International Journal of Frontiers in Medicine, 2023, 5(6); doi: 10.25236/IJFM.2023.050619.
Bairong Wang1, Xuebin Chen2, Danyang Hao1
1Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
2Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712000, China
"The heart and the small intestine are in sympathy with each other" is one of the classical theories in Chinese medicine, which believes that the heart and the small intestine are in sympathy with each other, and the internal organs are in sympathy with each other, with physiological correlation and pathological correlation, therefore, in terms of treatment, there are methods to treat the internal organs for diseases of the organs, to treat the internal organs for diseases of the organs, and to treat the internal organs together. This theory is in line with the modern medical research that hypertension is related to the intestinal flora. It is found that the occurrence of hypertension will cause changes in the structure, diversity and richness of the intestinal flora, and similarly, the metabolites produced by the intestinal flora will in turn affect the development of hypertension. Therefore, this article intends to discuss the TCM connotation of "the heart and small intestine are in harmony with each other", the TCM etiology and pathogenesis of hypertension, and the relationship between hypertension and intestinal flora, in order to provide new ideas for the regulation of intestinal flora in TCM to prevent and treat hypertension.
Heart and small intestine; Hypertension; Intestinal flora; Chinese medicine
Bairong Wang, Xuebin Chen, Danyang Hao. The Exploration of the Relationship between Intestinal Flora and Hypertension based on "heart and small intestine". International Journal of Frontiers in Medicine (2023), Vol. 5, Issue 6: 124-131. https://doi.org/10.25236/IJFM.2023.050619.
[1] Ma Liyuan, Wang Zengwu, Fan Jing, Hu Shengshou. Epidemiology and Management of Hypertension in China:an Analysis Using Data from the Annual Report on Cardiovascular Health and Diseases in China(2021) [J]. China General Practice, 2022, 25(30):3715-3720.
[2] Zhu Wei, Fan Jingyang, Xue Qingjie, et al. Progress of research on human intestinal flora and hypertension [J]. Chinese Journal of Microecology, 2021, 33(09):1109-1121.
[3] Liu Yanwei, Liu Zhongyong. To explore the relationship between intestinal flora and coronary heart disease based on the theory of “Interior and Exterior of Heart and Intestine”[J]. Lishizhen Medicine and Materia Medica Research, 2018, 29(11):154-156.
[4] Chen Jianfei, Wang Ming, Wang Shumei. Interpretation of“Interior and Exterior of Heart and Intestine”Based on the“Gut Heart Axis”[J]. Journal of Liaoning University of Traditional Chinese Medicine, 2022, 24(03):143-147.
[5] Guo Zongyao, Liu Yun, Gao Yuping, et al. Origin and Development of the Theory of “the Heart and the Small Intestine Sharing a Paired Relationship”[J]. Journal of Traditional Chinese Medicine, 2018, 58(02):96-99.
[6] Yang Wenqian. Study on the theory of "Heart and Small Intestine" based on infrared thermography [D]. Jiangxi University of Traditional Chinese Medicine, 2022:34-35.
[7] Sun Weiming, Jiao Xiaomin. Research Progress on Name, Etiology and Pathogenesis of Hypertension in Traditional Chinese Medicine [J]. Journal of Practical Traditional Chinese Internal Medicine, 2021, 35(01):101-105.
[8] Yuan Peng, Qi Xin, Liu Yue. Exploring the relationship between hypertension and intestinal flora from the theory of Yingwei[J]. Hunan Journal of Traditional Chinese Medicine, 2022, 38(09):114-118.
[9] He Yanhu, Jin Hua, Liu Zhijun, et al. Discussion on Correlation Between Spleen-intestine-bacteria and Hypertension Based on the Theory of“Communication Between Spleen and Small Intestine”[J]. Chinese Journal of Information on Traditional Chinese Medicine, 2022, 29(08):1-5.
[10] Zverev AА, Leonov NV, Аnikina ТА, et al. Vasoactive Intestinal Peptide Changes the Frequency and Force of Myocardial Contraction in Rats[J]. Bulletin of experimental biology and medicine, 2020, 169(6): 787-790.
[11] He Shun, Kahles Florian, Rattik Sara, et al. Gut intraepithelial T cells calibrate metabolism and accelerate cardiovascular disease[J]. Nature, 2019, 566:115-119.
[12] Liu Sheng, Yang Guowang, Wang Xiaomin. Analysis of "Heart and Small Intestine Exterior-Interior" [J]. China Journal of Chinese Medicine, 2015, 30(03):376-377.
[13] Sender R, Fuchs S, Milo R. Revised estimates for the number of human and bacteria cells in the body [J]. PLoS Biology, 2016, 14(8):e1002533.
[14] Lozupone C A, Stombaugh J I, Gordon J I, et al. Diversity, stability and resilience of the human gut microbiota[J]. Nature, 2012, 489(7415):221-223.
[15] Rahman MM, Islam F, Or-Rashid MH, et al. The Gut Microbiota (Microbiome) in Cardiovascular Disease and Its Therapeutic Regulation[J]. Front Cell Infect Microbiol, 2022, 12:903570.
[16] M. M. Santisteban, Qi Yanfei, J. Zubcevic, et al. Hypertension-linked pathophysiological alterations in the gut[J]. Circulation Research, 2017, 120(2):312-323.
[17] Shreiner A B, Kao J Y, Young V B. The gut microbiome in health and in disease[J]. Curr Opin Gastroen, 2015, 31(1):69-75.
[18] Hills RD Jr, Pontefract BA, Mishcon HR, et al. Gut Microbiome: Profound Implications for Diet and Disease[J]. Nutrients, 2019, 11(7):1613.
[19] Yang T, Santisteban MM, Rodriguez V, et al. Gut dysbiosis is linked to hypertension[J]. Hypertension (Dallas, Tex.: 1979) 2015, 65(6):1331-1340.
[20] Li Jing, Zhao Fangqing, Wang Yidan, et al. Gut microbiota dysbiosis contributes to the development of hypertension[J]. Microbiome, 2017, 5(1): 14.
[21] Buford TW, Sun Y, Roberts LM, et al. Angiotensin (1-7) delivered orally via probiotic, but not subcutaneously, benefits the gut-brain axis in older rats [J]. Geroscience, 2020, 42(5):1307-1321.
[22] Richards Elaine M, Li Jing, Stevens Bruce R, et al. Gut Microbiome and Neuroinflammation in Hypertension [J] . Circulation Research, 2022, 130(3):401-417.
[23] Yang F, Chen H, Gao Y, et al. Gut microbiota-derived short-chain fatty acids and hypertension: Mechanism and treatment [J]. Biomed Pharmacother, 2020, 130:110503.
[24] Robles-Vera I, Toral M, Visitación N, et al. Protective effects of short-chain fatty acids on endothelial dysfunction induced by angiotensin Ⅱ[J]. Frontiers in physiology, 2020, 11:277.
[25] Bartolomaeus H, Balogh A, Yakoub M, et al. Short-Chain Fatty Acid Propionate Protects From Hypertensive Cardiovascular Damage[J]. Circulation. 2019; 139(11): 1407-1421.
[26] Cook Katherine L., Chappell Mark C. Gut dysbiosis and hypertension: is it cause or effect? [J]. Journal of Hypertension, 2021, 39(9).
[27] M. Onyszkiewicz, M. Gawrys-Kopczynska, P. Konopelski, et al. Butyric acid, a gut bacteria metabolite, lowers arterial blood pressure via colon-vagus nerve signaling and GPR41/43 receptors[J]. Pflugers Archiv: European journal of physiology, 2019, 471(11-12): 1441-1453.
[28] Ge X, Zheng L, Zhuang R, et al. The gut microbialmetabolite trimethylamine N-oxide and hypertension risk: asystematic review and dose-response Meta- AdvNutr, 2020, 11(1):66-76.
[29] Jiang Shan, Shui Yongjie, et al. Gut microbiota dependent trimethylamine N-oxide aggravates angiotensin II-induced hypertension [J]. Redox Biol, 2021, 46:102115.
[30] Yilang Ke, Dang Li, Mingming Zhao, et al. Gut flora-dependent metabolite Trimethylamine -N-oxide accelerates endothelial cell senescence and vascular aging through oxidative stress [J]. Free Radical Biology and Medicine, 2018, 116:88-100.
[31] Richards EM, Pepine CJ, Raizada MK, et al. Gut Microbiome, Sympathetic Nervous System, and Hypertension [J]. Curr Hypertens Rep, 2017, 19(4):36.
[32] Zhu Jiayuan, Zheng Tao, Yang Yong, et al. Research progress on the relationship between intestinal flora and its metabolites and hypertension[J]. Chinese Journal of Microecology, 2022, 34(03): 347-351.
[33] Yi Wuqiang, Cai Shufang, Cai Xuyang. Curative Effect Analysis of Tianmagouteng Decoction Combined with Western Medicine on Hypertensive Syndrome of Liver Yang Hyperactivity[J]. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine, 2021, 21(08):123-124+140.
[34] Wen Zhiqi, He Mingzhen, Peng Chunyan, et al. Metabolomics and 16S rRNA Gene Sequencing Analyses of Changes in the Intestinal Flora and Biomarkers Induced by Gastrodia- Uncaria Treatment in a Rat Model of Chronic Migraine[J]. Frontiers in pharmacology, 2019, 10:1425.
[35] Xu Xinghua, Yu Xiaoying, Jin Hua, et al. Influence of Zhengan Xifeng Decoction on Blood Pressure and Cecal and Colonic Flora in Spontaneously Hypertensive Rats[J]. Pharmacology and Clinics of Chinese Materia Medica, 2022, 38(04):9-14.
[36] Yan Chunlu, Jin Hua, Liu Fenglin, et al. Effects of Zhengan Xifeng Decoction on Blood Pressure and Gastrointestinal Motility in Spontaneously Hypertensive Rats[J]. Chinese Journal of Information on Traditional Chinese Medicine, 2015, 22(03):69-72.
[37] Liu Li, Zhang Ke, Zou Guoliang, Sui Yanbo, Han Yubo. Based on the Gut Microbiota to Discuss Huanglian Wendan Decoction in the Treatment of Essential Hypertension [J]. Jilin Journal of Chinese Medicine, 2020, 40(05):659-662.
[38] Li Mengli, Wu Dandan, Chen Yu, et al. Effects of baicalin on the intestinal barrier impairment of hypertensive mice induced by angiotensin Ⅱ [J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2022, 37(09):5375-5379.
[39] He Kai. Rhizoma Coptidis alkaloids exert their anti-hyperlipidemic effects through modulation of bile acids signaling and gut microbiota in hyperlipidemia C57BL/6J mice [D]. Chongqing:Southwest University, 2017:55-69.
[40] Ma Xiaocong, Xiong Xingjiang, Mo Yi, et al. Study on Changes of Intestinal Microflora in Spontaneously Hypertensive Rats Based on 16S rDNA Sequencing and Intervention of Traditional Chinese Medicine[J]. Chinese Archives of Traditional Chinese Medicine, 2020, 38(8):71-74.
[41] Lv Yan. Research progress on the classic prescriptions application of heat-clearing in hypertension [J]. Guangxi Journal of Traditional Chinese Medicine, 2021, 44(04):61-64.
[42] Mao Libo. Study on the intervention effect of Xuefu Zhuyu Decoction Granule on Intestinal Flora and Its Products TMAO and Platelet Aggregation [D]. Shandong: Shandong University of Traditional Chinese Medicine, 2019:11-20.