【摘要】 反复妊娠丢失是常见的不良妊娠结局，中医称之为滑胎。中医认为，脾肾亏虚、冲任不固为滑胎的根本病机，补脾益肾为其临床公认的治疗原则，疗效确切，但其作用机制尚不明确。近年来的研究发现，脾肾亏虚会引发肠道菌群失调，补肾健脾之方药对肠道微生态具有调节作用，而肠道菌群及其代谢产物的变化与反复妊娠丢失的发病密切相关。该文探讨了反复妊娠丢失、肠道微生态、脾肾三者之间的关系，基于肠道菌群在反复妊娠丢失发病中的重要作用以及肠道菌群与脾肾在生理、病理上的相关性，提出调节肠道菌群可能是中医药从脾肾论治反复妊娠丢失的作用机理之一。更多还原

【Abstract】 Recurrent pregnancy loss(RPL),termed as habitual abortion in traditional Chinese medicine(TCM),is a common outcome of adverse pregnancy. TCM theory posits that spleen-kidney deficiency and insecurity of the Chong-Ren meridian constitute the fundamental pathogenesis of RPL. Clinically, spleen-tonifying and kidneyreplenishing therapies have demonstrated reliable efficacy,though their underlying mechanisms remain unclear. Recent studies have revealed that spleen-kidney deficiency may induce intestinal dysbacteriosis,while kidneytonifying and spleen-fortifying herbal formulas exhibit regulatory effects on gut microbiota. Notably,alterations in gut microbiota and their metabolites are closely associated with RPL pathogenesis. This article elucidates the interrelationship among RPL, gut microbiota, and spleen-kidney systems. Based on the pivotal role of gut microbiota in the prevalence of RPL development and the correlation of physiological and pathological features of the spleen-kidney systems with the gut microbiota,this article proposes that the modulation of gut microbiota may represent one of the mechanisms that TCM treats RPL via spleen-kidney regulation.更多还原