健脾祛痰方联合艾灸疗法对高脂血症患者RCT代谢途径及肠道菌群的影响  

Effect of Jianpi Qutan Recipe(健脾祛痰方)Combined with Moxibustion Therapy on RCT Metabolic Pathway and Gut Microbiota in Patients with Hyperlipidemia

作　　者：王华文 张颖 陈民[1] WANG Huawen;ZHANG Ying;CHEN Min(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China;School of Nursing,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032 [2]辽宁中医药大学护理学院,辽宁沈阳110847

出　　处：《辽宁中医杂志》2024年第10期150-155,I0002,共7页Liaoning Journal of Traditional Chinese Medicine

基　　金：辽宁省科学技术计划(2017225046);辽宁省博士科研启动基金计划(2022-BS-205)。

摘　　要：目的研究健脾祛痰方联合艾灸疗法降脂的临床疗效,探究健脾祛痰方降脂的生物学机制。方法在辽宁中医药大学附属医院纳入脾虚痰浊血脂异常受试者共计120例,按照就诊顺序随机分为模型组、治疗组,每组60例。两组均予健康宣教,治疗组予健脾祛痰方颗粒剂配合双侧足三里、双丰隆穴、中脘穴、神阙穴温和灸治疗。对比两组受试者血脂水平、中医证候疗效、肠道菌群的结构变化及胆固醇逆转运相关蛋白胆固醇酯转运蛋白(cholesterol ester transporter protein,CETP)、磷脂转运蛋白(phospholipid transfer protein,PLTP)、卵磷脂胆固醇酰基转移(lecithin cholesterol acyltransferase,LCAT)、髓过氧化物酶(myeloperoxidase,MPO)、对氧磷酶1(paraoxonase 1,PON1)、血清淀粉样蛋白A(serum amyloid A,SAA)、载脂蛋白AI(apolipoprotein A-I,ApoAI)水平。结果治疗组患者血脂水平、中医证候积分较治疗前改善,明显优于模型组。治疗后患者HDL功能指标血清ApoA-I、PON1、LCAT含量较治疗前升高,SAA、MPO、CETP、PLTP含量较治疗前显著降低。治疗组患者用药后肠道菌群的多样性和物种丰度较治疗前明显增加,样本间差异明显,各分类水平物种组成比例发生变化,肠道菌群平衡有所恢复。结论健脾祛痰法能够显著降低血脂异常患者TC、TG、LDL水平,升高HDL水平,改善中医证候,调节肠道菌群结构,其机制可能与调控HDL功能相关的胆固醇逆转运(RCT)过程继而改善血脂水平有关。Objective To study the clinical effect of Jianpi Qutan Recipe(健脾祛痰方)combined with moxibustion therapy on reducing blood lipid and explore the biological mechanism of Jianpi Qutan Recipe on reducing blood lipid.Methods A total of 120 subjects who were normal subjects and subjects with spleen deficiency,turbid phlegm and abnormal blood lipid were included in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.They were randomly divided into a model group and a treatment group according to the visiting order,with 60 cases in each group.Both groups were given health education.The treatment group was given Jianpi Qutan Recipe Granules combined with mild moxibustion at bilateral Zusanli(T36),bilateral Fenglong(ST40),Zhongwan(RN12)and Shenque(RN8).The blood lipid levels,curative effects of traditional Chinese medicine syndromes,structural changes of intestinal flora and the expression levels of cholesterol ester transporter protein(CETP),phospholipid transporter protein(PLTP),lecithin cholesterol acyl transfer(LCAT),Myeloperoxidase(MPO),paraoxonase 1(PON1),serum amyloid A(SAA)and apolipoprotein AI(ApoAI).Results The patients in the treatment group had better lipid levels and TCM syndrome scores than those before treatment and were significantly better than those in the model group.After treatment,the levels of serum ApoA-I,PON1 and LCAT,high density lipoprotein(HDL)functional indicators of the patients were higher than those before treatment,and the levels of SAA,MPO,CETP and PLTP were significantly lower than those before treatment.The diversity and species abundance of intestinal flora in patients of the treatment group were significantly increased compared with those before treatment,and the differences were significant among samples.The composition proportion of species at each classification level was changed,and the balance of intestinal flora was restored.Conclusion The method of strengthening spleen and expelling phlegm can significantly reduce the levels of total cholesterol

关 键 词：健脾祛痰法 高脂血症 肠道菌群 艾灸法 胆固醇逆转运 

分 类 号：R256[医药卫生—中医内科学]