基于代谢组学探讨益气养阴解毒化瘀方对肝硬化轻微型肝性脑病肠道代谢物的影响  

Effect of Yiqi Yangyin Jiedu Huayu prescription on intestinal metabolites in liver cirrhosis with minimal hepatic encephalopathy:A study based on metabolomics

作　　者：姜婷婷 张群 王宪波 江宇泳 刘晓利 于浩 杨志云 JIANG Tingting;ZHANG Qun;WANG Xianbo;JIANG Yuyong;LIU Xiaoli;YU Hao;YANG Zhiyun(Department of Integrated Traditional Chinese and Western Medicine,Beijing Ditan Hospital,Capital Medical University,Laboratory for Clinical Medicine,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院中西医结合中心,首都医科大学基础-临床联合实验室,北京100015

出　　处：《临床肝胆病杂志》2025年第3期469-477,共9页Journal of Clinical Hepatology

基　　金：国家自然科学基金(82104781);北京市属医院科研培育计划(PZ20241802);北京市医院管理中心“登峰”人才培养计划(DFL20191803);高层次公共卫生技术人才建设项目培养计划(学科带头人-02-16)。

摘　　要：目的通过肠道代谢组学探讨益气养阴解毒化瘀方对肝硬化轻微型肝性脑病(MHE)的作用。方法选取2024年3月—2024年5月于首都医科大学附属北京地坛医院住院且经肝性脑病心理测量评分诊断为MHE的肝硬化患者(n=11)作为研究对象,同时招募健康患者家属作为对照组(n=11)。通过采集对照组及益气养阴解毒化瘀方治疗前后MHE患者的粪便进行代谢组学分析,探索MHE患者的肠道代谢物特征,并通过人群队列探讨益气养阴解毒化瘀方对MHE患者肠道代谢的影响。计数资料两组间比较采用Fisher精确检验;符合正态分布的计量资料两组间比较采用成组t检验,同一组内治疗前后的比较采用配对t检验,非正态分布的计量资料两组间及同组内治疗前后的比较采用Wilcoxon秩和检验。结果MHE组与对照组共检测出29种差异代谢物,差异代谢物主要为氨基酸类、有机酸类、有机胺类、碳水化合物类、脂肪酸类和维生素类,MHE组明显上调12种,下调17种,主要富集在鸟氨酸代谢通路、支链氨基酸代谢通路和芳香氨基酸代谢通路。MHE患者经益气养阴解毒化瘀方治疗前后共检测出80种差异代谢物,差异代谢物主要为碳水化合物类、有机酸类和氨基酸类,中药治疗后上调56种,下调24种,差异通路也主要富集在鸟氨酸代谢通路、支链氨基酸代谢通路和芳香氨基酸代谢通路。结论益气养阴解毒化瘀方可能通过调节MHE患者的肠道代谢发挥治疗作用。Objective To investigate the effect of Yiqi Yangyin Jiedu Huayu prescription on minimal hepatic encephalopathy in liver cirrhosis based on intestinal metabolomics.Methods A total of 11 patients with liver cirrhosis who were hospitalized in Beijing Ditan Hospital,Capital Medical University,from March to May 2024,and were diagnosed with MHE based on psychometric hepatic encephalopathy score were enrolled as subjects,and 11 healthy family members of the patients were enrolled as control group.Fecal samples were collected for metabolomics analysis from the control group and the patients with MHE before and after treatment with Yiqi Yangyin Jiedu Huayu prescription,and a population cohort study was conducted to investigate the effect of Yiqi Yangyin Jiedu Huayu prescription on intestinal metabolism of patients with MHE.The Fisher’s exact test was used for categorical data between two groups;the independent samples t-test was used for comparison of normally distributed continuous data between two groups,the paired t-test was used for comparision before and after treatment within the same group,and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups.Results A total of 29 differentially expressed metabolites were detected between the MHE group and the control group,mainly amino acids,organic acids,organic amines,carbohydrates,fatty acids,and vitamins,and there were 12 upregulated metabolites and 17 downregulated metabolites in the MHE group,which were mainly enriched in the metabolic pathways of ornithine,branched-chain amino acid,and aromatic amino acid.After the treatment with Yiqi Yangyin Jiedu Huayu prescription,80 differentially expressed metabolites were detected in the patients with MHE,mainly carbohydrates,organic acids,and amino acids,and there were 56 upregulated metabolites and 24 downregulated metabolites,which were mainly enriched in the metabolic pathways of ornithine,branched-chain amino acid,and aromatic amino acid.Conclusion Yiqi Yangyin Jie

关 键 词：肝硬化 肝性脑病 益气养阴解毒化瘀方 中医药疗法 代谢组学 

分 类 号：R57[医药卫生—消化系统]