清热退黄灌肠方对新生儿黄疸代谢标志物的影响及其作用机制  

Effect of Qingretuihuang Enema Decoction on Metabolic Markers of Neonatal Jaundice and its Mechanism

作　　者：马圆圆[1] 颜佳佳 阮为勇[1] 步伟全[1] 苏婕 MA Yuan-yuan;YAN Jia-jia;RUAN Wei-yong;BU Wei-quan;SU Jie(The Affiliated Hospital of Integrated Traditional and Western Medicine,Nanjing University of Traditional Chinese Medicine,Nanjing 210028,China;Traditional Chinese Medicine Hospital of Suqian City,Suqian 223800,China)

机构地区：[1]南京中医药大学附属中西医结合医院,江苏南京210028 [2]江苏省宿迁市中医院,江苏宿迁223800

出　　处：《云南中医中药杂志》2022年第12期77-80,共4页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

基　　金：江苏省中医药研究院自主科研项目(BM2018024-2019011)。

摘　　要：目的运用液相色谱-质谱(LC-MS)代谢组学的技术和方法,先筛选出清热退黄灌肠方治疗新生儿黄疸(湿热郁蒸证)前后血浆代谢物的差异,然后探究该治疗方案可能的代谢组学作用机制。方法选取符合纳入标准的黄疸新生儿共20例。随机分为对照组(西医治疗组)与治疗组(联合中药灌肠方),每组各10个新生儿,治疗疗程为5天。2组患儿均在治疗前与治疗后采集血浆,基于LC-MS代谢组学技术,运用多元统计分析方法(主成分分析即PCA分析、正交偏最小二乘判别分析即OPLS-DA分析)结合单变量、多变量统计分析,结合人类代谢组学数据库(HMDB)、京都基因和基因组百科全书(KEGG)数据库,筛选出显著差异代谢物,根据差异代谢物,揭示清热退黄灌肠方代谢组学方面的作用机制。结果治疗组患儿治疗前后血浆共得出种差异代谢物17种,其中α-酮戊二酸、2-氨基己二酸、胆碱、乙酰胆碱等物质的含量上调,尿酸、肌酸酐、泛酸等含量下调;治疗后,2组共得出15种差异代谢物,其中α-酮戊二酸、胆碱、乙酰胆碱等物质含量上调,尿酸、肌酸等含量下调。结论本研究能够阐释清热退黄灌肠方治疗新生儿黄疸(湿热郁蒸证)前后的代谢物的差异;清热退黄灌肠方的作用机制可能与调节氨基酸代谢、能量代谢及胆碱能通路有关。Objective:To screen out the differences of plasma metabolites before and after Qingretuihuang Enema Decoction in the treatment of neonatal jaundice(dampness-heat stagnation-steaming syndrome)by using liquid chromatography-mass spectrometry(LC-MS)metabolomics techniques and methods and then explore the possible metabolomics mechanism of the treatment.Methods:20 neonates with jaundice who met the inclusion criteria were selected and randomly divided into control group(Western medicine treatment group)and treatment group(combined with TCM enema decoction),10 neonates each group,and 5 days was a course of treatment.The plasma of the baby patients in the 2 groups was collected before and after treatment.Based on LC-MS metabolomics technology,multivariate statistical analysis(principal component analysis,PCA analysis,orthogonal partial least squares discriminant analysis,OPLS-DA analysis)combined with univariate and multivariate statistical analysis was made.Combined with Human Metabolomics Database(HMDB)and Kyoto Encyclopedia of Genes and Genomes(KEGG)database,significantly differentmetabolites were screened out.According to the differentmetabolites,the metabolomic mechanism of Qingretuihuang Enema Decoction was revealed.Results:A total of 17 different metabolites were obtained in the plasma of the treatment group before and after treatment,among which the contents ofα-ketoglutaric acid,2-aminoadipic acid,choline and acetylcholine were up-regulated while the contents of uric acid,creatinine and pantothenic acid were down-regulated.After treatment,a total of 15 different metabolites were obtained in the two groups,among which the contents ofα-ketoglutaric acid,choline and acetylcholine were up-regulated while the contents of uric acid and creatine were down-regulated.Conclusion:This study can explain the difference of metabolites before and after the treatment of neonatal jaundice with Qingretuihuang Enema Decoction and its mechanism may be related to the regulation of amino acid metabolism,energy metabolism and chol

关 键 词：清热退黄灌肠方 湿热郁蒸证 新生儿黄疸 代谢组学 

分 类 号：R285.6[医药卫生—中药学]