摘要
目的:探讨清化活血方对湿热内蕴型高尿酸血症(HUA)患者血清炎症因子及肠道菌群的影响。方法:纳入符合中医湿热内蕴证型的HUA患者52例,按随机数字表法分为治疗组和对照组各26例,治疗组患者予清化活血方颗粒剂,对照组予等量安慰剂共治疗12周。服药期间每周对患者进行1次随访,对所有患者进行饮食及运动指导。比较治疗前后两组临床疗效及血清白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、γ-干扰素(IFN-γ)、白介素-1β(IL-1β)等炎症因子水平,留取患者粪便样本测定两组患者肠道菌群多样性及丰度变化。结果:治疗12周后,治疗组患者较对照组舒张压下降(P<0.05);治疗组患者总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平下降,与对照组比较差异有统计学意义(P<0.05),与治疗前相比差异有统计学意义(均P<0.01);治疗12周后,治疗组与对照组患者尿酸水平差异有统计学意义(P<0.05);治疗前后两组患者肝肾功能差异无统计学意义(P>0.05);治疗后两组患者血清炎症因子IFN-γ及IL-1β比较差异有统计学意义(均P<0.05);治疗组患者治疗前后菌群多样性差异无统计学意义(P>0.05);对于菌群丰度分析发现门水平治疗组患者治疗前后拟杆菌门、放线菌门、酸杆菌门、绿弯菌门、硝化菌门、甲基杆菌门、GAL15菌门丰度与治疗前均存在差异;对照组患者仅芽单孢菌门和绿弯菌门丰度存在差异;属水平的分析发现治疗组患者治疗前后拟杆菌属、布劳特菌属、双歧杆菌属、肠杆菌属、鞘氨醇单胞菌属、gaiella(放线菌门下的菌属之一)丰度存在差异,对照组治疗前后仅布劳特菌属、鞘氨醇单胞菌丰度差异有统计学意义(均P<0.05)。结论:清化活血方能够降低湿热内蕴型HUA患者尿酸水平,同时调节患者血脂,改善舒张压,与体内促炎因子IFN-γ和IL-1β表达降低,肠道布劳特菌属、双歧杆菌属等优势菌群丰度增加,拟杆菌丰度降低有关。
Objective:To observe the effect of Qinghua Huoxue(QHHX)formula on serum inflammatory factors and gut microbiota in hyperuricemia(HUA)patients with damp heat intrinsic syndrome.Methods:52 patients with HUA were divided into two groups randomly,26 patients in treatment group and 26 in control group.After enrollment,patients in treatment group were given QHHX granules,and patients in control group were given the same amount of placebo for 12 weeks.During treatment,patients were followed up once a week,and all patients were given diet and exercise guidance.To compare the clinical effect of improving uric acid level and difference of serum IL-6 and TNF-α、IFN-γ、IL-1β between two groups after treatment.Meanwhile,the fecal samples of all patients were taken to determine the diversity and abundance of intestinal flora in all patients.Results:After 12 weeks of treatment,diastolic blood pressure of the patients in treatment group decreased with significant difference compared with that in control group(P<0.05);levels of total cholesterol and low-density lipoprotein in treatment group decreased significantly compared with those in control group(P<0.05),and significant difference was also observed compared with that before treatment(all P<0.01);after 12 weeks of therapy,uric acid level of patients in treatment group decreased significantly compared with patients before treatment(P<0.05),and a significant difference was also observed about uric acid between the two groups after treatment(P<0.05);also differences appeared in serum inflammatory factor IFN-γ and IL-1β between the two groups after treatment(P<0.05),but no significant was found about difference in bacterial diversity before and after therapy in treatment group(P>0.05),but differences in the abundance of bacteroidate,actinobacteriota,acidobacteriota,chloroflexi,nitrospirota,nethyllomirabilota and GAL15 were found in phylum level before and after treatment;however,only the abundance of chloroflexi and gemmatimonadota had difference in the control group;in the genus level,there were differences in the abundance of bacteroides,blautia,bifidobacterium,intestinibacter,sphingomonas and gaiella in treatment group before and after treatment.In the control group,only significant difference in abundance of bacillus and sphingomonas appeared before and after treatment(P<0.05).Conclusion:QHHX formula can improve the uric acid level of patients with internal damp-heat syndrome,reduce the total cholesterol and low-density lipoprotein levels and improve the diastolic pressure of patients with hyperuricemia.It may play a metabolic regulatory role by reducing the expression of proinflammatory factors IFN-γ and IL-1β,increasing the abundance of dominant bacteria such as blautia and bifidobacterium and reducing the abundance of bacteria such as bacteroides.
作者
张洪艳
刘风静
孟胜喜
王宇新
马丽
彭文波
王兵
李翠娟
孙永宁
ZHANG Hongyan;LIU Fengjing;MENG Shengxi;WANG Yuxin;MA Li;PENG Wenbo;WANG Bing;LI Cuijuan;SUN Yongning(Affiliated Sixth People’s Hospital of Shanghai Jiaotong University Medical College,Shanghai 200233,China;Shaanxi University of Traditional Chinese Medicine,Xianyang 712046,China;Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai 200040,China)
出处
《陕西中医》
2025年第10期1330-1335,共6页
Shaanxi Journal of Traditional Chinese Medicine
基金
国家自然科学基金资助项目(81874377,8210649)
陕西省中医体质与疾病防治研究重点实验室开放课题(KF202310)
上海交通大学医学院附属第六人民医院院级课题(YNLC201827)。
关键词
高尿酸血症
清化活血方
湿热内蕴证
肠道菌群
炎症因子
白细胞介素-6
Hyperuricemia
Qinghua Huoxue formula
Internal damp-heat syndrome
Intestinal flora
Inflammatory factor
Interleukin-6
