摘要
随着全球老龄化加剧,老年2型糖尿病发病率持续攀升,其治疗面临长期代谢紊乱、并发症风险及药物依赖等挑战。中医理论“年长则求之于府”强调了六腑功能在老年疾病防治中的重要性,指出老年人脏腑功能衰退,尤以六腑传化失职为要,老年2型糖尿病呈现本虚标实、腑气易壅、浊邪易聚的病机特点,“求之于府”是改善老年2型糖尿病“标实”证候的关键,是脏腑表里互治必然性的体现,也是阻断病情进展的重要环节。中医“府”与肠道菌群关系密切,两者在解剖、生理和病理层面具有一致性。研究表明,老年2型糖尿病患者常有肠道菌群失调,肠道菌群通过调控糖脂代谢稳态、维护肠黏膜屏障完整性、介导炎性反应及参与肠–脑轴调节等机制在疾病进程中发挥重要作用。针对老年2型糖尿病,中医可采用健脾和胃、通腑泄浊、燮理阴阳等治法调畅腑气,整体调节脏腑功能,恢复机体阴阳平衡,从而在调节肠道菌群、改善糖脂代谢紊乱方面彰显显著优势。已有研究证实,某些中药复方及中药活性成分可恢复肠道菌群平衡,减轻炎症,保护肠屏障,参与肠–脑–轴调节,改善糖脂代谢,以治疗老年2型糖尿病。融合中医腑病理论与现代肠道菌群研究凸显了中医药通过调节肠道菌群治疗老年2型糖尿病的潜在价值,为本病的治疗提供了新思路和理论依据。
With the aggravation of global aging,the incidence of type 2 diabetes mellitus(T2DM)in the elderly continues to rise,and its treatment faces challenges such as long-term metabolic disorders,risk of complications,and drug dependence.The traditional Chinese medicine(TCM)theory of“seeking therapy from Fu(腑)organs for the aged”emphasizes the importance of the functions of six Fu organs in preventing and treating geriatric diseases,and points out that the functional decline of Zang-fu(脏腑)organs of the elderly is particularly characterized by impaired transportation and transformation of six Fu organs.Elderly T2DM presents the pathogenic characteristics of deficiency in origin with excess in manifestation,susceptibility to Qi(气)stagnation of Fu organs,and tendency for accumulation of turbid pathogens,and the theory of“seeking therapy from Fu organs”is crucial for alleviating the excess syndrome in elderly T2DM patients,which embodies the necessity of treating from the aspects of interior and exterior simultaneously of Zang organs and Fu organs,and constitutes a critical intervention for halting disease progression.The concept of“Fu”in TCM is closely related to the gut microbiota,they demonstrate concordance across anatomical,physiological,and pathological aspects.Studies have shown that elderly T2DM patients frequently exhibit intestinal microbiota dysbiosis.Gut microbiota plays a significant role in the disease progression through multi-targeted mechanisms,including modulating glucose and lipid metabolic homeostasis,maintaining intestinal mucosal barrier integrity,mediating inflammatory responses,and participating in gut-brain axis regulation.For elderly T2DM,TCM employs therapeutic approaches such as fortifying the spleen and harmonizing the stomach,unblocking Fu organs and discharging turbidity,and modulating Yin(阴)and Yang(阳)to regulate Qi of Fu organs,holistically modulate visceral function,and restore the body’s Yin-Yang equilibrium,thereby demonstrating significant advantages in modulating the gut microbiota and ameliorating glucose and lipid metabolic disorders.Studies have confirmed that some Chinese medicine compounds and Chinese medicinal material active ingredients can restore the balance of intestinal flora,reduce inflammation,protect intestinal barrier,participate in the regulation of gut-brain axis,and ameliorate glucose and lipid metabolism,so as to treat elderly T2DM.After integrating the TCM theory of Fu organ diseases with contemporary gut microbiota research,the potential value of TCM in treating elderly T2DM through regulating gut microbiota is highlighted,which provides novel ideas and theoretical basis for the treatment of this disease.
出处
《中医临床研究》
2025年第26期49-55,共7页
Clinical Journal Of Chinese Medicine
关键词
老年2型糖尿病
六腑
肠道菌群
中医药
Type 2 diabetes mellitus
Six Fu organs
Gut microbiota
Traditional Chinese medicine
