二术天麻颗粒对临界性高血压痰湿证患者肠道菌群、TMAO的影响  

Curative Effect of Erzhu Tianma Granules on Gut Microbiota and TMAO Patients with Prehypertension with Phlegm-Dampness Syndrome

作　　者：周思敏 徐思雨 林建国 王擎擎 姚魁武[1,2] ZHOU Simin;XU Siyu;LIN Jianguo;WANG Qingqing;YAO Kuiwu(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing China 100053;Eye Hospital,China Academy of Chinese Medical Sciences,Beijing China 100040)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]中国中医科学院眼科医院,北京100040

出　　处：《中医学报》2024年第12期2655-2666,共12页Acta Chinese Medicine

基　　金：国家自然科学基金资助项目(81873173);国家重点研发计划项目(2019YFC1708703);中国中医科学院科技创新工程重大攻关项目(CI2021A00906);中国中医科学院科技创新工程创新团队项目(CI2021B004);中华中医药学会资助项目(T/CACM 1419-2022)。

摘　　要：目的:探讨二术天麻颗粒对临界性高血压(prehypertension,PHT)痰湿证患者的疗效、肠道菌群、氧化三甲胺(trimethylamine oxide,TMAO)的影响。方法:选取25例PHT痰湿证患者作为研究组,研究组基线水平作为干预前组,口服二术天麻颗粒12周后作为干预后组,随机选取25例同期健康居民作为对照组。比较3组治疗前后收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、降压疗效、中医证候评分、中医证候疗效、总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、高密度脂蛋白(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白(low density lipoprotein cholesterol,LDL-C)、TMAO、三甲胺(trimethylamine,TMA)、胆碱(choline,CHO)、甜菜碱(betaine,BET)、肌酐(creatinine,CRE)、左旋肉碱(L-carnitine,LECA)水平和肠道菌群变化。结果:与对照组比较,干预前组SBP、DBP、TC、TG、LDL-C、TMAO、TMA、CHO、BET、CRE、LECA升高,HDL-C下降(P<0.01);肠道菌群物种丰度略增加、多样性略减少(P>0.05),均匀度降低;在门水平方面,厚壁菌门相对丰度略升高(P>0.05),拟杆菌门相对丰度降低,二者比值F/B升高,在属水平上惰性真杆菌属、拉乌尔菌属、罗斯菌属、SWB02相对丰度升高,优/真杆菌属相对丰度降低(P<0.05)。与干预前组比较,二术天麻颗粒干预12周后SBP、DBP、中医证候总积分降低,降压疗效有效率为84%,中医证候疗效有效率为100%,TG、TC、LDL-C、TMAO、CRE、LECA、TMA、CHO显著下降(P<0.05);肠道菌群物种丰度及多样性略下降(P>0.05),均匀度增加;在门水平方面,拟杆菌门相对丰度升高,厚壁菌门相对丰度降低,F/B降低;在属水平方面,惰性真杆菌属、放线菌属、拉乌尔菌属、SWB02相对丰度降低,Colidextribacter、Muribaculum、Candidatus_Arthromitus相对丰度升高(P<0.05);其中拟杆菌门相对丰度与LECA、CRE、CHO、TMA水平呈负相关,惰性真杆菌属相对丰度与TMAO、LECA水平�Objective:To investigate the efficacy of Erzhu Tianma Granule on patients with Phlegm-Dampness syndrome of borderline hypertension(PHT)and its effect on intestinal flora and trimethylamine n-oxide(TMAO).Methods:Twenty-five patients with Phlegm-Dampness syndrome of PHT were selected as the study group.The study group was treated as the pre-intervention group at baseline level,and the post-intervention group was treated as the post-intervention group after 12 weeks of oral administration of Erzhu Tianma Granule,and the control group consisted of 25 randomly selected healthy residents in the same period of time.The three groups were compared before and after treatment for systolic blood pressure(SBP),diastolic blood pressure(DBP),antihypertensive efficacy,Chinese medicine evidence score,Chinese medicine evidence efficacy,total cholesterol(TC),triglycerides(TG)and triglycerides(TG).triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),TMAO,trimethylamine(TMA),and other substances.LDL-C,TMAO,trimethylamine(TMA),choline(CHO),betaine(BET),creatinine(CRE),L-carnitine(LECA)and intestinal flora.Results:Compared with the control group,the pre-intervention group showed an increase in SBP,DBP,TC,TG,LDL-C,TMAO,TMA,CHO,BET,CRE,and LECA,and a decrease in HDL-C(P<0.01);the intestinal bacterial flora showed a slight increase in species abundance,a slight decrease in diversity(P>0.05),and a decrease in homogeneity;and the relative abundance of phylum Thickwalled was slightly elevated at the phylum level(P>0.05),the relative abundance of Anabaena phylum decreased,and the ratio of the two,F/B,increased;at the genus level the relative abundance of inert Fusobacterium spp.,Raoulia spp.,Rossella spp.,and SWB02 increased,and the relative abundance of Eugenius/Fusobacterium spp.decreased(P<0.05).Compared with that of the pre-intervention group,SBP,DBP,and total points of Chinese medicine evidence decreased after 12 weeks of intervention with Erzhu Tianma Granule,the effective rate of anti

关 键 词：临界性高血压 痰湿证 二术天麻颗粒 肠道菌群 氧化三甲胺 

分 类 号：R259.441[医药卫生—中西医结合]