贺粤 周亚滨 王贺 客蕊

〔摘要〕 缺血性心脏病为慢性、难治性疾病，“气血水”理论从人体气、血、水的生成、运化等生理及病理过程的角度，宏观地阐释人体疾病的发生发展及趋势。本文探析“气血水”与肠道菌群之间的相互作用，以及肠道菌群与缺血性心脏病的病因病机的相关性，并从“气血水调和-后天脾胃功能正常-肠道菌群-心”角度分析，认为肠道菌群的代谢產物、营养状况等改变，可促进与缺血性心脏病危险事件相关的病理改变，进而影响缺血性心脏病的病情进展与预后，主张以“调补后天脾胃功能”来改善肠道菌群，进而达到中西医结合防治缺血性心脏病的目的。

〔关键词〕 肠道菌群;缺血性心脏病;气血水;调补后天;脾胃功能

〔中图分类号〕R256.2       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.05.030

Discussion on Relationship Between Intestinal Microflora and Ischemic Heart

Disease Based on "Qi-Blood-Water"

HE Yue1， ZHOU Yabin1，2， WANG He1，2*， QIE Rui2

（1. Heilongjiang University of Chinese Medicine， Harbin， Heilongjiang 150040， China; 2. The First Affiliated Hospital of Heilongjiang University of Chinese Medicine， Harbin， Heilongjiang 150040， China）

〔Abstract〕 Ischemic heart disease is a chronic and refractory disease. The theory of "Qi-blood-water" is to explain the occurrence and development of human diseases from the perspective of physiological and pathological processes such as the production， transportation and transformation of Qi， blood， and water in the human body. trend. This article explores the interaction between "Qi-blood-water" and intestinal flora， as well as the correlation between intestinal flora and the etiology and pathogenesis of ischemic heart disease， and from "harmonization of Qi， blood and water-acquired normal spleen and stomach function-intestinal flora-heart" suggests that changes in the metabolites and nutritional status of the intestinal flora can promote pathological changes related to ischemic heart disease risk events， thereby affecting the progression and prognosis of ischemic heart disease. It is suggested to improve intestinal flora by "regulating and replenishing acquired spleen and stomach function"， thereby achieving the purpose of preventing and treating ischemic heart disease with integrated Chinese and western medicine.

〔Keywords〕 ischemic heart disease; intestinal flora; Qi-blood-water; adjustment and supplement of acquired constitution; function of spleen and stomach

缺血性心脏病（ischemic heart disease， IHD）是指部分心肌处于供血、供氧不足的状态，通常在心肌细胞血氧供需失衡时发生。随着社会发展，IHD发病率逐年升高，现已成为临床常见的、严重危害人类健康的多发病，在临床具有较高的致死率、致残率[1]。近年来，中医药在防治缺血性心脏病中被广泛应用、效果明显，同时在发现发掘预防及治疗防治IHD的经济有效的新靶点方面潜力巨大，对于维系全球人民健康亦具有深远意义[2]。现代医学临床研究[3]发现，肠道菌群与IHD之间可能存在联系，如激活促炎机制、代谢毒性等，这与中医基础理论中“心主小肠”“心之脉络小肠，心与小肠相表里”等观点不谋而合。现代医学证实，肠……