“肠-甲状腺”轴。该文将中医学经络理论、藏象理论用于阐释肠、甲状腺的脏腑功能、生理特点及病理机制;并从现代分子生物学角度阐明肠道菌群通过诱导免疫炎症反应、改变甲状腺激素代谢等途径影响甲状腺内平衡的作用机制,从中西医双重视角明确“肠-甲状腺”轴的合理性。同时,在“肠-甲状腺”轴的指导下,中医药调节肠道菌群治疗甲状腺疾病研究越来越多,中药单体大黄素、中药复方益气化痰活血方等均能通过调节肠道菌群的丰度及多样性,改善肠道黏膜屏障等达到治疗甲状腺疾病的目的。但是,缺少中医药调节肠道菌群治疗甲状腺疾病的研究的系统综述。基于此,该文拟从中西医视角明确“肠-甲状腺”轴,并对中医药调节肠道菌群防治甲状腺疾病的研究进行系统梳理、归纳、总结,为中医药防治甲状腺疾病提供新思路、新视角。

Thyroid diseases are common endocrine disorders with high incidence.The diseases are closely related to genetic factors,immune system disorders,and hormone levels.Although modern medical therapies have achieved certain therapeutic effects,the side effects have affected clinical treatment.In recent years,studies have proven that gut microbiota is a key factor affecting thyroid diseases,and increasing studies have referred to the bidirectional information interaction system between the gut and thyroid as the gut-thyroid axis.This study adopts the meridian-collateral theory and the visceral manifestation theory of traditional Chinese medicine(TCM)to explain the functions,physiological characteristics,and pathological mechanisms of the gut and thyroid.Furthermore,this paper clarifies the mechanism of gut microbiota in modulating thyroid homeostasis by inducing inflammation and altering thyroid hormone metabolism from the perspective of molecular biology,clarifying the rationality of the gut-thyroid axis from the perspectives of TCM and Western medicine.Meanwhile,under the guidance of the gut-thyroid axis,increasing studies have been carried out regarding the application of TCM in regulating gut microbiota in the treatment of thyroid diseases.Both the active component emodin and compound prescription Yiqi Huatan Huoxue prescription of Chinese medicine can treat thyroid diseases by regulating the abundance and diversity of gut microbiota and improving the intestinal mucosal barrier.However,the systematic review of the research on TCM treatment of thyroid diseases by regulating gut microbiota remains to be conducted.This study expounds the gut-thyroid axis from both TCM and Western medicine and reviews the research progress in the TCM treatment of thyroid diseases by regulating gut microbiota,aiming to give new insights into the prevention and treatment of thyroid diseases with TCM.