摘要
目的探讨化痹健脾康肾方对脾虚湿热型尿酸性肾病患者的肠道菌群及其代谢产物的影响,为该类患者的治疗提供参考。方法选取20例脾虚湿热型尿酸性肾病患者,给予化痹健脾康肾方治疗12周,收集患者治疗前后的血清及粪便样本,进行非靶向血清代谢组学检测及16S rRNA基因测序分析,筛选差异代谢物和肠道菌群,分析代谢通路及菌群结构变化,并进行相关性分析。结果治疗后患者的差异代谢物共59种,包括26种上调的代谢物和33种下调的代谢物,主要属于脂类及类脂分子类、有机杂环化合物类、有机酸及其衍生物类、激素及激素相关物质类代谢物、苯及其衍生物类代谢物、氨基酸及其代谢物等,其中以脂类物质为主。差异代谢物主要富集在甘油磷脂代谢、肌醇磷酸代谢等多条代谢通路。其中肌醇磷酸代谢、磷脂酰肌醇信号、长时程抑制、甘油酯代谢、磷酸戊糖途径表现出下调的趋势;而亚油酸代谢、胞葬作用、磷脂酶D信号通路则表现出上调的趋势。治疗后,患者肠道拟杆菌门、普雷沃菌科、阿加托杆菌属、普拉梭菌及青春双歧杆菌等有益菌的相对丰度显著上升,肠杆菌科等有害菌的相对丰度显著下降。与肥胖相关的厚壁菌门与拟杆菌门比值(F/B值)下降。治疗后相关性分析显示,与差异微生物呈显著相关的差异代谢物主要为甘油磷脂类(磷脂酰肌醇、磷脂酰丝氨酸、磷脂酰胆碱等)。结论化痹健脾康肾方可能通过调节肠道菌群结构,改善代谢通路,延缓脾虚湿热型尿酸性肾病患者的肾脏损伤。
Objective To observe the changes in intestinal microbiota and their metabolites in patients with spleen-deficiency dampness heat type hyperuricemic nephropathy(HN)treated with Huabi Jianpi Kangshen Formula,providing a reference for the treatment.Methods Twenty patients with spleen-deficiency dampness heat type HN were enrolled and treated with Huabi Jianpi Kangshen Formula for 12 weeks;serum and fecal samples were collected before and after treatment.Non-targeted serum metabolomics and 16S rRNA gene sequencing were performed to identify differential metabolites and microbiota.Metabolic pathways and microbial structural changes were analyzed,and correlation analysis was conducted.Results After treatment,59 differential metabolites were identified,including 26 upregulated and 33 downregulated metabolites.These metabolites primarily belonged to lipids and lipid-like molecules,organic heterocyclic compounds,organic acids and derivatives,hormones and hormone-related metabolites,benzene and derivatives,amino acids and their metabolites,with lipids being the most prominent.The differential metabolites were mainly enriched in metabolic pathways such as glycerophospholipid metabolism and inositol phosphate metabolism.Among them,inositol phosphate metabolism,phosphatidylinositol signaling,long-term depression,glycerolipid metabolism,and pentose phosphate pathway showed a downward trend,while linoleic acid metabolism,efferocytosis,and phospholipase D signaling pathway exhibited an upward trend.After treatment,the relative abundances of intestinal beneficial bacteria such as Bacteroidota,Prevotellaceae,Agathobacter,Faecalibacterium prausnitzii and Bifidobacterium adolescentis increased significantly.In contrast,harmful bacteria like Enterobacteriaceae showed a notable decrease.The Firmicutes/Bacteroidota ratio,associated with obesity,also declined.After treatemnt,correlation analysis between differential microbes and metabolites revealed that the metabolites significantly associated with microbial changes were mainly glycerophospholipids,such as phosphatidylinositol,phosphatidylserine,and phosphatidylcholine.Conclusion Huabi Jianpi Kangshen Formula may delay renal injury in patients with spleen deficiency dampness-heat type HN by modulating the structure of intestinal microbiota and improving metabolize pathways.
作者
李晟
戚晨云
陈钦
LI Sheng;QI Chenyun;CHEN Qin(Tongde Hospital of Zhejiang Province Affiliated to Zhejiang Chinese Medical University(College of Integrated Traditional Chinese and Western Medicine Clinical Medicine),Hangzhou,Zhejiang 310012,China;不详)
出处
《中国微生态学杂志》
北大核心
2025年第9期1049-1059,共11页
Chinese Journal of Microecology
基金
浙江省康复医学会科研专项基金项目(ZKKY2024013)。
关键词
脾虚湿热型尿酸性肾病
化痹健脾康肾方
血清代谢组学
16S
rRNA基因测序
肠道菌群
Spleen-deficiency dampness heat type hyperuricemic nephropathy
Huabi Jianpi Kangshen Formula
Serum metabolomics
16S rRNA gene sequencing
Intestinal flora
