TACA-38 肠脑轴
本帖最后由 StarCare 于 2026-5-15 16:59 编辑TACA-38 肠脑轴
The Gut Brain Connection
原文网址：https://tacanow.org/family-resources/the-gut-brain-connection/
肠道被称为人的第二大脑是有充分理由的。我们超过70%的免疫系统都存在于肠道中。此外，最新研究表明肠道微生物群产生的代谢物包括谷氨酸、GABA、血清素和多巴胺等神经递质。因此，肠道不仅影响我们的情绪，还保护我们免受感染。
There is good reason the gut is referred to as a person's second brain. Over 70% of our immune system resides in the gut. Additionally, recent studies show that the metabolites produced by the gut microbiota include neurotransmitters such as glutamate, GABA, serotonin, and dopamine. Therefore, the gut influences our mood as well as protects us against infection.
然而，多达70%的自闭症儿童胃功能受损。这反过来直接影响大脑功能。
However, up to 70% of children with autism have impaired GI function. In turn, this directly affects brain function.
中枢神经系统（CNS）由大脑和脊髓组成，以及胃肠系统，拥有一个双向的信号通路网络，构成了肠脑轴。
The central nervous system (CNS), consisting of the brain and spinal cord, and the gastrointestinal system have a two-way communication network of signaling pathways that make up the gut-brain axis.
研究持续显示，自闭症患者迷走神经张力、免疫系统以及肠道微生物组（细菌、寄生虫、真菌和病毒菌群）存在差异。因此，这些信息揭示了大脑与肠道之间复杂的联系，也为自闭症治疗提供了新的见解。
Research continues to demonstrate differences in vagal tone, the immune system, and the microbiome (bacteria, parasites, fungi and viral flora in the intestines) in individuals with autism. Consequently, this information shows the complex connections between the brain and the gut and is also is providing new insights into treatments for autism.
本文将讨论：
[*]肠道与大脑的联系
[*]肠脑连接的关键调节因子
[*]改善肠脑连接的治疗方法
This article will discuss:
[*]The connection between the gut and the brain
[*]Key regulators of the gut–brain connection
[*]Treatments to improve gut–brain connection
什么是肠道-大脑轴？
What is the Gut-Brain Axis?
肠脑轴指的是消化系统与神经系统之间的双向通信系统。研究才刚刚开始全面理解这一交流系统的复杂性及其对我们情绪、行为、消化以及学习和处理信息能力的影响。事实上，研究人员发现，消化系统壁内有肠神经系统（ENS），即"第二大脑"，其神经元数量超过脊髓或周围神经系统。消化道中的第二个大脑与大脑保持持续沟通。
The gut-brain axis refers to the two-way communication system between the digestive system and the nervous system. Research has only begun to fully understand the complexities of this communication system and its impact on our mood, behavior, digestion, and ability to learn and process information. In fact, researchers have discovered that within the walls of the digestive system is the enteric nervous system (ENS), or "second brain" which contains more neurons than in either the spinal cord or the peripheral nervous system. This second brain in the digestive tract is in constant communication with the brain.
肠道与大脑之间交流的例子：
Examples of communication between the gut and brain:
[*]大脑通过下丘脑-垂体-肾上腺轴（HPA轴）和自主神经系统管理肠道功能。（自主神经系统调节心率、血压、呼吸和消化等非自主过程。）
[*]The brain manages gut function through the hypothalamic-pituitary-adrenal axis (HPA axis) and the autonomic nervous system. (The autonomic system regulates involuntary processes such as heart rate, blood pressure, breathing, and digestion.)
[*]肠道通过微生物（细菌/酵母/病毒）副产物和肠道激素影响中枢神经系统（CNS），这些激素通过肠神经系统（ENS）、迷走神经、循环系统或免疫系统到达大脑。
[*]The gut impacts the central nervous system (CNS) function through the involvement of microbial (bacteria/yeast/viruses) by-products and gut hormones that travel through the enteric nervous system (ENS), vagus nerve, circulatory system, or immune system to reach the brain.
肠脑轴的关键调节者
Key Regulators of the Gut-Brain Axis
促成肠道-大脑健康连接的关键因素是多样的肠道微生物组、肠道粘膜的紧密连接以及紧致的迷走神经。我们将在下面逐一讨论。
The key factors contributing to a healthy gut – brain connection are a diverse gut microbiome, tight junctions in the gut lining, and a well-toned vagus nerve. We will discuss each below.
肠道微生物群
Gut Microbiota
肠道微生物群是生活在我们消化道中的成千上万种微生物，包括细菌、真菌和病毒。肠道-大脑轴的信号通路受这些微生物及其产生的影响。事实上，研究已证明肠道微生物群在多种疾病中起作用，包括自闭症、焦虑、肥胖、精神分裂症、帕金森病和阿尔茨海默病。
The gut microbiota are the thousands of microorganisms including bacteria, fungi, and viruses, that live in our digestive tract. The signaling pathways involved in the gut-brain axis are impacted by these microorganisms and what they produce. Indeed, the gut microbiota has been demonstrated in studies as having a role in many conditions including autism, anxiety, obesity, schizophrenia, Parkinson's disease, and Alzheimer's disease.
有趣的是，研究表明，自闭症儿童肠道中的微生物多样性低于神经典型同龄人。(1)(2)(3)(4)(5)
Interestingly, studies tell us that there is a lower microbial diversity found in the guts of children with autism compared to their neurotypical peers. (1)(2)(3)(4)(5)
自闭症中胃肠功能障碍的高发率及其与挑战性行为和症状的关联，表明自闭症患者中有显著部分人肠道与大脑功能障碍存在关系。此外，越来越多的证据表明，肠脑交流的关键调节因素之一是肠道微生物组。
The high prevalence of GI dysfunction in autism and its connection to challenging behaviors and symptoms suggest the relationship between gut and brain dysfunction in a significant subset of individuals with autism. Moreover, increasing evidence suggests that one of the key modulators of gut-brain communication is the intestinal microbiome.
许多因素影响早期微生物群的组成，如感染、分娩/分娩、抗生素使用、营养、环境压力和遗传因素。具体来说，哈佛和麻省理工学院的研究人员将母体免疫激活（MIA）与自闭症联系起来，并证明孕期母体感染会改变微生物组并影响大脑发育。
Many factors impact the microbiota composition in early life such as infection, birth/delivery, antibiotic use, nutrition, environmental stressors, and genetics. Specifically, Harvard & MIT researchers have linked maternal immune activation (MIA) to autism and have shown that maternal infection during pregnancy can alter the microbiome and impact brain development.
肠道通透性与血脑屏障
Gut Permeability and the Blood Brain Barrier
肠道通透性指的是肠道内膜不健康，连接处不够紧密，导致部分消化的食物残渣、毒素和细菌进入血液循环。我们称之为"肠漏"。小鼠研究显示，肠漏会调节大脑中与免疫激活、氧化应激和髓鞘形成相关的基因网络。因此，肠道内发生的事情会影响我们在自闭症中观察到的行为。此外，肠漏的生物标志物也被研究为自闭症的可能诊断工具。
Gut permeability refers to an unhealthy gut lining where the junctions are not tight enough, allowing partially digested food particles, toxins, and bacteria to gain access to the bloodstream. We call this "leaky gut". In mice studies, a leaky gut was shown to dysregulate gene networks in the brain associated with immune activation, oxidative stress, and myelination. Therefore, what is happening in the gut can affect the behaviors we see in autism. Additionally, biomarkers of leaky gut are being investigated as possible diagnostic tools for autism.
导致肠道通透性（肠漏）的因素包括：
Factors that contribute to gut permeability (leaky gut) are:
[*]压力 (Stress)
[*]Zonulin（含麸质）(Zonulin in gluten)
[*]肥大细胞脱颗粒 (Mast cell degranulation)
[*]草甘膦 (Glyphosate)
[*]微生物群失衡（也称为菌群失衡）(Imbalances in the microbiota, also known as dysbiosis)
这些也可能导致血脑屏障（BBB）的渗透性。
These can also lead to permeability of the Blood Brain Barrier (BBB).
许多自闭症患者面临酵母菌和细菌过度生长的挑战。例如，这项2018年研究结果显示，36.5%的自闭症儿童中检测到抗白色念珠菌的抗体，而神经典型儿童中仅有14.3%。肠道菌群失衡（酵母菌/细菌失衡）会导致肠脑轴的信号通路失调，并与血脑屏障（BBB）通透性改变及脑部炎症有关。
Many Individuals with autism have increased challenges with yeast and bacterial overgrowth. For example, results from this 2018 study show that anti-Candida albicans antibodies were found in 36.5% of children with autism versus only 14.3% in neurotypical kids. With dysbiosis (yeast/bacterial imbalance in the gut), the signaling pathways involved in the gut-brain axis are dysregulated and associated with altered permeability of the blood-brain barrier (BBB) and brain inflammation.
有些医生可能会进行IgG食物敏感性测试。然而，如果检测结果显示多项食物敏感，这仅仅说明肠道有漏，允许食物颗粒进入血液，身体会对这些食物产生抗体。解决办法是治愈并封闭肠道。（详见本文的处理部分。）
Some doctors may run an IgG food sensitivity test. However, if the test comes back with numerous food sensitivities, it is simply a sign that there is a leaky gut barrier allowing food particles into the bloodstream where the body makes antibodies against that food. The solution is healing and sealing the gut. (See the treatment section of this article.)
迷走神经
Vagus Nerve
迷走神经是人体最长的神经，连接大脑与包括肠道在内的多个器官系统。此外，迷走神经是自主神经系统（ANS）的重要组成部分。自主神经系统"自动"调节身体的重要功能，如呼吸、心率和消化。
The vagus nerve is the longest nerve in the body and connects the brain to various organ systems in the body including the gut. Moreover, the vagus nerve is a contributing part of the autonomic nervous system (ANS). The ANS works "automatically" to regulate vital functions in the body such as breathing, heart rate and digestion.
自主神经系统分为两个部分：
There are two parts to the autonomic nervous system:
[*]交感神经系统：为身体准备"战斗或逃跑"。
[*]Sympathetic Nervous System: Prepares the body for "fight or flight".
[*]副交感神经系统：使身体恢复平静状态（"休息和消化"）。
[*]Parasympathetic Nervous System: Returns the body to a calm state ("rest and digest").
战斗或逃跑反应发生在大脑杏仁核对压力的反应中。在自闭症中，压力和环境诱因刺激肥大细胞和小胶质细胞，导致神经元连接功能障碍。这一过程可能导致过度的"战斗或逃跑"反应。
The fight or flight response occurs as the amygdala in the brain responds to stress. In autism, stress and environmental triggers stimulate mast cells and microglia causing dysfunctional neuronal connectivity. This process can lead to an exaggerated "fight or flight" reaction.
迷走神经帮助解除交感神经系统的战斗/逃跑反应。此外，低迷走神经张力会导致迷走神经在交感神经和副交感神经之间流动适应，帮助身体从过度的战斗或逃跑反应恢复到更平静的状态。
The vagus nerve helps to disengage the sympathetic nervous system fight/flight response. Furthermore, low vagal tone results in challenges with the vagus nerve fluidly adapting between the sympathetic and parasympathetic and helping to return the body from an exaggerated fight or flight reaction to a calmer state.
增加迷走神经张力会激活副交感神经系统。此外，刺激副交感神经系统可以：
Increasing your vagal tone activates the parasympathetic nervous system. Additionally, stimulating the parasympathetic nervous system can:
[*]减少炎症 (Decrease Inflammation)
[*]帮助挑食或吞咽困难的孩子 (Help kids that are picky eaters or have trouble swallowing)
[*]消化辅助 (Aid in digestion)
[*]帮助焦虑 (Help anxiety)
[*]帮助控制PANS症状 (Help control PANS symptoms)
有些医生甚至使用植入式迷走神经刺激器来控制癫痫。
Some doctors are even using implanted vagus nerve stimulators to control epilepsy.
如何改善肠脑连接
How to improve the Gut-Brain Connection
所有这些都引出了一个大问题：我该如何改善我孩子的肠脑连接？本节将回顾肠道菌群多样化、肠道漏的修复与封闭，以及改善迷走神经张力。
All this leads us to the big question: How do I improve my child's gut-brain connection? This section will review diversifying gut flora, healing and sealing leaky gut, and improving vagal tone.
提升微生物多样性
Improve Microbial Diversity
肠道内拥有多种细菌非常重要。为此，应致力于改善饮食、添加细菌，并展望自闭症粪便移植的研究。
It is important to have a wide variety of bacteria in the gut. In order to accomplish this, work on improving diet, adding bacteria, and looking ahead to the research on fecal matter transplants for autism.
饮食：
Diet:
迄今为止，提升微生物多样性最有效的方法是食用各种全食物。注意，每天吃同样的东西只会促进同样的细菌生长。尝试新食物和轮换食物都为肠道中的不同细菌提供营养。
By far, the most effective way to improve microbial diversity is to eat a wide variety of whole foods. Note that eating the same thing every day only works to encourage the same bacteria growth. Trying new foods and rotating foods both feed different bacteria in the gut.
益生菌、益生元食品和蔬菜发酵：
Probiotics, prebiotic foods, and vegetable ferments:
根据Ombre粪便检测和OAT结果，使用益生元或益生菌：
Use prebiotics or probiotics depending on Ombre stool testing & OAT results:
[*]过量的拟杆菌、拟心菌、副杆菌、Prevotella等，表明需要以下条件：
[*]Too much Bacteroides, Allistipes, parabacteroides, Prevotella indicates a need for:
[*]高纤维饮食 (High fiber diet)
[*]没有菊粉 (No inulin)
[*]Bacteroides、Allistipes、Parabacteroides、Prevotella等植物不足，表明需要：
[*]Not enough Bacteroides, Allistipes, parabacteroides, Prevotella indicates a need for:
[*]菊粉（仅限短期）(Inulin, short-term only)
[*]动物蛋白 (Animal based protein)
[*]S. 布拉尔迪 (S. Boulardii)
[*]过多的杆菌、梭菌、肠球菌、乳酸杆菌、鲁米诺克斯表示需要：
[*]Too much Bacillus, Clostridium, Enterococcus, Lactobacillus, Ruminoccocus indicates a need for:
[*]乳果糖 (Lactulose)
[*]高双歧多症需要黄连素 (High Bifido requires berberine)
[*]高梭菌（OAT）需要肉碱、布拉氏菌、高剂量益生菌 (High Clostridia on OAT requires Carnitine, S. Boulardii, High dose probiotics)
[*]乳杆菌、梭菌、肠球菌、乳酸杆菌、鲁米诺科菌不足，表明需要：
[*]Not enough Bacillus, Clostridium, Enterococcus, Lactobacillus, Ruminoccocus indicates a need for:
[*]菊粉 (Inulin)
[*]植物性饮食 (Plant based diet)
[*]抗性淀粉 (Resistant starches)
[*]Lactobacillus Rhamnosus (gg)
[*]Bifido Logum
粪便移植（FMT）：
Fecal Matter Transplant (FMT):
研究人员James Adams博士和Rosa Brown博士试验了一种特殊的粪便移植，称为微生物移植疗法（MTT），在自闭症儿童中显示出改善效果。这仍处于试验阶段，尚未被批准用于治疗自闭症。您可以在以下链接阅读更多信息：
Researchers Dr. James Adams and Dr. Rosa Brown have trialed a special kind of fecal matter transplant called Microbiota Transplant Therapy (MTT) that is demonstrating improvements in kids with autism. This is still in trial phases and is not yet approved to treat autism. You can read more about it below:
[*]ASU researchers use bacteria to improve autism symptoms – Arizona PBS (azpbs.org)
[*]Shotgun Metagenomics Study Suggests Alteration in Sulfur Metabolism and Oxidative Stress in Children with Autism and Improvement after Microbiota Transfer Therapy – PubMed (nih.gov)
修复并封闭肠漏
Heal and Seal Leaky Gut
修复肠漏的过程通常被称为"4R"——去除（Remove）、替代（Replace）、修复（Repair）、再接种（Reinoculate）。因此，有许多步骤和成分可以帮助紧密细胞连接。
The process of healing leaky gut is often referred to as "The 4 Rs" – Remove, Replace, Repair, Reinoculate. Therefore, there are numerous steps and ingredients to help tighten cell junctions.
去除（REMOVE）炎症诱因，如：
REMOVE Inflammatory triggers, such as:
[*]加工食品 (Processed foods)
[*]麸质、乳制品和大豆 (Gluten, Dairy, and Soy)
[*]您的孩子可能对其有反应的其他食物 (Other foods that your child may be reacting to)
[*]精制和未精制糖 (Refined and unrefined sugar)
替代（REPLACE）炎症诱因：
REPLACE inflammatory triggers with:
[*]Omega-3脂肪酸（鱼油）(Omega 3 fatty acids, fish oil)
[*]营养丰富的全食物 (Nourishing, whole foods)
[*]富含纤维的食物 (Fiber-rich foods)
[*]洋车前子壳、蔬菜和水果 (Psyllium husk, vegetables and fruit)
[*]健康蛋白质 (Healthy protein)
[*]瘦肉、坚果和种子、鱼类 (Lean meat, Nuts and seeds, and fish)
有时这个阶段还需要消化酶，当身体难以分解食物和吸收营养时。蛋白酶用于消化蛋白质，脂肪酶帮助消化脂肪，淀粉酶帮助消化碳水化合物。
Sometimes this stage will also require digestive enzymes when the body has trouble breaking down food and absorbing nutrients. Protease to digest proteins, lipase to help digest fats and amylase to help digest carbohydrates.
修复（REPAIR）肠道：
REPAIR the gut with:
[*]L-谷氨酰胺 (L-Glutamine)
[*]滑榆皮 (Slippery Elm)
[*]芦荟 (Aloe)
[*]锌肌肽 (Zinc Carnosine)
[*]丁酸盐 (Butyrate)
[*]线粒体支持以帮助肠道蠕动 (Mitochondrial support to help gut motility)
有一些组合型胃肠道修复产品包含这些成分及更多。然而，如果您的孩子不耐受该补充剂，很难找出罪魁祸首。您可以考虑一次尝试一种成分。
There are some combination GI repair products that include these ingredients and more. However, if your child does not tolerate the supplement, it is difficult to know the culprit. You might consider trying one ingredient at a time.
如果跳过这一步直接使用益生菌，您可能会发现孩子反应不佳，表现为攻击性、易怒，甚至自身免疫问题。此外，可能还有其他问题在起作用，如小肠细菌过度生长（SIBO）导致对益生菌的反应不佳。
If you skip this step and go straight to probiotics, you may find your child responds poorly with aggression, irritability, or even autoimmune issues. In addition, there may be other issues at play such as small intestine bacterial overgrowth (SIBO) causing a poor response to probiotics.
再接种（REINOCULATE）肠道：
REINOCULATE the gut with:
[*]益生菌 (Probiotics)
[*]发酵食品 (Fermented foods)
[*]益生元 (Prebiotics)
请记住，益生菌只是添加到肠道中的少数几种细菌菌株。人类胃肠道微生物群包含大约300到500种细菌，近8000种细菌菌株。仅服用少数菌株可能会使肠道微生物群失衡，因此许多医生建议只在短时间内服用益生菌，并经常更换菌株。此外，不同菌株的细菌有不同的功能。
Remember that probiotics are simply a handful of bacteria strains added to the gut. The human gastrointestinal microbiota contains approximately 300 to 500 bacterial species with nearly 8000 strains of bacteria. Taking only a handful of strains can skew the gut microbiome, so many doctors advise only taking probiotics for short periods of time and changing strains often. Additionally, different strains of bacteria have different functions.
发酵食品（如果耐受）如酸奶、开菲尔、未煮熟的酸菜和泡菜，含有的细菌菌株比益生菌多得多。因此，它们往往是更好的选择。从发酵食品开始要非常缓慢，并观察反应。它们可能非常强效。
Fermented foods (if tolerated) such as yogurt, kefir, uncooked sauerkraut, and kimchi contain many more strains of bacteria than probiotics. Therefore, they tend to be a better option. Always start very slowly with fermented foods and watch for reactions. They can be extremely strong.
相比之下，益生元是现有肠道细菌的食物来源。它们存在于水果和蔬菜中以及补充剂中（如菊粉和低聚果糖）。肠道微生物群发酵益生元产生短链脂肪酸（SCFA），这对结肠健康很重要。由于它们喂养的是已经生活在肠道中的东西，您需要小心不要喂养现有的致病（坏）细菌。如果这样做，它可能会过度生长并导致症状恶化。进行粪便检测（如TACA关于实验室检测的文章中所述）可以告诉您是否有需要注意的致病细菌。
By contrast, prebiotics are a food source for your existing gut bacteria. They are found in both fruits and vegetables and in supplements (such as inulin and fructooligosaccharides). Fermentation of prebiotics by gut microbiota produces short-chain fatty acids (SCFAs) which are important to the health of the colon. Since they feed what is already living in the gut, you need to be careful not to feed existing pathogenic (bad) bacteria. If you do, it can overgrow and cause worsening of symptoms. Doing a stool test (as is outlined in this TACA article on lab testing) can tell you if there are pathogenic bacteria that you need to be aware of.
改善迷走神经张力
Improve Vagal Tone
改善迷走神经张力的方法如下：
Ways to improve vagal tone are listed below:
[*]冷暴露。在淋浴最后30秒将水温调至冷水，可以随着时间推移减少交感神经的激活。
[*]Cold exposure. Turning the water temperature to cold in the last 30 seconds of a shower can reduce sympathetic activation over time.
[*]深腹式呼吸。慢慢用鼻子吸气，让胃部向外膨胀。呼气应当长而缓慢地通过嘴巴。
[*]Deep belly breathing. Slow inhaling through your nose making your stomach expand outward. Your exhale should be long and slow through the mouth.
[*]安全与良好方案（Safe and Sound Protocol）：这是一个基于斯蒂芬·波尔格斯博士多迷走神经理论的倾听系统。
[*]Safe and Sound Protocol: This is a listening system based upon Dr. Stephen Porges' Polyvagal Theory.
[*]唱歌、吟唱、哼唱、漱口：迷走神经连接着喉咙后部的声带和肌肉。
[*]Singing, chanting, humming, gargling: The vagus nerve is connected to your vocal chords and muscles at the back of the throat.
[*]心率变异性（HRV）生物反馈。在这篇关于自闭症治疗方法的TACA文章中了解更多相关内容。
[*]Heart Rate Variability (HRV) Biofeedback. Read more about it in this TACA article on Autism Treatment Methods.
结论
Conclusion
如你所见，肠道健康直接影响大脑健康。同样，大脑通过自主神经系统管理肠道功能。改善肠道微生物多样性，修复并密封可渗透肠道，改善迷走神经张力，最终都将帮助我们孩子的大脑功能。
As you can see, gut health directly impacts brain health. And likewise, the brain manages gut function through the autonomic nervous system. Improving microbial diversity in the gut, healing and sealing permeable intestines, and improving vagal tone will all ultimately help brain function in our children.
额外研究
Additional Research
[*]脑-肠道-微生物组系统：自闭症谱系障碍的通路及其影响——PMC（nih.gov）（请查看精彩的图解）
[*]The Brain-Gut-Microbiome System: Pathways and Implications for Autism Spectrum Disorder – PMC (nih.gov) (Check out the great graphic)
[*]自闭症谱系障碍作为脑-肠-微生物轴障碍——PubMed（nih.gov 年）
[*]Autism Spectrum Disorder as a Brain-Gut-Microbiome Axis Disorder – PubMed (nih.gov)
[*]肠道-脑轴：微生物群和宿主炎症小体如何影响大脑生理与病理（2020年）
[*]The Gut-Brain Axis: How Microbiota and Host Inflammasome Influence Brain Physiology and Pathology (2020)
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