基于“肺与大肠相表里”探讨肠道菌群与肺结核关系的研究进展

肺结核是常见的呼吸道传染疾病,肠道菌群紊乱是肺结核的常见合并症。肠道菌群紊乱会加重肺结核的病理损伤。从中医病机角度,二者之间的关系体现了“肺与大肠相表里”的经络理论、津液理论及气机升降理论。从生物学机制角度,肠道菌群可通过调节宿主固有免疫和适应性免疫,产生抗结核作用的代谢产物以限制肺结核进展;肺结核导致的肠道菌群改变或与血液循环及淋巴循环相关;抗结核药物治疗对肠道菌群的影响或与药物杀菌性相关。肠道菌群的相关疗法对肺结核诊疗具有一定临床价值。通过增加肠道益生菌、粪菌移植、合理使用抗结核药物、改善饮食结构等方法可调节肠道菌群以达到辅助治疗肺结核的目的。本文中,笔者将结合既往文献进行综述。

Research progress on the correlation of gut microbiota with and pulmonary tuberculosis based on the theory of exterior and interior of lung and large intestine

Pulmonary tuberculosis is a common respiratory infectious disease, and the disorder of gut microbiota is a common complication of it. The disorder of gut microbiota can aggravate the pathological damage of pulmonary tuberculosis. From the perspective of pathogenesis of Traditional Chinese Medicine, the relationship of them embodies the meridian theory, the body fluid theory and the movement theory of Qi. From the perspective of biological mechanism, gut microbiota can limit the progress of pulmonary tuberculosis by producing anti-tuberculosis metabolites through regulating the host innate immunity and adaptive immunity. The disorder of gut microbiota caused by pulmonary tuberculosis may be associated with blood circulation and lymphatic circulation, and the influence of anti-tuberculosis drug on gut microbiota may be related to the bactericidal properties of drugs. The related therapy of intestinal flora has a certain clinical value in the diagnosis and treatment of pulmonary tuberculosis. The intestinal flora can be adjusted by increasing intestinal probiotics, fecal bacteria transplantation, rational use of anti-tuberculosis drugs, improving dietary structure and so on, which has achieved the purpose of adjuvant treatment of pulmonary tuberculosis. In this paper, the author will review the previous literature.