脐灸对阈下抑郁患者肠道菌群的影响  

Effect of umbilical moxibustion on intestinal flora in patients with subthreshold depression

作　　者：于子如 仙晋 王玲 于慧娟[1,2] YU Ziru;XIAN Jin;WANG Ling;YU Huijuan(College of Acupuncture-Moxibustion and Tuina,Shandong University of TCM,Jinan 250014,China;Disease Prevention Centre,Affiliated Hospital of Shandong University of TCM,Jinan 250014)

机构地区：[1]山东中医药大学针灸推拿学院,济南250014 [2]山东中医药大学附属医院治未病中心,济南250014

出　　处：《中国针灸》2024年第8期881-888,918,共9页Chinese Acupuncture & Moxibustion

基　　金：山东省中医药科技项目:Q-2023088,2021Q110。

摘　　要：目的:观察脐灸治疗阈下抑郁(SD)患者的临床疗效以及对肠道菌群的影响,探讨其作用机制。方法:招募36例SD患者作为阈下抑郁组(脱落1例,剔除2例),招募36例健康受试者作为健康对照组(剔除1例)。阈下抑郁组采用脐灸治疗,每周1次,共治疗8次;健康对照组不予任何干预。观察阈下抑郁组治疗前后汉密尔顿抑郁量表17项(HAMD-17)、流调中心抑郁量表(CES-D)评分,并评定临床疗效。分别于阈下抑郁组治疗前后及健康对照组入组时采集粪便样本,采用16S rRNA测序技术分析肠道菌群情况。结果:与治疗前比较,阈下抑郁组治疗后HAMD-17、CES-D评分降低(P<0.05),总有效率为90.9%(30/33)。与健康对照组比较,阈下抑郁组治疗前Sobs、Shannon、Ace指数降低(P<0.05),Simpson指数升高(P<0.05),有害菌埃希杆菌-志贺菌属(Escherichia-Shigella)相对丰度升高(P<0.01),有益菌霍氏真杆菌属(Eubacterium_hallii_group)、瘤胃球菌属(Ruminococcus)、克里斯滕森菌科R7群(Christensenellaceae_R-7_group)、帕拉普氏菌属(Paraprevotella)相对丰度降低(P<0.05,P<0.01);与治疗前比较,阈下抑郁组治疗后Escherichia-Shigella相对丰度降低(P<0.01),Ruminococcus、Christensenellaceae_R-7_group、Paraprevotella相对丰度升高(P<0.01,P<0.05)。Christensenellaceae_R-7_group、Paraprevotella与CES-D评分呈负相关(P<0.01,P<0.05);Escherichia-Shigella与HAMD-17评分呈正相关(P<0.05),Christensenellaceae_R-7_group与HAMD-17评分呈负相关(P<0.01)。结论:SD患者存在肠道菌群紊乱,脐灸可能通过调节肠道菌群的丰度和多样性,增加有益菌,减少有害菌,从而发挥疗效。Objective To observe the clinical efficacy of umbilical moxibustion for subthreshold depression(SD)and its effect on intestinal flora,and to explore its mechanism.Methods Thirty-six SD patients were recruited as the SD group(1 case dropped out,2 cases excluded),and 36 healthy subjects were recruited as the healthy control group(1 case excluded).The SD group was treated with umbilical moxibustion,once a week,a total of 8 times were required.The healthy control group did not receive any intervention.Hamilton depression scale 17-item(HAMD-17)and Center for Epidemiologic Studies depression scale(CES-D)scores were observed in the SD group before and after treatment,and the clinical efficacy was evaluated.Fecal samples were collected in the SD group before and after treatment and in the healthy control group when enrolled,the intestinal flora was analyzed by 16S rRNA sequencing technology.Results The HAMD-17 and CES-D scores after treatment in the SD group were reduced compared with those before treatment(P<0.05),and the total effective rate was 90.9%(30/33).Compared with the healthy control group,Sobs index,Shannon index and Ace index were reduced in the SD group before treatment(P<0.05),Simpson index was increased(P<0.05),the relative abundance of Escherichia-Shigella was increased(P<0.01),the relative abundance of Eubacterium_hallii_group,Ruminococcus,Christensenellaceae_R-7_group,Paraprevotella was decreased(P<0.05,P<0.01).Compared before treatment,the relative abundance of Escherichia-Shigella after treatment in the SD group was decreased(P<0.01),the relative abundance of Ruminococcus,Christensenaceae_R-7_group,Paraprevotella was increased(P<0.01,P<0.05).Christensenellaceae_R-7_group and Paraprevotella were negatively correlated with the CES-D score(P<0.01,P<0.05).Escherichia-Shigella was positively correlated with the HAMD-17 score(P<0.05).Christensenellaceae_R-7_group was negatively correlated with the HAMD-17 score(P<0.01).Conclusion Patients with subthreshold depression have dysbiosis of intestinal flora,and u

关 键 词：阈下抑郁 抑郁 脐灸 16S rRNA 肠道菌群 

分 类 号：R246.6[医药卫生—针灸推拿学]