路小轩 孙之中

【摘 要】 文章对中医经典著作《内经》中“大肠者，皮其应”理论进行研究，探讨痤疮与肠道菌群之间的关系。有研究表明痤疮与肠道菌群有关联，但其具体作用机制尚未明确，文章从中医理论角度阐释二者可能的联系，将皮肤与肠道视为一个整体，这与中医的整体观相符合。中药治疗痤疮有良好疗效可能与肠道微生物机制有关，需要进一步证实，这对拓展痤疮的临床治疗思路有重要的理论和实践意义。

【关键词】 痤疮；肠道菌群；内经；皮肤病

【中图分类号】R221   【文献标志码】 A    【文章编号】1007-8517（2023）08-0014-04

Abstract：In this paper， the theory of “large intestine should be treated by skin” in the traditional Chinese medicine classic Huang Di Vei jing was studied to explore the relationship between acne and intestinal flora. Modern studies have shown that acne is associated with intestinal flora， but the specific mechanism of action is not clear. This paper explains the possible relationship between the two from the perspective of traditional Chinese medicine theory. The skin and intestine are regarded as a whole， which is consistent with the holistic view of traditional Chinese medicine. The good curative effect of traditional Chinese medicine on acne may be related to the intestinal microbial mechanism， which needs further confirmation. This has important theoretical and clinical significance for broadening the clinical treatment of acne.

Key words：Acne; Intestinal Flora; The Internal Canon of Medicine; Skin Disease

痤疮是一种皮肤科的常见疾病，属于毛囊皮脂腺慢性炎症性疾病［1］，影响了大约80%的青年人［2］。在我国寻常痤疮发病率是70%～87%，临床表现主要以面部、前胸、后背部位的丘疹、脓疱、结节等多形性皮损为特征［3］，且会造成疤痕，因其常造成面部的不美观，痤疮还可造成患者焦虑、自卑、抑郁等，可明显影响日常生活、学习和工作，应予以重视［4］。痤疮的发病机制目前未完全阐明，由于其病因复杂，与饮食、情绪、遗传、内分泌等诸多因素相关。目前认为，本病的发生机制与雄激素分泌旺盛以致皮脂腺及皮脂分泌增加，上皮异常角化过度并导致毛囊皮脂腺导管堵塞，痤疮丙酸杆菌介导的免疫性炎症［2］有关。目前有关皮肤-肠轴的研究是学术热点，有研究阐释了肠道菌群影响痤疮的机制，主要包括肠道菌群失调，肠道通透性增加，促进了内毒素产生，引起炎症因子水平提高以及抗炎因子水平下降［5］，刺激皮脂腺增生肥大从而诱发痤疮。……