Exploring the relationship between intestinal flora and postmenopausal osteoporosis based on the theory of "earth restricting water"

LI Tongtong; MA Weiwei; XIONG Yong; ZHOU Guangwen; WEN Feng

doi:10.3969/j.issn.1006-2157.2023.10.007

您当前的位置：

首页 >

文章列表页 >

Exploring the relationship between intestinal flora and postmenopausal osteoporosis based on the theory of "earth restricting water"

Theoretical Studies | 更新时间：2023-11-06

- Exploring the relationship between intestinal flora and postmenopausal osteoporosis based on the theory of "earth restricting water"
- Journal of Beijing University of Traditional Chinese Medicine Vol. 46, Issue 10, Pages: 1367-1373(2023)
- 作者机构：
  
  1.湖北中医药大学针灸骨伤学院　武汉　430061
  2.湖北中医药大学附属医院
- 作者简介：
  
  A/Prof. XIONG Yong, Ph.D., Associate Physician, Master’s Supervisor. School of Acupuncture-Moxibustion and Orthopedics, Hubei University of Chinese Medicine, No.188, Tanhualin, Wuchang District, Wuhan 430061. E-mail: xiongyong1978@163.com
- 基金信息：
  
  National Natural Science Foundation of China(81904267);Scientific Research Plan Guiding Project of Hubei Provincial Department of Education in 2022(B2022107);Traditional Chinese Medicine Scientific Research Project of Hubei Provincial Administration of Traditional Chinese Medicine in 2023-2024(ZY2023Q005)
- DOI：10.3969/j.issn.1006-2157.2023.10.007
  CLC： R271.9
- Received：16 April 2023，
  
  Online First：14 August 2023，
  
  Published：30 October 2023
- 稿件说明：
移动端阅览
LI Tongtong, MA Weiwei, XIONG Yong, et al. Exploring the relationship between intestinal flora and postmenopausal osteoporosis based on the theory of "earth restricting water"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(10): 1367-1373.
DOI：

LI Tongtong, MA Weiwei, XIONG Yong, et al. Exploring the relationship between intestinal flora and postmenopausal osteoporosis based on the theory of "earth restricting water"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(10): 1367-1373. DOI： 10.3969/j.issn.1006-2157.2023.10.007.

摘要

绝经后骨质疏松症是一种女性在绝经期后发生的骨代谢疾病，中医学将其归属为“骨痿”“骨蚀”等范畴。近年来，绝经后骨质疏松症与肠道菌群关联的研究逐渐深入。本文以中医学五行生克思想为基础，引用李东垣《脾胃论》中的“脾病则下流乘肾，土克水，则骨乏无力，是为骨蚀”观点，提出“土克水”致痿的理论。基于该理论基础，本文探讨脾虚、肾虚、痰浊三者在绝经后骨质疏松症病理过程中所起的作用，并阐释肠道菌群在其中的媒介角色。由此提出“脾土－肠道菌群－肾水－绝经后骨质疏松症”完整治疗链，为临床治疗绝经后骨质疏松症提供新的思路。

Abstract

Postmenopausal osteoporosis is a bone metabolism disease that occurs in women after menopause and is categorized in Chinese medicine as "bone flaccidity" and "bone erosion". In recent years

postmenopausal osteoporosis has been closely associated with studies on intestinal flora. Based on the generating-restricting relationship between the five elements in Chinese medicine and LI Dongyuan’s view that "when the spleen is sick

water-dampness flows downward to the kidney

and when the earth restricts water

the bones become weak and feeble

resulting in bone erosion" in

Piwei Lun

this article puts forward the theory that "earth restricting water" causes flaccidity. Building upon this theoretical foundation

we explore the roles of spleen deficiency

kidney deficiency

and phlegm turbidity in the pathologic process of postmenopausal osteoporosis

while highlighting the role of intestinal flora as a mediator in this process. We propose a comprehensive therapeutic approach involving the interplay of "spleen earth-intestinal flora-kidney water-postmenopausal osteoporosis"

which offers a new perspective for the clinical treatment of postmenopausal osteoporosis.

关键词

Keywords

references

ARCEO-MENDOZA RM , CAMACHO PM . Postmenopausal osteoporosis: latest guidelines [J]. Endocrinol Metab Clin North Am , 2021 , 50 ( 2 ): 167 － 178 .

WANG LH , YU W , YIN XJ , et al . Prevalence of osteoporosis and fracture in China: The China osteoporosis prevalence study [J/OL]. JAMA Netw Open , 2021 , 4 ( 8 ): e2121106 [ 2023－04－10 ]. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783043 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783043 .

中华医学会骨质疏松和骨矿盐疾病分会 . 原发性骨质疏松症诊疗指南(2022) [J]. 中华骨质疏松和骨矿盐疾病杂志， 2022 ， 15 ( 6 )： 573 － 611 .

盛彤，谢培凤，王新祥．原发性骨质疏松症从脾论治及相关机制探讨 [J]. 中华中医药杂志， 2012 ， 27 ( 7 )： 1922 － 1926 .

HANSEN MS , FROST M . Alliances of the gut and bone axis [J]. Semin Cell Dev Biol , 2022 , 123 : 74 － 81 .

D’AMELIO P , SASSI F . Gut Microbiota, Immune System, and Bone [J]. Calcif Tissue Int , 2018 , 102 : 415 － 425 .

CANO A , CHEDRAUI P , GOULIS DG , et al . Calcium in the prevention of postmenopausal osteoporosis: EMAS clinical guide [J]. Maturitas , 2018 , 107 : 7 － 12 .

JANSSON PA , CURIAC D , AHRÉN IL , et al . Probiotic treatment using a mix of three Lactobacillus strains for lumbar spine bone loss in postmenopausal women: a randomised, double-blind, placebo-controlled, multicentre trial [J]. Lancet Rheumatol , 2019 , 1 ( 3 ): 154 － 162 .

ZHANG YW , CAO MM , LI YJ , et al . Fecal microbiota transplantation as a promising treatment option for osteoporosis [J]. J Bone Miner Metab , 2022 , 40 ( 6 )： 874 － 889 .

劳泽辉，黄智斌，彭俊祥．从“土克水”角度认识“骨痿” [J]. 中国骨质疏松杂志， 2021 ， 27 ( 4 )： 609 － 612 .

金子开，郭子为，孙萌，等．朱丹溪痿证诊疗思路探微 [J]. 中国中医基础医学杂志， 2021 ， 27 ( 3 )： 386 － 388 .

沈正寅，倪晶，张弘菁，等． “骨肉不相亲”理论发微及其对中医治疗PMOP的指导作用探析 [J]. 中国骨质疏松杂志， 2021 ， 27 ( 9 )： 1366 － 1368 .

RYAN MJ , SCHLOTER M , BERG G , et al . Development of microbiome biobanks-challenges and opportunities [J]. Trends Microbiol , 2021 , 29 ( 2 ): 89 － 92 .

SEELY KD , KOTELKO CA , DOUGLAS H , et al . The human gut microbiota: a key mediator of osteoporosis and osteogenesis [J/OL]. Int J Mol Sci , 2021 , 22 ( 17 ): 9452 [ 2023－04－10 ]. https://www.mdpi.com/1422-0067/22/17/9452 https://www.mdpi.com/1422-0067/22/17/9452 .

AWUTI K , WANG XK , SHA LQ , et al . Exploring the regulatory mechanism of osteoporosis based on intestinal flora: A review [J/OL]. Medicine (Baltimore) , 2022 , 101 ( 52 ): e32499 [ 2023－04－10 ]. https://journals.lww.com/md-journal/Fulltext/2022/12300/Exploring_the_regulatory_mechanism_of_osteoporosis.35.aspx https://journals.lww.com/md-journal/Fulltext/2022/12300/Exploring_the_regulatory_mechanism_of_osteoporosis.35.aspx .

SCHEPPER JD , COLLINS FL , RIOS-ARCE ND , et al . Probiotic Lactobacillus reuteri prevents postantibiotic bone loss by reducing intestinal dysbiosis and preventing barrier disruption [J]. J Bone Miner Res , 2019 , 34 ( 4 )： 681 － 698 .

XU ZM , XIE Z , SUN JG , et al . Gut microbiome reveals specific dysbiosis in primary osteoporosis [J/OL]. Front Cell Infect Microbiol , 2020 , 10 : 160 [ 2023－04－10 ]. https://www.frontiersin.org/articles/10.3389/fcimb.2020.00160/full https://www.frontiersin.org/articles/10.3389/fcimb.2020.00160/full .

HUANG F , WONG P , LI JL , et al . Osteoimmunology: The correlation between osteoclasts and the Th17/Treg balance in osteoporosis [J]. J Cell Mol Med , 2022 , 26 ( 13 ): 3591 － 3597 .

SUN P , ZHANG CT , HUANG YM , et al . Jiangu granule ameliorated OVX rats bone loss by modulating gut microbiota-SCFAs-Treg/Th17 axis [J/OL]. Biomed Pharmacother , 2022 , 150 : 112975 [ 2023－04－10 ]. https://www.sciencedirect.com/science/article/pii/S075333222200364X https://www.sciencedirect.com/science/article/pii/S075333222200364X .

杨洲，高静媛，田发明． Wnt信号通路在骨稳态中的作用 [J]. 中国骨质疏松杂志， 2022 ， 28 ( 1 )： 109 － 113 .

BENNEDSEN ALB , FURBO S , BJARNSHOLT T , et al . The gut microbiota can orchestrate the signaling pathways in colorectal cancer [J]. APMIS , 2022 , 130 ( 3 ): 121 － 139 .

刘雷蕾，孟静岩．从中医基础理论角度认识肠道微生态 [J]. 北京中医药大学学报， 2016 ， 39 ( 9 )： 724 － 727 .

郭文茜，王琦，郭刚，等．基于人体肠道菌群探讨“脾为后天之本” [J]. 中华中医药杂志， 2021 ， 36 ( 9 )： 5165 － 5168 .

WEAVER CM , MARTIN BR , STORY JA , et al . Novel fibers increase bone calcium content and strength beyond efficiency of large intestine fermentation [J]. J Agric Food Chem , 2010 , 58 ( 16 ): 8952 － 8957 .

LI B , LIU MY , WANG Y , et al . Puerarin improves the bone micro-environment to inhibit OVX-induced osteoporosis via modulating SCFAs released by the gut microbiota and repairing intestinal mucosal integrity [J/OL]. Biomed Pharmacother , 2020 , 132 : 110923 [ 2023－04－10 ]. https://www.sciencedirect.com/science/article/pii/S075333222031115X?via%3Dihub https://www.sciencedirect.com/science/article/pii/S075333222031115X?via%3Dihub .

邓洋洋，吕爱平，郑洪新，等．基于“生长壮老取决于肾”理论对健康人群神经－内分泌－免疫网络相关指标变化趋势的研究 [J]. 中华中医药杂志， 2021 ， 36 ( 8 )： 4591 － 4594 .

吉媛媛，霍丽静，任路平．绝经后妇女骨质疏松症的管理：北美绝经协会2021年立场声明解读 [J]. 中国骨质疏松杂志， 2022 ， 28 ( 8 )： 1232 － 1237 .

GUO X , ZHONG K , ZHANG JH , et al . Gut microbiota can affect bone quality by regulating serum estrogen levels [J]. Am J Transl Res , 2022 , 14 ( 9 ): 6043 － 6055 .

TANG XY , GAO MX , XIAO HH , et al . Effects of Xian-Ling-Gu-Bao capsule on the gut microbiota in ovariectomized rats: Metabolism and modulation [J/OL]. J Chromatogr B Analyt Technol Biomed Life Sci , 2021 , 1176 : 122771 [ 2023－04－10 ]. https://www.sciencedirect.com/science/article/pii/S157002322100252X?via%3Dihub https://www.sciencedirect.com/science/article/pii/S157002322100252X?via%3Dihub .

XIE H , HUA ZY , GUO MY , et al . Gut microbiota and metabonomics used to explore the mechanism of Qing’e Pills in alleviating osteoporosis [J]. Pharm Biol , 2022 , 60 ( 1 ): 785 － 800 .

廖荣臻，陈德骏，何敏聪，等．老年性骨质疏松症中医证型与脂代谢中细胞外信号调节激酶的相关性 [J]. 中国组织工程研究， 2022 ， 26 ( 29 )： 4704 － 4708 .

WANG B , WANG H , LI YC , et al . Lipid metabolism within the bone micro-environment is closely associated with bone metabolism in physiological and pathophysiological stages [J/OL]. Lipids Health Dis , 2022 , 21 ( 1 ): 5 [ 2023－04－10 ]. https://lipidworld.biomedcentral.com/articles/10.1186/s12944-021-01615-5 https://lipidworld.biomedcentral.com/articles/10.1186/s12944-021-01615-5 .

VÄRRI M , NISKANEN L , TUOMAINEN T , et al . Association of adipokines and estradiol with bone and carotid calcifications in postmenopausal women [J]. Climacteric , 2016 , 19 ( 2 ): 204 － 211 .

LUO W , ZHANG J , XU L , et al . Use of zoledronic acid in antiosteoporosis treatment is associated with a decreased blood lipid level in postmenopausal women with osteoporosis: a cohort study in China [J]. Postgrad Med , 2022 , 134 ( 4 ): 406 － 412 .

HSU JJ , LU JX , UMAR S , et al . Effects of teriparatide on morphology of aortic calcification in aged hyperlipidemic mice [J]. Am J Physiol Heart Circ Physiol , 2018 , 314 ( 6 ): 1203 － 1213 .

VALLIANOU N , STRATIGOU T , CHRISTODOULATOS GS , et al . Understanding the role of the gut microbiome and microbial metabolites in obesity and obesity-associated metabolic disorders: current evidence and perspectives [J]. Curr Obes Rep , 2019 , 8 ( 3 ): 317 － 332 .

林翔英，许若缨，郑榕，等．基于气机升降理论探讨脾胃湿热证与肠道微生态关系 [J]. 中国中医药信息杂志， 2021 ， 28 ( 7 )： 17 － 20 .

徐萌，岳仁宋，杨茂艺，等．半夏泻心汤对糖尿病胃轻瘫大鼠肠道菌群及炎症因子的影响 [J]. 中草药， 2018 ， 49 ( 13 )： 3056 － 3061 .

连秋华，朱惠萍，梁国强，等．健脾合剂对脾虚腹泻型肠易激综合征小鼠肠道菌群的干预研究 [J]. 世界科学技术—中医药现代化， 2020 ， 22 ( 3 )： 770 － 780 .

黄文武，彭颖，王梦月，等．四君子汤及其单味药水煎液对脾虚大鼠肠道菌群的调节作用 [J]. 中国实验方剂学杂志， 2019 ， 25 ( 11 )： 8 － 15 .

谷巍，孙明杰，王丽荣，等 . 4味常见中药对免疫抑制小鼠免疫功能及肠道菌群的影响 [J]. 中国畜牧兽医， 2019 ， 46 ( 1 )： 147 － 156 .

CHEVALIER C , KIESER S , ÇOLAKOČLU M , et al . Warmth prevents bone loss through the gut microbiota [J]. Cell Metab , 2020 , 32 ( 4 ): 575 － 590 .

李鸿泓，于峥，赵宏艳，等． “脾肾相关”机理探讨补肾健脾方对脾肾两虚型骨质疏松症大鼠外周血中OPG、RANKL、VIP、MTL、GAS含量的影响 [J]. 中国中医基础医学杂志， 2014 ， 20 ( 12 )： 1628 － 1631 .

朱伟 . 补肾化痰方治疗绝经后骨质疏松的临床疗效及其作用机制研究 [D]. 武汉：武汉大学， 2020 .

张妍，熊勇，周广文，等．补肾化痰方对去势骨质疏松大鼠雌激素及其骨组织ERα、ERβ的影响 [J]. 时珍国医国药， 2022 ， 33 ( 10 )： 2317 － 2320 .

LU YM , XIE JJ , PENG CG , et al . Enhancing clinical efficacy through the gut microbiota: a new field of traditional Chinese medicine [J]. Engineering , 2019 , 5 ( 1 )： 40 － 49 .

周广文，向楠，张妍，等．高通量测序研究补肾化痰方对去势骨质疏松大鼠肠道菌群结构与多样性的影响 [J]. 中华中医药杂志， 2019 ， 34 ( 7 )： 3305 － 3310 .

Views

460

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Managing atopic dermatitis through the perspectives of "clear-turbid interference" and the "gut-skin axis"

Treatment of allergic rhinitis based on the theory of " spleen and stomach deficiency and excess transformation"

Exploring the effects of "liver-smoothing and spirit-regulating" acupuncture on intestinal flora, lipopolysaccharide, and hippocampal TLR4/NF-κB signaling pathway in depressive disorder mice based on the gut-brain axis

Mechanism of Huogu Muli Prescription in regulating the osteoclast-osteogenesis balance in postmenopausal osteoporosis rats

Exploring the characteristics of six climatic exopathogens causing intestinal flora dysregulation based on etiological theory

Related Author

ZHAO Shengxuan

TANG Yang

LI Rongxin

CUI Wantong

ZHENG Fengjie

ZHAO Yuechun

GUO Hong

CHEN Dian

Related Institution

北京中医药大学中医学院北京 100029School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China

Chongqing Hospital of Traditional Chinese Medicine

Xiyuan Hospital, China Academy of Chinese Medical Sciences

The Second Affiliated Hospital of Guangzhou University of Chinese Medicine

Seventh Clinical Medical College of Guangzhou University of Chinese Medicine

AI问答

Postal code：100029
Tel：(010)53911857 Email：jbutcm@bucm.edu.cn
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰