| 引用本文: |
王俊骅, 郭玲, 刘昊炎.肠-肾轴视角下舌诊在糖尿病肾病诊治中的应用[J].湖南中医药大学学报,2026,46(4):777-782[点击复制] |
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| 肠-肾轴视角下舌诊在糖尿病肾病诊治中的应用 |
| 王俊骅,郭玲,刘昊炎 |
| (辽宁中医药大学, 辽宁沈阳 110847;辽宁中医药大学附属医院肾病科, 辽宁沈阳 110032) |
| 摘要: |
| 糖尿病肾病是糖尿病常见微血管并发症，其进展与肠-肾轴介导的肠道微生态失衡密切相关。肠道菌群紊乱可通过代谢产物蓄积、免疫炎症激活等途径加重肾损伤，而肾损伤又反向加剧肠道微生态失调，形成恶性循环。中医舌诊以“司外揣内”为核心，舌为脾之外候，舌苔菌群结构可反映脾之运化功能状态。本文以肠-肾轴为视角，结合糖尿病肾病气阴两虚、湿浊内蕴、瘀血阻络三阶段病机，系统阐释氧化应激、微生态失衡及微循环障碍调控舌苔菌群及参与形成特定病程下病理性舌象的内在机制，旨在为糖尿病肾病中医舌诊提供微观生物学依据，为中西医结合诊治本病提供新思路。 |
| 关键词: 肠-肾轴|糖尿病肾病|肠道菌群|舌苔菌群|舌诊|肠-口轴 |
| DOI：10.3969/j.issn.1674-070X.2026.04.017 |
| 投稿时间：2025-11-29 |
| 基金项目:全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号);辽宁省教育厅基本科研项目(JYTMS20231819) |
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| Application of tongue diagnosis in the diagnosis and treatment of diabetic nephropathy from the perspective of the gut-kidney axis |
| WANG Junhua, GUO Ling, LIU Haoyan |
| (Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110847, China;Department of Nephrology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110032, China) |
| Abstract: |
| Diabetic nephropathy(DN) is a common microvascular complication of diabetes mellitus, and its progression is closely associated with intestinal microecological imbalance mediated by the gut-kidney axis. Gut microbiota dysbiosis can exacerbate renal injury through pathways such as the accumulation of metabolic products and the activation of immune inflammation, while renal injury, in turn, further aggravates intestinal microecological imbalance, forming a vicious cycle. In Chinese Medicine, tongue diagnosis is grounded in the principle of "judging the inside from observing the outside". The tongue is considered the external reflection of the spleen, and the structure of the tongue coating microbiota can indicate the functional state of the spleen's transporting and transforming functions. From the perspective of the gut–kidney axis, and in combination with the three-stage pathogenesis of DN—namely, qi-yin deficiency, internal retention of dampness-turbidity, and blood stasis obstructing collaterals—this paper systematically elucidates the intrinsic mechanisms by which oxidative stress, microecological imbalance, and microcirculatory disturbances regulate the tongue coating microbiota and contribute to the formation of pathological tongue manifestations specific to different disease stages. The aim is to provide a micro-biological basis for TCM tongue diagnosis in DN and to offer new insights for the integrated Chinese and Western medicine approach to diagnosing and treating this condition. |
| Key words: gut-kidney axis|diabetic nephropathy|gut microbiota|tongue coating microbiota|tongue diagnosis|gut-oral axis |
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