Yu Donglin, Shen Junxi, Li Liwen, Long Qi, Xie Shiqin, Zhou Mengsi, Tian Qianghong, Cai Ying
College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China.
Front Cell Infect Microbiol. 2025 Jan 10;14:1523708. doi: 10.3389/fcimb.2024.1523708. eCollection 2024.
Treatment methods in traditional Chinese medicine (TCM) are foundational to their theoretical, methodological, formulaic, and pharmacological systems, significantly contributing to syndrome differentiation and therapy. The principle of "promoting urination to regulate bowel movements" is a common therapeutic approach in TCM. The core concept is "promoting the dispersion and drainage of water dampness, regulating urination to relieve diarrhea," yet its scientific underpinning remains unclear. Modern medical treatment for watery diarrhea primarily focuses on electrolyte replenishment, as diuretics may lead to dehydration and other side effects. Some reports suggest that this TCM approach lacks scientific validity. Microecology, an area associated with the origins of TCM, is closely related to the development, diagnosis, and treatment of diarrhea. The renal-intestinal axis offers a molecular biological basis for examining associated pathological mechanisms, advancing therapeutic targets such as "treating the intestine to address kidney issues" and highlighting the interactions within the "renal-intestinal microbiota-liquid metabolism" framework, thus providing an endogenous mechanism to support "treating the intestine through the kidney." An increasing number of studies have shown that the intestinal microbiota and its metabolites, as unique mediators, are involved in the physiological and pathological changes of the body. Therefore, this study explores the relationship between fluid metabolism and diarrhea from the perspective of the intestinal microbiota and its metabolites, aiming to elucidate the biological mechanisms underlying the "promoting urination to regulate bowel movements" therapeutic approach and to clarify the scientific basis for treating diarrhea via the renal-intestinal axis. This research provides new insights for the study of TCM microbiology.
中医治疗方法是其理论、方法、方剂和药理体系的基础，对辨证论治有重要作用。“利小便以实大便”原则是中医常用的治疗方法。其核心概念是“促进水湿的散布与排泄，通利小便以止泻”，但其科学依据尚不清楚。现代医学对水样腹泻的治疗主要集中在补充电解质，因为利尿剂可能导致脱水等副作用。一些报告表明这种中医方法缺乏科学依据。微生态学与中医起源相关，与腹泻的发生、诊断和治疗密切相关。肾 - 肠轴为研究相关病理机制提供了分子生物学基础，推进了“治肠以治肾”等治疗靶点，突出了“肾 - 肠微生物群 - 液体代谢”框架内的相互作用，从而为“从肾治肠”提供了内在机制。越来越多的研究表明，肠道微生物群及其代谢产物作为独特的介质，参与了机体的生理和病理变化。因此，本研究从肠道微生物群及其代谢产物的角度探讨液体代谢与腹泻的关系，旨在阐明“利小便以实大便”治疗方法的生物学机制，并阐明通过肾 - 肠轴治疗腹泻的科学依据。本研究为中医微生物学研究提供了新的见解。
