基于菌群16S rDNA测序探讨和中降浊调糖颗粒治疗肥胖2型糖尿病痰浊中阻证的降糖机制  

Mechanism of Hezhong Jiangzhuo Tiaotang Granule in Treating Obesity Type 2 Diabetes Mellitus with Syndrome of Phlegm-Dampness Based on the Microbiota 16S rDNA Sequencing

作　　者：庞国明 吕志刚 李鹏辉 叶乃菁[3] 王凯锋 孙扶 许强[3] 张芳 朱璞 李方旭 娄静 高言歌 陈丹丹 孔丽丽 王银姗 南凤尾 张平 PANG Guo-ming;LU Zhi-gang;LI Peng-hui;YE Nai-jing;WANG Kai-feng;SUN Fu;XU Qiang;ZHANG Fang;ZHU Pu;LI Fang-xu;LOU Jing;GAO Yan-ge;CHEN Dan-dan;KONG Li-li;WANG Yin-Shan;NAN Feng-wei;ZHANG Ping(Department of Endocrinology,Kaifeng Traditional Chinese Medicine Hospital,Henan,475001;School of Pharmacy,Nanjing University of Traditional Chinese Medicine,Nanjing,210046;Clinical College,Chengdu University of Traditional Chinese Medicine,Chengdu,610075;Department of Digestive and Endocrinology,Jinshui District General Hospital,Zhengzhou,450000)

机构地区：[1]开封市中医院内分泌科,开封475001 [2]南京中医药大学药学院,南京210046 [3]成都中医药大学临床医学院,成都610075 [4]郑州市金水区总医院消化与内分泌科,郑州450000

出　　处：《中国中西医结合杂志》2021年第10期1197-1205,共9页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：河南省重点研发与推广专项(科技攻关)(No.192102310431)。

摘　　要：目的探讨和中降浊调糖颗粒治疗肥胖2型糖尿病(T2DM)痰浊中阻证的作用机制。方法收集开封市中医院内分泌科肥胖T2DM痰浊中阻证受试者66例,按照随机数字表法分为治疗组及对照组,每组33例。治疗组给予和中降浊调糖颗粒,对照组给予盐酸二甲双胍片,疗程均为12周,收集干预前后受试者血液和粪便样本,测定空腹血糖(FPG)、餐后2小时血糖(2h PG)和糖化血红蛋白(HbA1c)及总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等,同时抽提粪便基因组DNA,首先进行Illumina PE250文库构建与测序,然后进行OTU聚类分析、物种分类学多样性与血糖关联分析。结果与本组干预前比较,两组干预后BMI、腰围(WC)、FPG、2h PG、HbA1c、TC、TG水平降低(P<0.05,P<0.01),HDL-C升高(P<0.05),对照组LDL-C水平下降(P<0.05);与对照组比较,治疗组BMI降低(P<0.05)。肥胖T2DM痰浊中阻证的肠道菌群在属水平上以劳特氏菌(Blautia)、埃希氏菌-志贺氏菌属(Escherichia-Shigella)、粪杆菌属(Faecalibacterium)和拟杆菌(Bacteroides)等为主;肥胖T2DM痰浊中阻证患者治疗后肠道菌群的菌属在组成上存在明显差异;和中降浊调糖颗粒可显著上调双歧杆菌(Bifidobacterium)和霍氏真杆菌(Eubacteriumhalliigroup)相对丰度及多样性。这些菌群变化与血糖变化水平呈显著相关性。结论和中降浊调糖颗粒可降低肥胖T2DM患者血糖水平,其机制可能与双歧杆菌(Bifidobacterium)、霍氏真杆菌(Eubacteriumhalligroup)富集并重塑肠道菌群结构有关。Objective To investigate the mechanism of Hezhong Jiangzhuo Tiaotang Granule(HZJZTTG) in treating Type 2 diabetes(T2 DM) with syndrome of phlegm-dampness. Methods Totally 66 cases of obese T2 DM patients(syndrome of phlegm-dampness) from the Department of Endocrinology,Kaifeng Traditional Chinese Medicine Hospital were recruited. According to random number table, the patients were assigned to the treatment group treated with HZJZTTG,and the control group treated with metformin hydrochloride Tablets,33 cases in each group and the course of treatment was 12 weeks. Blood and stool samples are collected before and after the treatment. Fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 h PG),HbA1 c and total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C) were detected. At the same time,fecal DNA was extracted,and Illumina PE250 library construction and sequencing were performed, and then the OTU cluster analysis,species taxonomy and the correlation analysis of environmental factor diversity,blood glucose and blood glucose diversity were carried out. Results Compared with the same group before treatment, the levels of BMI,WC,FPG, 2 h PG,HbA1 c,TC and TG in two groups decreased after treatment(P<0.05,P<0.01),HDL-C increased(P<0.05),and LDL-C in control group decreased(P<0.05).Compared with the control group,BMI of the treatment group was decreased(P<0.05).Intestinal microbial community of T2 DM with phlegm-dampness was dominated by Blautia,Eschericha-Shigella,Faecalibacterium and Bacteroides at the level of genus. The composition of intestinal flora in obese T2 DM patients with phlegm-dampness was significantly different before and after the treatment. HZJZTTG could significantly increase the relative abundance and diversity of Bifidobacterium and Eubacterium hallii group,and these changed intestinal flora had significant correlation analysis with blood glucose. Conclusion The HZJZTTG could reduce the blood glucose level of obese T2 DM

关 键 词：和中降浊调糖颗粒 痰浊中阻证 2型糖尿病 肠道菌群 降糖机制 

分 类 号：R259[医药卫生—中西医结合]