小肠细菌过度生长在肝硬化中的驱动作用及相关靶向治疗策略

李仙萍; 唐映梅

doi:10.12449/JCH260629

小肠细菌过度生长在肝硬化中的驱动作用及相关靶向治疗策略

DOI: 10.12449/JCH260629

李仙萍,
唐映梅^, ,

昆明医科大学第二附属医院消化内科，昆明 650000

基金项目:

国家自然科学基金 (82360108);

云南省医学领军人才 (L-2019013)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：李仙萍负责设计论文框架，起草论文，修改论文；唐映梅负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
唐映梅， tangyingmei_med@kmmu.edu.cn （ORCID： 0000-0002-0731-4198）

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- 被引次数: 0
出版历程
- 收稿日期: 2025-09-15
- 录用日期: 2025-12-30
- 出版日期: 2026-06-25

Driving role and related targeted therapeutic strategies of small intestinal bacterial overgrowth in liver cirrhosis

Xianping LI,
Yingmei TANG^{,
,}

Department of Gastroenterology，The Second Affiliated Hospital of Kunming Medical University，Kunming 650000，China

Research funding:

National Natural Science Foundation of China (82360108);

Medicine Leading Talents of Yunnan Province (L-2019013)

More Information

Corresponding author: TANG Yingmei， tangyingmei_med@kmmu.edu.cn （ORCID： 0000-0002-0731-4198）

摘要

摘要: 小肠细菌过度生长（SIBO）在肝硬化患者中的发生率显著升高。近年研究表明，SIBO不仅是一种伴随现象，更是通过“肠-肝轴”机制主动驱动肝硬化进展的关键因素。本文创新性提出“菌群-免疫-纤维化”病理正反馈循环模型，系统阐述了SIBO通过破坏肠道屏障功能、促进细菌及内毒素易位、诱发系统性炎症反应及加速肝纤维化等多重机制，推动疾病进展的连续性病理过程。同时，评估了目前针对SIBO的抗生素治疗、微生态调节、中草药治疗及饮食疗法等策略的临床应用价值与局限，为开发多靶点、个体化的综合治疗策略提供了理论依据与未来研究方向。
- 肝硬化 /
- 小肠细菌过度生长 /
- 肠-肝轴 /
- 治疗学
Abstract: Small intestinal bacterial overgrowth （SIBO） is significantly more prevalent in patients with liver cirrhosis. Recent studies indicate that SIBO is not merely a concomitant phenomenon but a key driver of cirrhosis progression via the “gut-liver axis” mechanism. This review innovatively proposes a “microbiota-immunity-fibrosis” pathological positive feedback loop model， systematically elucidating the sequential pathological process through which SIBO drives disease progression via multiple mechanisms—including disruption of intestinal barrier function， facilitation of bacterial and endotoxin translocation， induction of systemic inflammatory responses， and acceleration of hepatic fibrosis. Furthermore， it provides a systematic evaluation of the clinical application value and limitations of current SIBO-targeted therapeutic strategies， such as antibiotic therapy， microbial modulation， herbal medicine interventions， and dietary therapies. This work aims to establish a theoretical foundation and identify future research directions for the development of multi-targeted and personalized comprehensive treatment strategies.
- Liver Cirrhosis /
- Small Intestinal Bacterial Overgrowth /
- Gut-Liver Axis /
- Therapeutics

HTML全文

注： SIBO，小肠细菌过度生长；LPS，脂多糖；TLR4，Toll样受体4；NF-κB，核因子κB；TNF-α，肿瘤坏死因子α；IL，白细胞介素；MyD88，髓样分化因子88；Bambi，骨形态发生蛋白和激活素膜结合抑制剂；TGF-β，转化生长因子β。

图 1 SIBO促进肝硬化进展的核心机制

Figure 1. Core mechanism of SIBO promoting cirrhosis progression

下载: 全尺寸图片幻灯片

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