摘要
目的:探讨参苓白术散对脾虚湿盛证型腹泻型肠易激综合征(IBS-D)疗效机制及IBS-D潜在生物标志物。方法:入组28例健康人为对照组,28例脾虚湿盛证型IBS-D为治疗组,治疗组给予参苓白术散,连续2周;采集对照组,治疗前后两组的血浆,三者两两比较;评估治疗前后两组的BSFS、IBS-SSS积分、IBS-QOL量表、HAMD和HAMA变化以及筛选血浆中差异代谢物,分析差异代谢物相关性和显著富集差异代谢物。结果:治疗后IBS-SSS总分、BSFS、腹胀程度、腹痛频率、腹痛程度、IBS-QOL显著降低;对生活的影响度,排便满意度,HAMA,HAMD均低于治疗前;与对照组对比,治疗前有24种差异代谢物,治疗后有47种差异代谢物,通过韦恩图、差异代谢物相关性分析及KEGG富集分析,α-酮戊二酸、乙酰乙酸、柠檬酸、中康酸4种代谢物被认为是IBS-D的潜在生物标志物,此外乙酰乙酸、柠檬酸、中康酸为下调,并且三者间呈正相关。与治疗前比较时,观察到有19种差异代谢物;治疗后差异代谢物主要富集在去甲吗啡、腺苷、富马酸3个代谢物,其次治疗后的α-酮戊二酸、柠檬酸、中康酸均低于治疗前。结论:IBS-D的发病机制可能与能量代谢异常有关,参苓白术散则改善能量代谢以及调节腺苷、去甲吗啡、富马酸代谢到达防治脾虚湿盛证型IBS-D疗效。
Objective: The purpose of this study was to investigate the treatment mechanism of ShenlingBaizhu Powder for diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen deficiency and ex-cessive dampness syndrome, as well as potential IBS-D biomarkers. Method: The control group con-sisted of 28 healthy people, while the treatment group comprised 28 patients with spleen deficien-cy and excessive dampness syndrome (IBS-D). Two consecutive weeks of ShenlingBaizhu Powder were administered to the treatment group. Collect plasma from the control group as well as before and after treatment, and compare them to each other. The BSFS, IBS-SSS score, IBS-QOL scale, HAMD, and HAMA changes were examined before and after treatment, and differential metabolites in plasma were screened to examine the association between differential metabolites and the sig-nificant enrichment of differential metabolites. Result: The IBS-SSS total score, BSFS, degree of ab-dominal distension, frequency of abdominal pain, degree of abdominal pain, and IBS-QOL were sig-nificantly reduced following treatment. The impact on life, defecation satisfaction, HAMA, and HAMD were all reduced after therapy compared to before. Before therapy, there were 24 different metab-olites compared to the control group, whereas there were 47 different metabolites after treatment. Four metabolites—alpha-ketoglutaric acid, acetoacetate, citric acid, and mesaconic acid—were identified as possible biomarkers for IBS-D using a Venn diagram, differential metabolite correla-tion analysis, and KEGG enrichment analysis. Additionally, acetoacetate, citric acid, and mesaconic acid are down-regulated, and the three have a positive association. Compared to before treatment, 19 differential metabolites were identified;the differential metabolites after treatment were pri-marily enriched with three metabolites: Normorphine, adenosine, and fumaric acid. Second, the levels of alpha-ketoglutaric acid, citric acid, and mesaconic acid were lower after therapy than be-fore treatm
出处
《中医学》
2023年第12期3629-3644,共16页
Traditional Chinese Medicine
