nav emailalert searchbtn searchbox tablepage yinyongbenwen piczone journalimg journalInfo journalinfonormal searchdiv searchzone qikanlogo popupnotification paper paperNew
2025, 06, v.44 625-631
中医肠-肾轴理论与老年人高血压相关性探讨
基金项目(Foundation): 国家自然科学基金青年科学基金项目(编号:82205015)
邮箱(Email): daixia696@163.com;
DOI: 10.16295/j.cnki.0257-358x.2025.06.004
发布时间: 2025-06-05
出版时间: 2025-06-05
移动端阅读
摘要:

近年来肠道菌群与高血压的关系不断被揭示,同时中医学认为老年人高血压责之于肾,肾与大肠在多方面相契合,二者在生理上相互协同,功能上相互调控,病理上相互影响,治疗上相互为用。肠-肾轴与老年人高血压密切相关,具体可体现在老年人高血压的发病、进展及危险因素与肠道菌群失调、肠道免疫反应紊乱、肠壁通透性增加相关。肠-肾轴失调可能是诱导老年人高血压进展的原因之一,肾肠同治优于单一靶向疗法,或为未来老年人高血压调控的新思路。

Abstract:

In recent years,the correlation between intestinal flora and hypertension has been continuously revealed. Meanwhile,traditional Chinese medicine holds that the cause of senile hypertension lies with the kidneys. In traditional Chinese medicine,the kidneys and the large intestine are compatible in many aspects.They work in synergy physiologically,regulate each other functionally,influence each other pathologically,and complement each other in treatment. The intestinal-renal axis is closely related to senile hypertension.Specifically,it can be reflected that the onset,progression and risk factors of senile hypertension are related to intestinal flora imbalance,intestinal immune response disorder and increased intestinal wall permeability.Dysregulation of the intestinal-renal axis may be one of the reasons for the progression of senile hypertension. Combined treatment of kidney and intestine is superior to single-target therapy and may be a new idea for the regulation of senile hypertension in the future.

参考文献

[1]骆雷鸣,任金霞.高血压心脏形态、结构改变及危害[J].中华保健医学杂志,2021,23(6):555-560.

[2]朱平.老年人高血压的特点及诊疗进展[J].中华老年心脑血管病杂志,2021,23(8):785-787.

[3]胡娟,汪星辉,高杉,等.肠道菌群在心血管疾病中的作用及其机制研究进展[J].中国药理学通报,2019,35(11):1496-1500.

[4] MEIJERS B K I,EVENEPOEL P. The gut-kidney axis:indoxyl sulfate,p-cresyl sulfate and CKD progression[J].Nephrol Dial Transplant,2011,26(3):759-761.

[5] PAHL M V,VAZIRI N D. The chronic kidney diseasecolonic axis[J]. Semin Dial,2015,28(5):459.

[6]张鑫,曾鑫,齐心.基于肾司二便探究中医“肾”与肠黏膜屏障的关系[J].中医临床研究,2022,14(15):45-47.

[7]陈士铎.石室秘录[M].张灿玾,点校.北京:中国中医药出版社,1991.

[8]赵献可.医贯[M].北京:人民卫生出版社,1982:86.

[9]杨佩诗,黄宏丽,夏艳秋,等.浅谈从大肠论治排卵障碍性不孕症[J].中医药学报,2023,51(8):13-16.

[10]张介宾.景岳全书[M].北京:中国中医药出版社,1994:286.

[11]沈金鳌.杂病源流犀烛[M].李占永,李晓林,校注.北京:中国中医药出版社,1994.

[12]潘华信,朱伟常.叶天士医案大全[M].上海:上海中医药大学出版社,1994:333.

[13]虞抟.医学正传[M].郭瑞华,点校.北京:中医古籍出版社,2002:10.

[14]苏妆,王淑娟,鞠宝兆.“阳明脉衰”与针灸美颜抗衰的关系探讨[J].实用中医内科杂志,2022,36(6):41-43.

[15]汪昂.医方集解[M].鲍玉琴,杨德利,校注.北京:中国中医药出版社,1997:153.

[16]高静,李国荣,张本艳,等.济川煎治疗老年功能性便秘临床研究[J].山东中医杂志,2023,42(12):1266-1273.

[17]王海峰,董秋安,李健,等.补肾健脾和胃法联合西药治疗老年顽固性便秘效果及对Wexner便秘评分、肠道菌群的影响[J].解放军医药杂志,2022,34(2):104-107.

[18]李少康,赵赟,高娜,等.补肾类方药及中药有效成分抗衰老的作用机制研究进展[J].天津中医药,2023,40(4):537-544.

[19]葛洪.抱朴子[M].上海:上海书店出版社,1986:65.

[20]徐蕾,马晓燕.基于“肠-肾轴”理论治疗慢性肾脏病研究进展[J].陕西中医药大学学报,2022,45(3):114-119.

[21]江志峰,郑培奋.肠道菌群与机体衰老关系的研究进展[J].中国慢性病预防与控制,2023,31(1):76-80.

[22]褚璨灿,师为人,陈云志,等.从调节肠道菌群探讨中医药治疗慢性阻塞性肺疾病的相关性[J].贵阳中医学院学报,2019,41(1):64-69.

[23]李路娇,李梅.肠道菌群与骨骼代谢[J].中华骨质疏松和骨矿盐疾病杂志,2018,11(3):317-322.

[24]陶永彪,汪龙德.基于中医对肾藏的理解探讨其与肠道菌群的联系[J].实用中医内科杂志,2022,36(9):97-99.

[25]丰雪,耿少辉,刘豫蒙,等.论肠道菌群与中医肾精的相关性[J].中华中医药杂志,2021,36(2):780-783.

[26]王贶,洪遵.全生指迷方[M].北京:人民卫生出版社,1986:65.

[27]顾靖远.顾松园医镜[M].北京:中国医药科技出版社,2014:219.

[28] WESLEY A. Role of the human microbiome in health and disease in United Kingdom[J]. Int J Nat Sci,2023,3(2):35-47.

[29]江燕,廖圣宝.高血压神经内分泌免疫学研究进展[J].安徽医药,2010,14(6):627-629.

[30]蒋传义.临床治疗眩晕之拙见[J].中国民间疗法,2020,28(15):95-96.

[31]颜磊,董桂英.《伤寒杂病论》眩晕证治探析[J].江苏中医药,2020,52(3):6-8.

[32] G?ZD-BARSZCZEWSKA A,KOZIOT-MONTEWKA M,BARSZCZEWSKI P,et al. Gut microbiome as a biomarker of cardiometabolic disorders[J]. Ann Agric Environ Med,2017,24(3):416-422.

[33] DAN X,MUSHI Z,BAILI W,et al. Differential analysis of hypertension-associated intestinal microbiota[J].Int J Med Sci. 2019,16(6):872-881.

[34] VIRWANI P D,QIAN G,HSU M S S,et al. Sex differences in association between gut microbiome and essential hypertension based on ambulatory blood pressure monitoring[J]. Hypertension. 2023,80(6):1331-1342.

[35]中国老年医学学会高血压分会,北京高血压防治协会,国家老年疾病临床医学研究中心.中国老年高血压管理指南2023[J].中华高血压杂志,2023,31(6):508-538.

[36]李恒,任明.盐、肠道微生物及其代谢产物和血压水平的关系研究进展[J].中国动脉硬化杂志,2023,31(11):1007-1012.

[37] WILCK N,MATUS M G,KEARNEY S M,et al. Saltresponsive gut commensal modulates TH17 axis and disease[J]. Nature,2017,551(7682):585-589.

[38]黄庆发.高盐饮食改变肠道菌群结构导致高血压的发生[D].广州:南方医科大学,2020.

[39]何春阳,邓英,唐艳,等.饮酒对肠道微生态的影响研究[J].中国微生态学杂志,2016,28(10):1238-1241.

[40]陈杰,陈宣颖,孙立勤,等.降压药物对盐敏感性高血压患者肠道菌群的影响[J].现代实用医学,2022,34(8):1104-1106.

[41] ROBLES-VERA I,TORAL M,DE LA VISITACION N,et al. Changes to the gut microbiota induced by losartan contributes to its antihypertensive effects[J]. Brit J Pharmacol,2020,177(9):2006-2023.

[42] YOO H H,KIM I S,YOO D H,et al. Effects of orally administered antibiotics on the bioavailability of amlodipine:gut microbiota-mediated drug interaction[J].J Hypertens,2016,34(1):156-162.

[43] DONG Y,WANG P,JIAO J,et al. Antihypertensive therapy by ACEI/ARB is associated with intestinal flora alterations and metabolomic profiles in hypertensive patients[J]. Front Cell Dev Biol,2022,10:861829.

[44]崔嘉琪.益生菌Probio-X辅助治疗老年高血压及调节其肠道菌群的研究[D].呼和浩特:内蒙古医科大学,2023.

[45] ZIMMERMANN M,ZIMMERMANN-KOGADEEVA M,WEGMANN R,et al. Mapping human microbiome drug metabolism by gut bacteria and their genes[J].Nature,2019,570(7762):462-467.

[46] KATO R,YUASA H,INOUE K,et al. Effect of Lactobacillus casei on the absorption of nifedipine from rat small intestine[J]. Drug Metab Pharmacokinet,2007,22(2):96-102.

[47]李森浩,周军,陈丽娜.肠道菌群对中青年高血压影响的研究进展[J].心电与循环,2022,41(6):617-620.

[48]李娜丽,闫俊卿,魏锦,等.肠道菌群与衰老相关疾病关系的研究进展[J].中国全科医学,2019,22(27):3298-3301.

[49] MANGIOLA F,NICOLETTI A,GASBARRINI A,et al.Gut microbiota and aging[J]. Eur Rev Med Pharmacol Sci,2018,22(21):7404-7413.

[50]罗永建,严培玲,刘海丰.老年高血压患者肠道菌群变化及其与C反应蛋白和脂代谢指标的相关性[J].中国老年学杂志,2017,37(8):1919-1921.

[51]刘蕊.实时荧光定量PCR法对老年高血压患者肠道菌群的初步分析[D].长春:吉林大学,2014.

[52] SU J,WANG Y J,YAN M Q,et al. The beneficial effects of Polygonatum sibiricum Red. superfine powder on metabolic hypertensive rats via gut-derived LPS/TLR4 pathway inhibition[J]. Phytomedicine,2022,106:154404.

[53]马旭,于杰,刘迎迎,等.黄精补益肾气在老年高血压病辨治中的临床应用[J].辽宁中医药大学学报,2025,27(1):91-97.

[54]郭丽娜,盛雯,何盈犀,等.药食同源中药复方改善肠道菌群结构和调节血清代谢物对高血压大鼠治疗作用[J].中草药,2023,54(20):6743-6752.

[55]李红,谢海彬,齐容,等.车前子粗多糖胶囊调节肠道菌对老年高血压病患者血压影响的临床研究[J].中医临床研究,2019,11(11):15-19.

[56]亓英姿,姜月华,姜凌宇,等.杜仲-刺蒺藜对老龄自发性高血压大鼠肠道微生物组的影响[J].中华高血压杂志,2019,27(5):454-462.

[57]杨晓忱,熊兴江,王阶.补肾方药治疗高血压病的研究进展[J].中国中药杂志,2013,38(23):4015-4019.

[58]柴学军,吴永继,孙鹏浩,等.杜仲通过肠道菌群促进小鼠海马成体神经发生和学习记忆能力[J].中国药理学与毒理学杂志,2019,33(9):705.

基本信息:

DOI:10.16295/j.cnki.0257-358x.2025.06.004

中图分类号:R259

引用信息:

[1]徐贤芳,亓英姿,戴霞.中医肠-肾轴理论与老年人高血压相关性探讨[J].山东中医杂志,2025,44(06):625-631.DOI:10.16295/j.cnki.0257-358x.2025.06.004.

基金信息:

国家自然科学基金青年科学基金项目(编号:82205015)

发布时间:

2025-06-05

出版时间:

2025-06-05

检 索 高级检索