紫花盆炎方保留灌肠治疗湿热瘀结型盆腔炎后遗症患者的血清代谢组学研究  

Serum metabolomics study of Zihuapenyan Prescription retention enema in the treatment of patients with sequelae of pelvic inflammatory disease of damp-heat stasis type

作　　者：吴嫣 苟小军 杨晓露 赵艳 WU Yan;GOU Xiao-jun;YANG Xiao-lu;ZHAO Yan(Department of Obstetrics and Gynecology,Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China;Central Laboratory,Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China)

机构地区：[1]上海市宝山区中西医结合医院妇产科,上海201999 [2]上海市宝山区中西医结合医院中心实验室,上海201999

出　　处：《中国医院药学杂志》2022年第20期2093-2100,共8页Chinese Journal of Hospital Pharmacy

基　　金：上海市中医优势病种培育建设项目[编号:ZY(2018-2020)-ZYBZ-22];上海市卫生健康委员会科研项目(编号:202140235)。

摘　　要：目的:观察紫花盆炎方(ZHPYP)对湿热瘀结型盆腔炎后遗症患者的临床疗效,并借助代谢组学技术分析ZHPYP保留灌肠治疗湿热瘀结型盆腔炎后遗症的疗效机制。方法:收集患者治疗前和治疗后以及正常人的血清,记录患者治疗前后的证候积分,检测患者血清中IL-2、IL-4和IL-10因子水平,采用气相色谱-质谱联用(GC-MS)技术检测血清样本。结果:与治疗前比较,治疗1,2,3周时,患者的中医证候积分均降低,差异均有统计学意义(P<0.01);治疗后患者血清IL-2水平明显降低,IL-4和IL-10水平明显升高,差异有统计学意义(P<0.01)。患者治疗前组和正常组血清代谢谱区分明显,治疗后组代谢谱位居于二者之间,并趋近于正常组,呈现回归正常的趋势。ZHPYP干预后可以引起患者体内16种内源性代谢物的表达变化,通路分析显示主要通过影响苯丙氨酸、丙氨酸、天冬氨酸和谷氨酸代谢等。结论:ZHPYP保留灌肠治疗湿热瘀结型盆腔炎后遗症的临床效果显著,可有效降低患者中医证候积分、改善炎症指标,其作用机理可能与其调节苯丙氨酸代谢,丙氨酸、天冬氨酸和谷氨酸代谢通路等有关。OBJECTIVE To observe the clinical efficacy of Zihuapenyan Prescription(ZHPYP)on patients with pelvic inflammatory disease sequelae of damp-heat stasis type,and analyze the mechanism of ZHPYP retention enema in the treatment of pelvic inflammatory disease sequelae of damp-heat stasis type by using metabolomics technology.METHODS Serum of patients before and after treatment as well as normal people were collected.The syndrome scores of patients before and after treatment were recorded,and the levels of IL-2,IL-4 and IL-10 factors in serum were detected.Serum samples were detected by gas chromatography-mass spectrometry(GC-MS).RESULTS Compared with the indexs before treatment,the TCM syndrome scores of the patients were significantly decreased at 1,2,and 3 weeks,the differences were statistically significant(P<0.01).The serum IL-2 level of the patients after treatment was significantly decreased,and the levels of IL-4 and IL-10 were significantly increased,and the differences were statistically significant(P<0.01).The serum metabolic profiles of the patients before treatment and the normal group were clearly distinguished.The metabolic profiles of the patients after treatment were between the pre-treatment group and the normal group,and approached the normal group,showing a trend of returning to normal.After the intervention of ZHPYP,the expression of 16 endogenous metabolites could be changed in patients.Pathway analysis showed that ZHPYP mainly affected the metabolism of phenylalanine,alanine,aspartic acid and glutamine acid.CONCLUSION ZHPYP retention enema has a significant clinical effect in the treatment of sequelae of pelvic inflammatory disease of damp-heat stasis type.ZHPYP can effectively reduce the patient’s TCM syndrome score and improve inflammatory indicators.Its mechanism of action may be related to the metabolism regulation of phenylalanine,alanine,aspartate acid and glutamate acid.

关 键 词：紫花盆炎方 保留灌肠 盆腔炎后遗症 气相色谱-质谱联用 代谢组学 

分 类 号：R969.1[医药卫生—药理学]