调控肠道平滑肌中线粒体改善阳虚型便秘的研究进展

The research progress on regulating mitochondria in intestinal smooth muscle to improve yang deficiency-related constipation

关键词:  线粒体  肠道平滑肌  阳虚  氧化应激  ATP合成  钙稳态

Key words:  mitochondria  intestinal smooth muscle  yang deficiency  oxidative stress  ATP synthesis  calcium homeostasis

摘要:

慢性便秘是常见的功能性胃肠疾病，而肠道平滑肌功能障碍在慢性便秘的发生和发展中发挥核心作用，与线粒体功能障碍密切相关。研究证明，线粒体在肠道平滑肌细胞的能量代谢、钙离子调控、氧化还原平衡等方面扮演着至关重要的角色。当线粒体功能受损时，肠道平滑肌的收缩、舒张节律性受到抑制，导致肠道动力异常，加剧便秘症状。阳虚型便秘作为慢性便秘的一种常见类型，其病因在中医理论中归因于阳气不足，导致脏腑功能衰退。研究显示，阳虚与线粒体功能障碍之间存在密切的生物学联系，温阳类中药可以通过调控线粒体功能，多通路、多靶点改善肠道平滑肌动力状态。文章综述了如何通过调控肠道平滑肌内线粒体的能量生成、维持钙稳态与活性氧平衡等功能影响肠道平滑肌生理状态，并探讨了中医温阳疗法通过调节线粒体功能改善阳虚型便秘的潜力。文章旨在通过整合中医理论与现代分子机制，为未来的阳虚型便秘临床研究与个性化治疗方案提供新的理论依据及研究视角。

Abstract:

Chronic constipation is a common functional gastrointestinal disorder，with intestinal smooth muscle dysfunction playing a central role in its onset and progression. The dysfunction is closely associated with mitochondrial impairment. Mitochondria are critical for energy metabolism，calcium ion regulation，and redox balance in intestinal smooth muscle cells. When mitochondrial function is compromised，the rhythmic contraction and relaxation of intestinal smooth muscle are disrupted，leading to abnormal gastrointestinal motility and aggravated constipation symptoms. Yang deficiency constipation，a prevalent subtype of chronic constipation in traditional Chinese medicine（TCM），is attributed to insufficient yang qi，resulting in impaired organ function. Increasing evidence suggests a strong biological link between yang deficiency and mitochondrial dysfunction. TCM formulations that warm yang have been shown to enhance intestinal motility by modulating mitochondrial function through multiple pathways and targets. The review explores how the regulation of mitochondrial energy production，calcium homeostasis，and reactive oxygen species（ROS） balance affects the physiological state of intestinal smooth muscle. It further investigates the therapeutic potential of yang-warming TCM interventions in alleviating yang deficiency-related constipation via mitochondrial modulation. By integrating TCM theory with modern molecular mechanisms，this article aims to offer new theoretical foundations and perspectives for future clinical research and individualized treatment strategies for yang deficiency-related constipation.