从能量代谢及粘膜免疫看“上火”与肠道菌群的关系

摘要

Objective] To explore the relationship between excessive internal heat in TCM and intestinal microflora ,provide scientific evidences for pathogenesis of excessive internal heat.[Method]With the research methods of clinical observation and literature review,analyze the characteristics of excessive internal heat,and collect research progress about intestinal microflora to find out the link.[Result] Head and facial tissue is more susceptible to injury,which is determined by the organizational characteristics. People suffering from excessive internal heat widely have problems of energy metabolism and mucosal immune disorders. Intestinal microflora plays an important role in energy production,conversion,storage and use.They can change the way that organizations use energy,and change AMPK phosphorylation to influence the energy metabolism of the body.Thus gut microflora imbalance may lead to disorders of energy metabolism.On the other hand,inflammatory mediators express abnormally in these people. Impaired immune function leads to inflammatory states,which causes imbalance of gut microflora.While intestinal microflora also can regulate intestinal mucosal immune response by adjusting related effective factors. [Conclusion]Excessive internal heat is closely related with intestinal microflora from the aspects of energy metabolism and mucosal immunity,which may provide new ideas to explore the pathogenesis of this disease.The researches based on intestinal microflora and diseases bring brilliant prospects of individual prevention and treatment for TCM and western medicine .%[目的]从能量代谢及粘膜免疫角度探究中医“上火”与肠道微生物之间的联系，为解释“上火”的发生机理提供科学依据。[方法]通过临床观察及文献查阅，分析“上火”的病证特点，搜集整理国内外有关肠道菌群研究进展的资料，从能量代谢及粘膜免疫角度找出连接“上火”及肠道菌群的纽带。[结果]“上火”对人体的损伤以头面部粘膜为主，具有组织学结构特点。“上火”者普遍存在相应的能量代谢紊乱及粘膜免疫失调。肠道菌群多方面参与机体的能量产生、转化、储存和利用，并通过改变组织对能量的利用方式、改变AMPK磷酸化等途径来影响机体的能量代谢。因而肠道微生态失衡可导致能量代谢发生紊乱。另一方面“上火”者体内炎症介质的表达与正常对照有明显差异。肠粘膜免疫功能下降会使肠道处于炎症状态，改变肠道微生态平衡。而肠道菌群亦可通过调节肠粘膜免疫反应的效应因子等途径来调控肠道的粘膜免疫反应。[结论]“上火”的发生同肠道菌群改变密切相关，能量代谢及粘膜免疫是连接两者的重要环节，对其进一步研究或可为科学解释“上火”的发病机制提供新的思路。肠道菌群与疾病的关联研究亦为中西医个体化防治疾病带来光明的前景。