基于“微生物-脑-肠轴”理论探讨肝豆状核变性伴发抑郁症的诊疗思路

Discussion on the diagnosis and treatment of Wilson′s disease with depression based on the“microbe-brain-gut axis”theory

肝豆状核变性(WD)是常染色体基因突变引起的铜代谢障碍疾病,病变部位常累及多脏器、多系统,其临床表现复杂。中医学认为该病以先天禀赋不足、铜毒内聚为根本病因,湿热内蕴、痰瘀互结为主要病机,以培补肝肾、清热利湿、化痰祛瘀、解毒排铜为治则,临床疗效显著。WD患者常伴发抑郁症,严重影响其日常工作与生活。近年,随着微生物-脑-肠轴相关理论及研究的迅速发展,越来越多的研究指出,微生物-脑-肠轴是一种涉及中枢神经系统与胃肠道之间双向调控的复杂机制,对精神疾病的治疗有重要的意义。中药、针灸治疗通过调节微生物-脑-肠轴功能,改善WD伴发抑郁症患者的临床症状,为WD伴发抑郁症临床诊疗提供新思路。

Wilson′s disease(WD)is a genetic disorder of copper metabolism due to autosomal recessive gene mutations,often affecting multiple organs and systems,with complex clinical manifestations.According to Chinese medicine,the fundamental cause of this disease is congenital insufficiency and internal accumulation of copper toxicity.The pathogenesis is retention of damp-heat in the interior and intermin-gled phlegm and blood stasis.Treatment principles include tonifying the liver and kidneys,clearing heat and draining dampness,resolving phlegm and eliminating stasis,as well as removing toxin and draining copper,with notable clinical efficacy.Patients with WD frequently suffer from depression,which severely affects their daily work and life.In recent years,with the rapid development of theories and research related to the microbe-brain-gut axis,an increasing number of studies have pointed out that the microbe-brain-gut axis is a complex mechanism involving bidirectional regulation between the central nervous system and the gastrointestinal tract,which has significant implications for the treatment of mental disorders.Chinese medicine and acupuncture treatments improve clinical symptoms in patients with WD and depression by modulating the function of the microbe-brain-gut axis,providing new insights into the clinical diagnosis and treatment of WD with depression.