缺血性心脏病作为心力衰竭的主要病因,具有患病人数多,再入院率和死亡率高的特点。近期研究发现,肠道菌群在心血管发病因素中发挥着重要的作用,肠道菌群失调时,肠道屏障功能发生障碍、肠道内有害菌如肠杆菌门、志贺氏菌和变形菌数量增加,厚壁菌门和乳酸杆菌门丰度减少,肠道内脂多糖、肿瘤坏死因子、干扰素γ增加,短链脂肪酸、白介素-10减少,加剧了全身炎症状态,可提高缺血性心肌病的发病率。因此重视肠道菌群在缺血性心肌病中的作用,通过及时调节肠道菌群,在心衰前期减少危险因素或在患心衰后防止病变加重,提高生活质量,这与中医“治未病”中未病先防,已病防传思想不谋而合,本文将从“治未病”角度探讨重视肠道菌群对缺血性心肌病的价值。As the main cause of heart failure, ischemic heart disease is characterized by a large number of patients, high readmission rates and high mortality. Recent studies have found that intestinal flora plays an important role in cardiovascular pathogenesis. When intestinal flora is disturbed, intestinal barrier function is impaired, the number of intestinal harmful bacteria such as Enterobacteria, Shigella and Proteobacteria increases, the abundance of firmicutes and Lactobacilli decreases, and intestinal lipopolysaccharides, tumor necrosis factor and interferon γ increase. The decrease of short-chain fatty acids and interleukin-10 can aggravate the systemic inflammatory state and increase the incidence of ischemic cardiomyopathy. Therefore, to pay attention to the role of intestinal flora in ischemic cardiomyopathy, through timely regulation of intestinal flora, reduce risk factors in the early stage of heart failure or prevent disease aggravation after heart failure, and improve the quality of life, which coincides with the idea of preventing disease before disease and preventing disease after disease in traditional Chinese medicine. This paper will discuss the value of paying attention to intestinal flora in ischemic cardiomyopathy from the perspective of “treating disease without disease”.
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