摘要：在古老而深邃的中医理论中，九种体质类型如同人体的九种密码，揭示了不同个体在生理、病理上的差异。其中，痰湿体质以其独特的表征和较高的代谢紊乱风险，成为了科研人员关注的焦点。近日，中国工程院院士、北京中医药大学国家中医体质与治未病研究院王琦团队在国际知名期刊《细胞

在古老而深邃的中医理论中，九种体质类型如同人体的九种密码，揭示了不同个体在生理、病理上的差异。其中，痰湿体质以其独特的表征和较高的代谢紊乱风险，成为了科研人员关注的焦点。近日，中国工程院院士、北京中医药大学国家中医体质与治未病研究院王琦团队在国际知名期刊《细胞发现》上发表的一项研究，更是将这一传统中医理论与现代微生物学紧密结合，揭示了痰湿体质人群肠道菌群失衡与代谢紊乱之间的深层关联。

痰湿体质，这个听起来略带诗意的名词，实则描绘了一幅令人担忧的画面：皮肤油腻、腹部肥满松软、胸闷、舌苔厚腻……这些特征不仅影响了人的外在形象，更潜藏着代谢紊乱的风险。流行病学研究表明，痰湿体质人群患肥胖、高血脂、糖尿病等代谢性疾病的概率显著高于其他体质类型。即使代谢指标正常，痰湿体质者的代谢相关基因表达也存在异常，仿佛一颗定时炸弹，随时可能引爆健康危机。

然而，这些看似神秘的体质差异，在现代科学的视角下逐渐露出了真容。肠道微生物群，这个被誉为人类“第二基因组”的奇妙世界，成为了解析中医体质理论的重要切入点。这些微小而强大的生物，通过其衍生的代谢物，参与着宿主的代谢过程，影响着全身的生理和病理状态。

王琦团队的研究，就像一把钥匙，打开了痰湿体质与肠道菌群之间的神秘之门。通过对167例痰湿体质和42例平和体质的多组学分析，他们发现痰湿体质人群的肠道菌群结构发生了显著改变。一种特征性有益菌——珀氏解黄酮菌（Flavonifractor plautii, F.plautii）的丰度明显降低，同时，其代谢产物植物鞘氨醇（phytosphingosine）的水平也随之下降。这一现象，甚至在代谢指标“正常”的痰湿体质者中就已经存在，预示着他们未来患代谢紊乱的风险。

动物实验更是进一步证实了这一发现。当研究人员将痰湿体质者的肠道菌群移植到小鼠体内时，这些小鼠竟然出现了肥胖、高脂血症和脂肪肝等代谢性疾病的症状。这一结果，无疑为痰湿体质与肠道菌群失衡之间的关联提供了强有力的证据。

这项研究的意义，远不止于揭示了痰湿体质与肠道菌群失衡的奥秘。它更是中医理论与现代科学相结合的一次成功尝试，为中医体质理论的现代化、科学化提供了有力支撑。它告诉我们，那些看似虚无缥缈的中医体质类型，其实有着坚实的生物学基础。而肠道菌群，这个曾经被忽视的生命世界，正逐渐成为连接传统医学与现代科学的桥梁。

当然，研究只是开始，未来的路还很长。但我们可以期待，随着科技的进步和科研的深入，中医体质理论将会得到更加全面、深入的解析。而痰湿体质与肠道菌群失衡之间的关联，也将为代谢性疾病的预防和治疗提供新的思路和方法。

在这个过程中，我们或许会发现，那些古老的中医智慧，其实并不遥远。它们就藏在我们的身体里，藏在那些微小而神奇的生物中，等待着我们去发现、去领悟、去运用。而当我们真正理解了这些智慧，或许就能找到那把打开健康之门的钥匙，让生命之树更加枝繁叶茂、生机勃勃。

最后，改变代谢紊乱，从纠正痰湿体质入手！

作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。

Academician Wang Qi: People with sputum are more likely to cause metabolic disorders

In the ancient and deep traditional Chinese medicine theory, the nine physical types are like the nine codes of the human body, revealing the differences in physiology and pathology between different individuals. Among them, sputum cytoplasm has become the focus of researchers with its unique characterization and high risk of metabolic disorders. Recently, Wang Qi, academician of Chinese Academy of Engineering, National Institute of Chinese medicine constitution and preventive treatment of disease, published a study in the international well-known journal, In addition, this traditional Chinese medicine theory is closely integrated with modern microbiology, revealing the deep connection between the imbalance of gut microbiota and metabolic disorders in people with sputum.

Phlegm, a slightly poetic-sounding term, paints a worrying picture of greasy skin, a swollen abdomen, tight chest, and thick tongue. These traits not only affect the appearance of a person, but also reveal the risk of metabolic disorders. Epidemic diseases such as adiposity, hyperlipidemia, diabetes mellitus and so on are more likely to occur in phlegm-dampness constitution group than in other constitution groups. Even if the metabolic index is normal, the metabolic gene expression of the phlegm-dampness constitution is abnormal, just like a time bomb, which may detonate the health crisis at any time.

However, these seemingly mysterious physical differences are gradually coming to light in the light of modern science. The gut microbiota, the wonderful world known as human "second genome," has become an important entry point for analyzing traditional Chinese physical theory. These tiny and powerful organisms, through their metabolites, participate in the metabolic processes of the host, affecting the physiological and pathological state of the whole body.

Wang Qi's team's research, like a key, opened the mysterious door between phlegm and gut flora. Through a multi-omics analysis of 167 cases of sputum and 42 cases of physiology, they found significant changes in gut microbiota structure in the sputum. The abundance of Flavonifractor plautii (F. plautii), a characteristic beneficial bacterium, was significantly reduced, along with the level of phytosphingosine, its metabolite. This phenomenon exists even in people with "normal" metabolic indicators, indicating their risk of future metabolic disorders.

Animal experiments have further confirmed this finding. When the gut microbiota from the phlegm-dampness patient was transplanted into the mice, the mice developed metabolic disorders such as obesity, hyperlipidemia and fatty liver. This result undoubtedly provides strong evidence of an association between sputum and an imbalance in gut microbiota.

The implications of this study go far beyond revealing the mysteries of the imbalance between sputum and gut flora. It is also a successful attempt to combine traditional Chinese medicine theory with modern science, providing strong support for the modernization and scientificization of traditional Chinese physical theory. It tells us that these seemingly illusory types of physical condition in Chinese medicine have a solid biological basis. The gut microbiota, a once neglected world of life, is becoming a bridge between traditional medicine and modern science.

Of course, the research is just the beginning, and there is still a long way to go. However, we can expect that with the advancement of science and technology and the deepening of scientific research, the theory of physical health in Chinese medicine will be more comprehensive and in-depth analyzed. The association between sputum and intestinal microbiota imbalance will also provide new ideas and methods for the prevention and treatment of metabolic diseases.

In the process, we may discover that those ancient Chinese medicine wisdom is not really far away. They are hidden in our bodies, in these tiny, amazing creatures, waiting for us to discover, to understand, and to use them. And when we truly understand these wisdoms, we may be able to find the key to opening the door to health and making the tree of life more flourishing and vibrant.

Finally, change the metabolic disorders by correcting the phlegm physique!

Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.

来源：老梁谈养生