中西醫結合談談腸道菌群 (Intestinal flora) The Intestinal Flora with Traditional Medicine

【Dr. Jennifer Chou中醫專欄】

這個腸道菌群得主題，在這兩年可是個熱門研究，因此有了十分蓬勃的研究成果。我用中西醫結合的方式來介紹中醫對腸道菌群失調的簡單因應。

先來簡單看看西醫對腸道益生菌群的認知。

腸道菌群，指的是分佈在小腸和大腸的菌叢。

小腸是有氧環境，大腸是厭氧環境，所以兩邊的菌叢分佈不太一樣，其中大腸的腸道菌數量最多。

在有氧環境的小腸，有種兼厭氧的乳酸杆菌(Lactobacillus)數量與分佈都較大。

在厭氧環境的大腸，專性厭氧的雙歧杆菌(Bifidobacterium)大多生存於此。

乳酸杆菌和雙歧杆菌除了占有腸道益生菌群的絕大多數，也可同時橫跨大小腸生存，在不同腸道發生不同的功能。這兩種也是有名的腸道益生菌群。

一般人快速改善腸道菌群問題的方法，大多服用益生菌。

另外可在服用益生菌前，加服蒙脫石散 (Diosmectite) 先將有害病原體吸收後排出。

中醫沒有腸道益生菌群這種術語。

中醫對腸道菌群的認知，是以其腸道環境的生態紊亂來看的。這其實有許多耳熟能詳的證型，例如脾虛證，濕熱證等都是一般人常聽但沒有懂的中醫術語。這些以症狀的表現來觀察內臟原理的證型，表達了中醫以腸道環境的生態紊亂造成的證象，做為用來治療的觀察。其中在研究論文中最常見證型，是脾虛證和胃腸濕熱證。

先來看看脾虛證，脾虛證患者有泄瀉，便溏、腹瀉等症狀。研究發現這類患者糞便中雙歧桿菌明顯減少，用參苓白朮散可改善便溏、腹瀉等症狀裡雙歧桿菌減少的情況。四君子湯及理中湯也可增加腸道菌群的多樣性及益生菌數量。

另外胃腸濕熱證，燔灼迫急, 易傷津耗氣. 腸桿菌屬、腸球菌屬、梭菌屬等條件致病菌過度增長,而雙歧桿菌屬、乳桿菌屬等益生菌的含量受濕熱發病機制影響出現含量的差異。中醫用四磨湯對脾虛便秘型進行治療研究, 許多研究結果顯示四磨湯對於雙歧桿菌的增殖有一定的促進作用, 而對大腸埃希菌較明顯的抑製作用。

由此可知，中藥在改善腸道益生菌也是很有精準的針對性，例如參苓白朮散可增加因為雙歧桿菌減少時產生的便溏、腹瀉情況。例如同樣是增加雙歧桿菌的減少，但四磨湯卻用在雙歧桿菌的減少的脾虛便秘的情況。

中西醫對腸道益生菌都有很好的實證辦法應對。（By Dr. Jennifer Chou，想知道更多相關信息請聯繫Dr. Jennifer Chou：電話: 602-775-9406 ）

This intestinal flora subject has been a hot research topic in the past two years, so there are very vigorous research results.

I use traditional medicine to introduce the intestinal flora imbalance.

Let's first take a brief look at Western medicine's understanding of intestinal probiotic flora. Intestinal flora refers to the flora distributed in the small and large intestines.

The small intestine is an aerobic environment. The large intestine is an anaerobic environment, so the flora's distribution on both sides is different, and the large intestine has the most intestinal bacteria. In the small intestine's aerobic environment, there are many and distribution of Lactobacillus, also anaerobic species. In the anaerobic environment of the large intestine, most obligate anaerobic Bifidobacterium (Bifidobacterium) live here. Lactobacillus and bifidobacteria are not only occupying the vast majority of the intestinal probiotic flora, but they can also live across the large and small intestines simultaneously and have different functions in different intestines area. These two are also well-known intestinal probiotics.

Most people use probiotics to improve their intestinal flora unbalance problems quickly.

Besides, before taking probiotics, adding Diosmectite to absorb harmful pathogens and then excreting them would be a good idea.

Traditional medicine does not have the term intestinal probiotics.

Traditional medicine's understanding of intestinal flora is based on the ecological disorder of the intestinal environment. Many familiar and well-known syndrome types, such as spleen deficiency syndrome, damp-heat syndrome, etc., are commonly heard but not understood by ordinary people. These syndromes that observe the internal organs' principle based on symptoms express the syndromes caused by the ecological disturbance of traditional medicine's intestinal environment and use as observations for treatment. The most common syndrome types in research papers are spleen deficiency syndrome and gastrointestinal damp-heat syndrome.

Let's first look at the syndrome of spleen deficiency. Patients with spleen deficiency syndrome have symptoms such as loose stools and diarrhea. Studies have found that the bifidobacteria in such patients' feces are significantly reduced. The use of Shenlingbaizhu powder can improve the reduction of bifidobacteria in symptoms such as loose stools and diarrhea. Sijunzi Tang and Lizhong Tang can also increase the diversity of intestinal flora and the number of probiotics.

As a gastrointestinal damp-heat syndrome, which has burning urgency that easily damages body fluid and biochemical function, it also shows conditional pathogenic bacteria such as Enterobacter, Enterococcus, and Clostridium overgrowth. Further, the content of probiotics, such as Bifidobacterium and Lactobacillus, is affected by the pathogenesis of damp heat. The pathogenesis of damp-heat involves the difference in content. In traditional medicine, Simo Tang is used to treating spleen-deficiency constipation. Many research studies show that Simo Tang can promote bifidobacteria proliferation but significantly inhibits Escherichia coli.

It can be seen that traditional medicine is also exact and targeted in improving intestinal probiotics. For example, the decrease of bifidobacteria can cause loose stools and diarrhea. Shenlingbaizhu powder can increase bifidobacteria. For example, the same is true when there is a decrease in bifidobacteria, but it causes spleen deficiency constipation. We can use Simo Tang to increase bifidobacteria.

As long as they are mastering adequately, both Traditional and Western medicine have acceptable empirical methods to manage intestinal probiotics. （By Dr. Jennifer Chou， get more information please contact Dr. Jennifer Chou： 602-775-9406 ）