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  • Writer's pictureAku Energija

Os črevesje-koža: razumevanje luskavice iz črevesja in kako lahko pomaga TKM

V zadnjem desetletju se je os črevesje-koža-možgani razvila kot raziskovalno področje, ki ponuja vse več dokazov o tem, kako lahko hrana in črevesna mikrobiota vplivata na razvoj črevesnih/kožnih bolezni[1] ter nevrološko-psihiatrično-psiholoških motenj[2]. [Preberi več: Povezava med črevesjem in možgani ter njen pomen]

Luskavica je kronična, vnetna, težko ozdravljiva avtoimunska bolezen z visoko stopnjo ponovitve. Po podatkih Svetovne zdravstvene organizacije je glavni simptom poškodovana koža, neznosno srbenje, ki ga spremljajo eritem, papule, luske in druge klinične značilnosti, kar resno ogroža telesno in duševno zdravje bolnikov. Poleg negativnih vplivov na kakovost življenja je luskavica povezana s številnimi zapleti, vključno z luskavičnim artritisom, depresijo in tesnobo, limfomom, debelostjo in presnovnim sindromom, kar poveča tveganje za zgodnjo smrt.

Koncept "osi črevesje-koža" povezuje spremembe črevesne mikrobiote z vnetnim odzivom kože. Razvoj luskavice je povezan s spremembami v delovanju in sestavi črevesne mikrobiote. Luskavica pogosto napreduje po vnetju prebavil, kot je na primer kronična vnetna črevesna bolezen. Spremembe črevesne mikrobiote so pomemben dejavnik patološkega mehanizma luskavice.  Vendar je poseben mehanizem tega medsebojnega delovanja še vedno nejasen.

Celovitost in dinamične značilnosti črevesne mikroekologije so v skladu s celostnim pogledom in pogledom večnega gibanja v tradicionalni kitajski medicini (TKM). Nekatere teorije, kot so: "Pljuča in debelo črevo sta povezana znotraj in zunaj", "Teorija o povezavi pljuč s kožo" in "Teorija osi črevesje-možgani-koža", ter nekatere raziskave o ohranjanju ravnovesja črevesne mikroekologije s strani TKM zagotavljajo podlago za raziskovanje mehanizma TKM za diagnozo in zdravljenje luskavice z vidika črevesne mikroekologije.[3]

Razumevanje luskavice z vidika osi "črevesje-koža" v tradicionalni kitajski medicini

Tradicionalna kitajska medicina verjame, da je človek organska in enotna celota. Notranji organi ne obstajajo samostojno, temveč so povezani prek meridianov in kolateral, ki tvorijo zunanji in notranji odnos med njimi. Tako fiziološko kot patološko so med seboj povezani in vplivajo drug na drugega.

Čeprav se luskavica kaže kot površinski kožni eritem in luske, je tesno povezana z motnjami v delovanju drobovja. V Kanonu interne medicine Rumenega cesarja je bilo že dolgo nazaj zapisano, da morajo tisti, ki imajo vse vrste notranjih organov, te pokazati navzven, zunanji odraz pa mora prav tako temeljiti na notranji disfunkciji drobovja.

Koža in debelo črevo sta povezana z dvema različnima organoma, ki se zdita "popolnoma nepovezana". Med njima koža prevladuje nad celotnim telesom in brani pred vdorom zunanjega zla. Debelo črevo je prevodni organ in glavni organ človeškega telesa za izločanje. Pod vodstvom "celostnega pogleda" tradicionalne kitajske medicine teorija "pljuča vladajo koži/kožuhu" meni, da pljuča širijo esenco qija na kožo, zato je lahko koža čvrsta in močna. Če je pljučnega qija premalo ali če je pljučni qi blokiran, je koža abnormalna.

Hkrati tradicionalna kitajska medicina verjame v "notranji in zunanji odnos med pljuči in debelim črevesjem", kar pomeni, da so pljuča in debelo črevo medsebojno povezani v meridianih ter vplivajo drug na drugega v fiziologiji in patologiji. Če lahko ena od lezij povzroči disfunkcijo druge strani, bodo bolezni pljuč in črevesja vplivale druga na drugo, se prenašale in vključevale.

Zdravljenje luskavice s TKM

Po teoriji TKM je koža tesno povezana z drobovjem, meridiani, qijem in krvjo, telesno tekočino, zlasti s pljuči, pri čemer pljuča uravnavajo difuzijo, kožuh, Sujiang ter prehode vode. Če je pljučni qi normalen, se lahko qi, kri in telesna tekočina razširijo po vsem telesu, obrambni qi je obilen in zunanje zlo ne more vdreti. Na podlagi ideje "koža je tesno povezana s črevesnim traktom, zato je tesno povezana tudi s črevesno mikroekologijo" nekateri raziskovalci menijo, da imajo terapevtska načela in metode "uravnavanja vranice in želodca" ter "umirjanja živcev", ki jih je tradicionalna kitajska medicina sprejela pri zdravljenju luskavice, verjetno terapevtsko vlogo pri uravnavanju črevesne flore.

Prednosti TKM pri zdravljenju luskavice

V primerjavi s sodobno medicino ima TKM pri zdravljenju luskavice edinstvene prednosti, vključno z edinstvenostjo klasifikacije sindromov ter številnimi in prilagodljivimi idejami za zdravljenje. Z upoštevanjem načel diferenciacije sindromov je bila uporabljena kombinacija notranjih in zunanjih metod zdravljenja na podlagi razumevanja etiologije in patologije. [Preberi več: TKM vs zahodna medicina]

Zdravljenje je prilagojeno različnim stopnjam kožnih lezij in individualni konstituciji bolnika, kar neposredno lajša simptome bolnika, spodbuja nazadovanje kožnih izpuščajev in ima značilnost "hitrega in učinkovitega zdravljenja". V TKM to razlikovanje vzorcev in zdravljenja omogoča posebno obvladovanje luskavice.

V AKU ENERGIJI ponujamo vrsto terapij, vključno z akupunkturo, zeliščno medicino in prehranskimi nasveti, ki lahko pomagajo učinkovito odpraviti težave s kožo, kot sta ekcem in luskavica, in so prilagojene različnim konstitucijam pacientov. Da bi določili svojo specifično konstitucijo in ustrezno metodo zdravljenja, nas kontaktirajte, mi pa vam bomo določili termin za posvet.


Viri:

  1. Mahmud RM, Akter S, Khanam Tamanna S, Mazumder L, Esti I Z, Banerjee S, et al.. Impact of gut microbiome on skin health: gut-skin axis observed through the lenses of therapeutics and skin diseases. Gut Microbes. (2022) 14:e2096995. 10.1080/19490976.2022.2096995

  2. Schiopu CG, Stefanescu C, Bolos A, Diaconescu S, Gilca-Blanariu GE, Stefanescu G. Functional gastrointestinal disorders with psychiatric symptoms: involvement of the microbiome–gut–brain axis in the pathophysiology and case management. Microorganisms. (2022) 10:2199. 10.3390/microorganisms10112199

  3. “Gut-skin”axis: understanding psoriasis from the gut. doi: 10.1691/ph.2021.1694

 

"Gut-skin” axis: understanding psoriasis from the gut and how TCM can help

In the last decade, the gut-skin-brain axis has emerged as a research field offering more and more evidence on the way foods and intestinal microbiota can affect the development of intestinal/skin diseases[1], and neurological-psychiatric-psychological disorders[2]. [Read more: The gut-brain connection and its importance]

Psoriasis is a chronic, inflammatory, difficult to cure autoimmune disease with high recurrence rate. According to WHO, because of the main symptom of damaged skin, itching is unbearable, and accompanied by erythema, papules, scales and other clinical characteristics, seriously threatening the physical and mental health of patients. In addition to the negative effects of quality of life, psoriasis is associated with a number of complications, including psoriasis arthritis, depression and anxiety, lymphoma, obesity and metabolic syndrome, which will increase the risk of early death.

The concept of the “gut-skin axis” links alterations in the gut microbiota with the inflammatory response in the skin. The development of psoriasis is associated with alterations in the function and composition of the gut microbiota. The progression of psoriasis often follows gastrointestinal inflammation, such as in IBD. Gut microbiota alterations is an important factor of the pathological mechanism of psoriasis.  However, the specific mechanism of this interaction is still unclear.

The integrity and dynamic characteristics of the intestinal micro-ecology are consistent with the holistic view and perpetual motion view in traditional Chinese medicine (TCM). Some theories such as "The lung and the large intestine are interior-exteriorly related", "Lung relating to skin theory" and "Gut-brain-skin axis theory", and some researches on TCM maintaining the balance of intestinal microecology, provide a basis for exploring the TCM mechanism of diagnosis and treatment of psoriasis from the perspective of intestinal microecology.[3]

Understanding of psoriasis from the perspective of “gut-skin” axis in Traditional Chinese Medicine

Traditional Chinese Medicine believes that human beings are an organic and unified whole. The viscera do not exist independently, but are connected through meridians and collaterals to form the external and internal relationship between the viscera and the viscera. Both physiologically and pathologically, they are interconnected and influence each other. 

Psoriasis, although manifested as superficial skin erythema and scales, is closely related to the dysfunction of the viscera. It has long been recorded in the Inner Canon of the Yellow Emperor that those who have all kinds of inner organs must show them to the outside, and the external expression must also be based on the internal dysfunction of the viscera. 

The skin and the large intestine are related to two different organs, which seems to “be totally unrelated”. Among them, skin dominates the whole body, defending against the invasion of  external evil. The large intestine is the conduction organ and the main excretion organ of the human body. Under the guidance of the “holistic view” of Traditional Chinese Medicine, the theory of “lung governs the skin/fur” believes that the lungs spread the essence of Qi on the skin, so that the skin can be firm and strong. If the lung Qi is insufficient or the lung Qi is blocked, it will be abnormal.

At the same time, Traditional Chinese Medicine believes in an “interior-exterior relationship between the lung and large intestine”, which means that the lung and the large intestine are interrelated in meridians and influence each other in physiology and pathology. If one of the lesions can cause the other side dysfunction, the diseases of the lung and intestines will affect each other, transmit and involve each other.

Treatment of psoriasis with TCM

According to TCM theory, skin is closely related to viscera, meridians, Qi and blood, body fluid, especially lung, with the lung governing diffusion, governing the fur, governing Sujiang, governing regulation of water passages. If the lung Qi is normal, the Qi, blood and body fluid can spread all over the body, the defensive Qi is abundant, and the external evil cannot invade. Based on the idea of “skin is closely related to the intestinal tract, so it is also closely related to the intestinal microecology”, some scholars believe that the therapeutic principles and methods of “regulating the spleen and stomach” and “calming the nerves” adopted by Traditional Chinese Medicine in the treatment of psoriasis are likely to play a therapeutic role by regulating the intestinal flora.[4]

TCM advantages in the treatment of psoriasis

Compared with modern medicine, TCM has unique advantages in the treatment of psoriasis, including the uniqueness of syndrome classification, abundance and flexibility of treatment ideas. By following the principles of differentiation of syndromes, a combination of internal and external treatment methods based on an understanding of the etiology and pathology were used. [Read more: TCM vs Western Medicine]

It tailors treatment to the different stages of skin lesions and individual patient constitution, directly alleviating patient symptoms, promoting the regression of skin rashes, and exhibiting a characteristic of “quick and effective treatment.” In TCM, this differentiation of patterns and treatment makes it possible to manage psoriasis in a special way.

At AKU ENERGIJA, we offer a range of therapies including acupuncture, herbal medicine and dietary advice that can help address such skin issues as eczema and psoriasis effectively, tailored to different patient constitutions. To determine your specific constitution and the appropriate treatment method, please make an appointment, and we will schedule a consultation for you.


Reference:

  1. Mahmud RM, Akter S, Khanam Tamanna S, Mazumder L, Esti I Z, Banerjee S, et al.. Impact of gut microbiome on skin health: gut-skin axis observed through the lenses of therapeutics and skin diseases. Gut Microbes. (2022) 14:e2096995. 10.1080/19490976.2022.2096995

  2. Schiopu CG, Stefanescu C, Bolos A, Diaconescu S, Gilca-Blanariu GE, Stefanescu G. Functional gastrointestinal disorders with psychiatric symptoms: involvement of the microbiome–gut–brain axis in the pathophysiology and case management. Microorganisms. (2022) 10:2199. 10.3390/microorganisms10112199

  3. “Gut-skin”axis: understanding psoriasis from the gut. doi: 10.1691/ph.2021.1694



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