抑囊方对慢性肾病3~4期成人型多囊肾病患者血清代谢组学影响  

Effects of Yinang Formula on Serum Metabonomics for Chronic Kidney Disease Stage 3-4 in Patients with Autosomal Dominant Polycystic Kidney Disease

作　　者：甘静 吴燕升 周嘉宝 李东东 郭亚芳[1,2] 张新志 龚学忠[3] 郁胜强[4] 高建东[1] GAN Jing;WU Yan-sheng;ZHOU Jia-bao;LI Dong-dong;GUO Ya-fang;ZHANG Xin-zhi;GONG Xue-zhong;YU Sheng-qiang;GAO Jian-dong(Department of Nephrology,Shuguang Hospital Afliated to Shanghai University of Traditional Chinese Medicine,TCM Institute of Kidney Disease,Shanghai University of Traditional Chinese Medicine,Key Laboratory of Liver and Kidney Diseases(Shanghai University of Traditional Chinese Medicine),Ministry of Education,Shanghai Key Laboratory of Traditional Chinese Clinical Medicine,Shanghai,201203;Department of TCM,Shanghai Pudong Hospital,Fudan University Pudong Medical Center,Shanghai,201399;Department of Nephrology,Shuguang Hospital Afliated to Shanghai University of Tradtional Chinese Medicine,Shanghai,200071;Department o1 Nephrology,Shanghai Changzheng Hospital Aflatled to Second Miltary Medical University,Chinese People's Liberation Army Institute of Nephrology,Shanghai,200433)

机构地区：[1]上海中医药大学附属曙光医院肾病科,上海中医药大学中医肾病研究所,上海市中医临床重点实验室,肝肾疾病病证教育部重点实验室(上海中医药大学),上海201203 [2]上海市浦东医院复旦大学附属浦东医院中医科,上海201399 [3]上海中医药大学附属上海市中医医院肾内科,上海200071 [4]第二军医大学长征医院肾内科,解放军肾脏病研究所,上海200433

出　　处：《中国中西医结合杂志》2021年第4期436-442,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：促进市级医院临床技能与临床创新能力三年行动计划项目(No.16CR3021A)。

摘　　要：目的观察抑囊方对慢性肾病(CKD)3~4期成人型多囊肾病(ADPKD)血清代谢组学的影响。方法选择2017年10月—2019年3月在上海中医药大学附属曙光医院、第二军医大学附属上海长征医院以及上海中医药大学附属上海市中医医院就诊的30例CKD 3~4期ADPKD患者,服用抑囊方24周。收集患者0周(治疗前组)、24周(治疗后组)血清样本,另收集同期健康人20名(健康对照组)血清样本,以GC-TOF-MS为检测手段,采用多元统计分析方法分析健康组、治疗前组与治疗后组血清中内源性代谢物的变化,筛选差异代谢物和重要代谢通路。结果三组血清代谢产物主成分均存在差异,可进行区分。共筛选出57种ADPKD患者的代谢差异物,抑囊方干预后有21种代谢物如亮氨酸、瓜氨酸、富马酸、天冬酰胺、谷氨酰胺、尿苷、山梨醇、喹啉酸、半胱氨酰甘氨酸等显著回调(P<0.01,P<0.05),通路涉及丙氨酸、天冬氨酸和谷氨酸代谢,嘧啶代谢,精氨酸和脯氨酸代谢,氮代谢,氨酰tRNA生物合成,半乳糖代谢。结论抑囊方可延缓CKD 3~4期ADPKD疾病进展,可能与其调节氨基酸代谢异常以减轻氧化应激对肾脏的损害,调节氮代谢及嘧啶代谢异常以促进机体内肾毒素的排泄有关。Objective To study the effects of Yinang Formula(YNF)on serum metabonomics for chronic kidney disease(CKD)stage 3-4 in patients with autosomal dominant polycystic kidney disease(ADPKD).Methods Thirty CKD3-4 patients with ADPKD treated with YNF for 24 weeks were selected from October 2017 to March 2019 at Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai Changzheng Hospital Affiliated to Second Military Medical University and Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine.Serum samples of patients at week 0(pre-treatment group)and week 24(post-treatment group)were collected,and serum samples of 20 healthy people(normal group)in the same period were collected.GC-TOF-MS and multivariate statistical analysis were used to analyze the changes of serum endogenous metabolites,to screen the differential metabolites and important metabolic pathways and to explore the treatment mechanism of YNF in normal group,pre-treatment group and post-treatment group.Results There were differences in the principal components of serum metabolic products among the three groups,which could be distinguished.A total of 57 kinds of metabolites in ADPKD patients were screened by GC-TOF-MS.Totally 21 kinds of metabolites including leucine,citrulline,fumaric acid,asparagine,glutamine,uridine,sorbitol,quinolinic acid,cysteonylglycine,etc were significantly reduced after intervention with YNF(P<0.01,P<0.05).The involved metabolism pathways included"Alanine,aspartate and glutamate metabolism""Pyrimidine metabolism""Arginine and proline metabolism""Nitrogen metabolism""Aminoacyl-tRNA biosynthesis"and"Galactose metabolism".Conclusion YNF could delay the progression of CKD stage 3-4 ADPKD disease,which might be related to the regulation of abnormal amino acid metabolism to reduce the damage of oxidative stress to the kidney,and the regulation of abnormal nitrogen metabolism and pyrimidine metabolism to promote the excretion of rena

关 键 词：抑囊方 成人型多囊肾病 慢性肾脏病3~4期 代谢组学 中药 

分 类 号：R277.5[医药卫生—中医学]