橘红提取物对非酒精性脂肪肝合并肥胖肠道菌群及中医体质影响的随机对照研究  

Effects of Exocarpium Citri Rubrum Extract on Intestinal Flora and Chinese Medicine Constitution in Non-Alcoholic Fatty Liver Disease with Obesity:A Randomized Controlled Trial

作　　者：程诗雨 陈晓云[1] 谭奚扬 谈欣怡 赵云帆 尤圣富[1] CHENG Shi-yu;CHEN Xiao-yun;TAN Xi-yang;TAN Xin-yi;ZHAO Yun-fan;YOU Sheng-fu(Rheumatology and Immunology Department,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200032)

机构地区：[1]上海中医药大学附属龙华医院风湿免疫科,上海200032

出　　处：《中国中西医结合杂志》2024年第10期1206-1214,共9页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：上海申康医院发展中心临床研究青年项目(No.SHDC2020CR4095)。

摘　　要：目的观察中药橘红提取物柠檬烯中长期干预对肥胖型非酒精性脂肪性肝病(NAFLD)患者的中医体质改变和肠道菌群的影响。方法于2021年2月—2022年1月在上海龙华医院招募72例患者,最终纳入60例患者,随机分为治疗组和对照组,每组30例,均要求饮食控制。治疗组予柠檬烯胶囊,对照组予安慰剂,按照每天3次,每次5粒,共计12周的方案服药。观察治疗前后体重指数(BMI)的变化,并观察基线期、干预第4周后、干预第12周后患者中医体质情况,并于治疗前后收集粪便样本进行16s菌群检测。结果最后完成试验57例。治疗组BMI差值(-0.68±0.57)低于对照组(-0.23±0.59,P<0.05);基线期NAFLD患者痰湿质占总单一体质的45%;经12周干预后治疗组痰湿质改善情况优于对照组;经12周干预后柠檬烯可以上调NAFLD痰湿质患者Catenibacterium、Lactobacillus等有益菌属和下调Clostridium_sensu_stricto_1等有害菌属的相对丰度。结论痰湿质是肥胖型NAFLD患者的主要偏颇体质,中药橘红提取物柠檬烯可以有效改善NAFLD患者的肥胖情况以及痰湿体质的发展,并且长期服用柠檬烯对痰湿质NAFLD患者的肠道菌群相对丰度起到一定的调节作用。(中国临床研究试验注册中心,No.ChiCTR2000035888)Objective To observe the effects of medium and long term intervention of the Exocarpium Citri Rubrum(ECR)extract limonene on changes in Chinese medicine constitution and intestinal flora in obese patients with non-alcoholic fatty liver disease(NAFLD).Methods Between February 2021 and October 2022,72 patients were recruited at Shanghai Longhua Hospital and finally 60 patients were included and randomly assigned to the treatment group and the control group,with 30 patients in each group.All patients were required to control their diet.The treatment group received limonene capsules,while the control group received placebos.They needed to follow a regimen of 3 times a day at 5 capsules each for a total of 12 weeks.The changes of body mass index(BMI)before and after treatment were observed.The Constitution in Chinese Medicine Questionnaire was observed at baseline,after 4 weeks of intervention,and after 12 weeks of intervention.Stool samples were collected before and after treatment for 16s microbiome analysis.Results A total of 57 patients completed the trial.The BMI difference in the treatment group(-0.68±0.57)was lower than that in the control group(-0.23±0.59,P<0.05).At baseline,phlegm-dampness constitution accounted for 45%of all single constitutions.After 12weeks'intervention,the improvement in phlegm-dampness constitution in the treatment group was better than that in the control group.Limonene could upregulate the relative abundance of beneficial bacterial genera such as Catenibacterium,Lactobacillus and other genera,and downregulate the relative abundance of harmful bacterial genera such as Clostridium_sensu_stricto_1 and other genera in NAFLD patients with phlegm-dampness constitution.Conclusions Phlegm-dampness constitution is the main biased constitution of obese NAFLD.ECR extract limonene can effectively improve obesity and the occurrence of phlegm-dampness constitution in NAFLD patients.Othermore,long-term use of limonene has a certain regulatory effect on the relative abundance of intestinal flora in

关 键 词：非酒精性脂肪肝病 肥胖 中医体质 肠道菌群 柠檬烯 橘红 中药提取物 中西医结合 随机对照试验 

分 类 号：R259[医药卫生—中西医结合]