Research advances on regulation of intestinal flora by Traditional Chinese Medicine in prevention and treatment of ulcerative colitis
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摘要: 溃疡性结肠炎是一种慢性非特异性炎症，其病变主要累及结肠、直肠黏膜和黏膜下层，病因及发病机制尚不明确。中医药在治疗溃疡性结肠炎上有明显的优势与鲜明的特点。近年来有研究表明溃疡性结肠炎的发病可能与肠道菌群有密切关系。本文通过综述肠道菌群与溃疡性结肠炎的相互关系以及中医药通过调节肠道菌群防治溃疡性结肠炎的研究进展，以期为临床治疗溃疡性结肠炎提供新的治疗策略和思路。Abstract: Ulcerative colitis is a chronic non-specific inflammatory disease whose lesions mainly involve the mucosa and submucosa of the colon and rectum, and its etiology and pathogenesis are still unclear. Traditional Chinese Medicine has obvious advantages and distinctive features in the treatment of ulcerative colitis. In recent years, some studies have shown that the pathogenesis of ulcerative colitis may be closely related to the intestinal flora. This article reviews the relationship between intestinal flora and ulcerative colitis and the research progress of Traditional Chinese Medicine in treating ulcerative colitis by regulating intestinal flora, with a view to providing heartfelt therapeutic strategies and ideas for the clinical treatment of ulcerative colitis.
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Key words:
- ulcerative colitis /
- intestinal flora /
- Traditional Chinese Medicine /
- research progress
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表 1 中药单体/有效成分对UC肠道菌群紊乱的调节作用
中药单体/有效成分 参考文献 研究对象 肠道菌群变化 相关指标变化 蒲公英多糖 [12] UC小鼠 双歧杆菌、乳酸杆菌↑，大肠杆菌↓ 体质、IL-4↑，IL-6、TNF-α↓ 马齿苋多糖 [13] UC小鼠 双歧杆菌、乳酸杆菌↑，肠杆菌、肠球菌↓ IL-10↑，TNF-α、IL-6↓ 地锦草多糖 [14] UC小鼠 双歧杆菌、霍德曼氏菌↑，大肠杆菌↓ IL-10↑，IL-6、IL-17↓ 黄芪甲苷 [15] UC小鼠 瘤胃球菌科、螺旋体科↑，大肠杆菌↓ 结肠损伤、中性粒细胞、巨噬细胞、MCP-1、TNF-α、IL-1β、IL-6、p-IκBα、p-IKKα/β、p-p65↓ 小檗碱 [16] UC小鼠 益生菌乳酸杆菌、乳球菌↑，肠道拟杆菌、分段丝状菌↓ ILC、ILC1、T-bet、ROR-γt、IL-1β、IL-23、IL-23R、TNF-α、IFN-γ↓，ILC3百分比、IL-22↑ 人参皂苷 [17] UC小鼠 螺旋体科↑，葡萄球菌、拟杆菌↓ IL-6、IL-33、CCL-2、TNF-α↓，IL-4、IL-10↑ 黄芩苷 [18] UC大鼠 厚壁菌门↑，变形杆菌、放线菌门↓ IL-17、RORγt↑ 鱼腥草多糖 [19] UC小鼠 厚壁菌↑，变形杆菌↓ TNF-α、IL-1β、IL-6↓，Th17、Treg细胞↑ 五味子多糖 [20] UC小鼠 厚壁菌↑，变形杆菌、拟杆菌、乳杆菌科↓ MPO、NO、ROS、MDA、TNF-α、IL-6、IL-13、IL-17、IL-23↓，GSH、SOD、IFN-γ、IL-4↑ 
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表 2 中药复方/有效成分对UC肠道菌群紊乱的调节作用
中药复方/有效成分 参考文献 研究对象 肠道菌群变化 相关指标变化 黄芪汤 [21] UC小鼠 螺旋体科↑，β变形杆菌、梭菌、铁杆菌↓ IL-1β、IL-17、MCP-1、TNF-α、IFN-γ、IL-6↓ 大黄牡丹汤 [22] UC小鼠 厚壁菌、放线菌↑，变形杆菌、拟杆菌↓ TGF-β↑，IL-6、TNF-α、IFN-γ、IL-10、IL-17A、IL-21、IL-22↓ 薏苡附子败酱散 [23] UC大鼠 厚壁菌、拟杆菌↑，变形杆菌↓ ZO-1、occludin、claudin-1蛋白↑，IL-1β、TNF-α↓ 平胃散 [24] UC小鼠 厚壁菌↑，拟杆菌↓ IL-17A、IFN-γ mRNA↓ 排脓散 [25] UC小鼠 Romboutsia、Lactobacillus、Bifidobacterium、Akkermansia↑，螺旋杆菌↓ TLR1、MyD4、p-NF-κB p4、p-IκBα的蛋白质表达↓ 白头翁汤 [26] UC小鼠 厚壁菌、拟杆菌、乳酸杆菌↑，变形杆菌、志贺氏菌↓ IL-6、IL-1β、TNF-α↓ 三黄熟艾汤 [27] UC小鼠 乳酸杆菌↑ IL-1、IL-6、TNF-α↓ 半夏泻心汤 [28] UC小鼠 杜波氏菌、拟杆菌、异位菌↑，乳杆菌、梭菌-dium_sensu_stricto_0、肠杆菌、Candidatus_Saccharimonas、Eubacterium_fissicatena_group↓ IL-1、TNF-α↓
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