基于“肠–肝”轴探讨肝脾同调论治酒精性肝病
Discussion on the Treatment of Alcoholic Liver Disease with Treating Both Liver and Spleen Based on the Theory of “Gut-Liver” Axis
DOI: 10.12677/ACM.2023.13102232, PDF,   
作者: 张毓航：黑龙江中医药大学研究生院，黑龙江 哈尔滨
关键词: “肠–肝”轴；酒精性肝病；肝脾同治；“Gut-Liver” Axis； Alcoholic Liver Disease； Treating Both Liver and Spleen
摘要: 酒精性肝病(Alcoholic liver disease, ALD)是我国的常见疾病，其发病率逐年上升，对人体健康构成严重威胁。“肠–肝”轴理论认为，肠道与肝之间复杂的相互作用影响了ALD的发生及发展，这与中医肝脾同治的理论内涵十分相似。本文分析了“肠–肝”轴与ALD和中医肝脾理论的联系，并结合中药复方探讨肝脾同调论治ALD，以期为临床治疗ALD提供理论基础，为中药研发提供新的思路。
Abstract: Alcoholic liver disease (ALD) is a common disease in China, the incidence of which is increasing year by year, posing a serious threat to human health. According to the theory of “Gut-liver” axis, the complex interaction between the gut and liver affects the occurrence and development of ALD, which is quite similar to the connotation of the theory of liver and spleen related to traditional Chi-nese medicine. This study analyzed the connection between the theory of “Gut-liver” axis and ALD and the link between the theory of “Gut-liver” axis and the theory of liver and spleen related to tra-ditional Chinese medicine, and discussed the treatment of ALD with Chinese medicine compound based on the theory of treating both liver and spleen, in order to provide a theoretical basis for the clinical treatment of ALD and offer a new thinking for the research and development of traditional Chinese medicine.
文章引用：张毓航. 基于“肠–肝”轴探讨肝脾同调论治酒精性肝病[J]. 临床医学进展, 2023, 13(10): 15970-15976. https://doi.org/10.12677/ACM.2023.13102232

参考文献

[1] 酒精性肝病防治指南(2018年更新版) [J]. 临床肝胆病杂志, 2018, 34(5): 939-946.
[2] Xu, H.Q., Xiao, P., Zhang, F.Y., Liu, T. and Gao, Y.H. (2022) Epidemic Characteristics of Alcohol-Related Liver Disease in Asia from 2000 to 2020: A Systematic Review and Meta-Analysis. Liver International, 42, 1991-1998. [Google Scholar] [CrossRef] [PubMed]
[3] Zhang, D., Liu, Z. and Bai, F. (2023) Roles of Gut Microbiota in Alcoholic Liver Disease. International Journal of General Medicine, 16, 3735-3746. [Google Scholar] [CrossRef] 
[4] Litwinowicz, K. and Gamian, A. (2023) Microbiome Alterations in Alcohol Use Disorder and Alcoholic Liver Disease. International Journal of Molecular Sciences, 24, Article 2461. [Google Scholar] [CrossRef] [PubMed]
[5] Wu, S., Wen, F., Zhong, X., et al. (2023) Astragaloside IV Ameliorate Acute Alcohol-Induced Liver Injury in Mice via Modulating Gut Microbiota and Regulating NLRP3/Caspase-1 Signaling Pathway. Annals of Medicine, 55, Article ID: 2216942. [Google Scholar] [CrossRef] [PubMed]
[6] Marshall, J.C. (1998) The Gut as a Potential Trigger of Ex-ercise-Induced Inflammatory Responses. Canadian Journal of Physiology and Pharmacology, 76, 479-484. [Google Scholar] [CrossRef] [PubMed]
[7] 许雅青, 吴月滢, 李小雅, 等. 健脾类中药修复肠黏膜屏障损伤的研究进展[J]. 中国实验方剂学杂志, 2021, 27(14): 235-241. [Google Scholar] [CrossRef] 
[8] Banan, A., Fields, J.Z., Decker, H., et al. (2000) Nitric Oxide and Its Metabolites Mediate Ethanol-Induced Microtubule Disruption and Intestinal Barrier Dysfunction. Journal of Pharmacology and Experimental Therapeutics, 294, 997- 1008.
[9] Pohl, K., Moodley, P. and Dhanda, A.D. (2021) Alcohol’s Impact on the Gut and Liver. Nutrients, 13, Article 3170. [Google Scholar] [CrossRef] [PubMed]
[10] 李国华, 李鹤龄, 陈智岗, 等. 酒精性肝病与肠道微生物群落研究进展[J]. 中国实验动物学报, 2022, 30(3): 423-427.
[11] Chen, L., Kan, J., Zheng, N., et al. (2021) A Botanical Dietary Supplement from White Peony and Licorice Attenuates Nonalcoholic Fatty Liver Disease by Modulating Gut Microbiota and Reducing Inflammation. Phytomedicine, 91, Article ID: 153693. [Google Scholar] [CrossRef] [PubMed]
[12] Zhou, Y., Tan, F., Li, C., et al. (2019) White Peony (Ferment-ed Camellia sinensis) Polyphenols Help Prevent Alcoholic Liver Injury via Antioxidation. Antioxidants, 8, Article 524. [Google Scholar] [CrossRef] [PubMed]
[13] Zhou, J., Zhang, N., Zhao, L., et al. (2021) Astragalus Polysaccharides and Saponins Alleviate Liver Injury and Regulate Gut Microbiota in Alcohol Liver Disease Mice. Foods, 10, Article 2688. [Google Scholar] [CrossRef] [PubMed]
[14] Hong, Y., Sheng, L., Zhong, J., et al. (2021) Desulfovibrio Vulgaris, a Potent Acetic Acid-Producing Bacterium, Attenuates Nonalcoholic Fatty Liver Disease in Mice. Gut Mi-crobes, 13, Article ID: 1930874. [Google Scholar] [CrossRef] [PubMed]
[15] Sun, S.S., Wang, K., Ma, K., Bao, L. and Liu, H.W. (2019) An Insoluble Polysaccharide from the Sclerotium of Poria cocos Improves Hyperglycemia, Hyperlipidemia and Hepatic Steatosis in ob/ob Mice via Modulation of Gut Microbiota. Chinese Journal of Natural Medicines, 17, 3-14. [Google Scholar] [CrossRef] 
[16] 姜悦航, 张越, 王妍妍, 等. 茯苓多糖提取物调控CYP2E1及NF-κB炎症通路改善小鼠酒精性肝病[J]. 中国中药杂志, 2022, 47(1): 134-140. [Google Scholar] [CrossRef] [PubMed]
[17] Zhu, L., Ye, C., Hu, B., et al. (2022) Regulation of Gut Microbiota and Intestinal Metabolites by Poria cocos Oligosaccharides Improves Glycolipid Metabolism Disturbance in High-Fat Diet-Fed Mice. The Journal of Nutritional Biochemistry, 107, Article ID: 109019. [Google Scholar] [CrossRef] [PubMed]
[18] 贾可欣, 李寒, 刘闰平. 调和肝脾类中药治疗“肠-肝”轴相关疾病作用机制的研究进展[J]. 中草药, 2023, 54(5): 1609-1619.
[19] 张慧珍, 卢秉久. 卢秉久辨治酒精性肝病经验[J]. 长春中医药大学学报, 2018, 34(4): 692-695. [Google Scholar] [CrossRef] 
[20] 陈丰, 陈绍红, 柳海艳, 等. 基于数据挖掘的中医药治疗酒精性肝病组方用药规律分析[J]. 中草药, 2020, 51(12): 3253-3259.
[21] 申绪芹, 李亚萍, 殷晓轩. 酒精性肝病诊疗的新进展[J]. 中西医结合肝病杂志, 2020, 30(3): 278-282.
[22] 尹周安, 毛娅男, 龙玲, 等. 酒精性肝病的防治策略及东垣葛花解酲汤的组方思路[J]. 中医药导报, 2017, 23(14): 34-36. [Google Scholar] [CrossRef] 
[23] 李晓玲, 吴玉泓, 李海龙, 等. 葛花解酲汤对脾虚湿热型溃疡性结肠炎“炎-癌转化”中相关原抑癌基因表达的影响[J]. 天然产物研究与开发, 2023, 35(5): 858-866, 887.
[24] Lu, J., Xie, Y., Tan, Y., et al. 2013) Simultaneous Determination of Isoflavones, Saponins and Fla-vones in Flos Puerariae by Ultra Performance Liquid Chromatography Coupled with Quadrupole Time-of-Flight Mass Spectrometry. Chemical and Pharmaceutical Bulletin, 61, 941-951. [Google Scholar] [CrossRef] [PubMed]
[25] Kubo, K., Shimada, T., Onishi, R., et al. (2012) Puerariaeflos Allevi-ates Metabolic Diseases in Western Diet-Loaded, Spontaneously Obese Type 2 Diabetic Model Mice. Journal of Natural Medicines, 66, 622-630. [Google Scholar] [CrossRef] [PubMed]
[26] 翁卫东. 复方中药葛花解酲汤对酒精性脂肪肝大鼠模型的影响[J]. 中国中西医结合消化杂志, 2008, 16(3): 162-164.
[27] 周步高, 艾志福, 喻松仁. 中药干预酒精性肝损伤的临床研究现状[J]. 江西中医药, 2014, 45(5): 74-77.
[28] 翁卫东. 葛花解酲汤治疗酒精性肝病的临床疗效观察[J]. 中华中医药学刊, 2010, 28(6): 1226-1227. [Google Scholar] [CrossRef] 
[29] 李军, 王镜辉, 田梦源, 等. 加减葛花解酲汤治疗酒精性肝病44例的临床研究[J]. 贵阳中医学院学报, 2013, 35(2): 75-77.
[30] 吴红伟, 李东辉, 张育贵, 等. 四逆散研究进展及质量标志物的预测分析[J]. 中华中医药学刊, 2021, 39(12): 13-20. [Google Scholar] [CrossRef] 
[31] Woodhouse, C.A., Patel, V.C., Singanayagam, A. and Shawcross, D.L. (2018) Review Article: The Gut Microbiome as a Therapeutic Target in the Pathogenesis and Treatment of Chronic Liver Disease. Alimentary Pharmacology & Therapeutics, 47, 192-202. [Google Scholar] [CrossRef] [PubMed]
[32] 郭晓萍, 程宇甫, 袁勤钊, 等. 加味四逆散对酒精性肝病患者肿瘤坏死因子-α、白细胞介素-6的影响[J]. 中国中医药信息杂志, 2007, 14(5): 10-11.
[33] 郭晓萍, 程宇甫, 袁勤钊, 等. 加味四逆散防治大鼠酒精性肝病实验研究[J]. 中国中医药信息杂志, 2006, 13(5): 33-34.
[34] 郭晓萍, 程宇甫, 袁勤钊, 等. 加味四逆散治疗酒精性肝病临床研究[J]. 中国中医药信息杂志, 2006, 13(6): 13-14.
[35] Cheng, Y., Wang, H.H., Hu, Y.Y., et al. (2011) Structural Shifts of Gut Flora in Rat Acute Alcoholic Liver Injury and Jianpi Hu-oxue Decoction’s (健脾活血汤) Effect Displayed by ERIC-PCR Fingerprint. Chinese Journal of Integrative Medicine, 17, 361-368. [Google Scholar] [CrossRef] [PubMed]
[36] 傅琪琳, 胡义扬, 冯琴, 等. 基于均匀设计的健脾活血方改善酒精性肠渗漏的主效应中药分析[J]. 中西医结合学报, 2011, 9(11): 1234-1241.
[37] 胡义扬. 加强脂肪肝的中医药治疗研究[J]. 中国中西医结合杂志, 2007, 27(4): 293-294.
[38] 成扬, 汪海慧, 胡义扬, 等. 健脾活血方对Lieber-DeCarli酒精性脂肪肝大鼠肠道菌群的影响[J]. 中国中西医结合杂志, 2011, 31(1): 73-79.
[39] 彭景华, 方志红, 崔剑巍, 等. 健脾活血方对酒精复合内毒素脂多糖诱导的肝损伤大鼠库普弗细胞活化信号通路的干预[J]. 中西医结合学报, 2007, 5(3): 302-306.

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