| 引用本文: |
王慧淑, 吴泽芝, 李祥明, 吴邦泰, 谢少庭.“肠-肾轴”视角下“脾气散精”理论对慢性肾脏病肠道菌群及免疫功能的影响[J].湖南中医药大学学报,2026,46(1):113-119[点击复制] |
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| “肠-肾轴”视角下“脾气散精”理论对慢性肾脏病肠道菌群及免疫功能的影响 |
| 王慧淑,吴泽芝,李祥明,吴邦泰,谢少庭 |
| (广州中医药大学附属汕头中医院, 广东 汕头 515000) |
| 摘要: |
| 慢性肾脏病，尤其是2~4期的发生与发展，与肠道菌群紊乱、免疫炎症激活及代谢毒素蓄积密切相关，“肠-肾轴”学说为理解其病理机制提供了重要视角。本文基于“肠-肾轴”现代医学理论，系统阐释中医学“脾失健运、精微不布、湿浊内生”的核心病机，将其与CKD中肠道菌群失调、短链脂肪酸减少、尿毒症毒素蓄积及免疫炎症通路激活等病理机制进行关联互释，揭示“脾气散精”通过破坏“肠-肾轴”稳态，形成“肠道微生态失衡-免疫屏障破坏-微炎症-肾损伤”的恶性循环，进而驱动CKD发生发展。据此，本文提出“祛湿健脾为本、温补肾阳为要、兼顾化痰祛瘀”的中医治疗策略，旨在通过恢复“脾气散精”功能，多靶点调节肠道菌群与免疫功能，干预上述恶性循环。本文从“肠-肾轴”与“脾气散精”理论结合的创新视角出发，以期为中医药干预CKD提供新的理论视角与思路。 |
| 关键词: 慢性肾脏病 肠-肾轴 肠道菌群 免疫功能 脾气散精 |
| DOI：10.3969/j.issn.1674-070X.2026.01.015 |
| 投稿时间：2025-09-19 |
| 基金项目:广东省卫济医学发展基金会科研基金项目（K-202505-1-27）；汕头市科技计划医疗卫生项目（240510106499152）。 |
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| Gut microbiota and immune function in chronic kidney disease: An interpretation from the "gut-kidney axis" perspective based on the theory of "spleen qi transporting and distributing nutrient essence throughout the whole body" |
| WANG Huishu, WU Zezhi, LI Xiangming, WU Bangtai, XIE Shaoting |
| (Shantou Hospital of TCM, Guangzhou University of Chinese Medicine, Shantou, Guangdong 515000, China) |
| Abstract: |
| The development and progression of chronic kidney disease (CKD), especially stages 2-4, are closely associated with gut microbiota dysbiosis, immune-inflammatory activation, and accumulation of metabolic toxins. The "gut-kidney axis" theory provides an important perspective for understanding these pathological mechanism. Based on the modern concept of the "gut-kidney axis" theory, this paper systematically elaborates the core TCM pathogenesis of "loss of splenic transportation, failure of distribution of refined nutrients, and endogenous production of damp-turbidity", and correlates it with CKD-related pathological mechanisms including gut microbiota dysbiosis, reduced short-chain fatty acids, uremic toxin accumulation, and activation of immune-inflammatory pathways. It further proposes that "impaired spleen qi in transporting and distributing nutrient essence throughout the whole body" disrupts "gut-kidney axis" homeostasis, leading to a vicious cycle of "intestinal microecological imbalance－immune barrier impairment－microinflammation－renal injury", thereby driving the onset and progression of CKD. Accordingly, this paper proposes a TCM therapeutic strategy featuring "resolving dampness and strengthening the spleen as the foundation, warming and tonifying kidney yang as the key, and concurrently dissolving phlegm and removing blood stasis", aiming to restore the function of "spleen qi transporting and distributing nutrient essence throughout the whole body", regulate the gut microbiota and immune function via multiple targets, and interrupt the vicious cycle described above. From this innovative integrated perspective combining the "gut-kidney axis" with the Chinese medicine theory of "spleen qi transporting and distributing nutrient essence throughout the whole body", this paper intends to provides new theoretical insights and ideas for Chinese medicine interventions in CKD. |
| Key words: chronic kidney disease gut-kidney axis gut microbiota immune function spleen qi transporting and distributing nutrient essence throughout the whole body |
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