Research Center for Traditional Chinese Medicine Complexity System, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Research Center for Traditional Chinese Medicine and System Biology, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Acta Pharmacol Sin. 2018 Jun;39(6):942-951. doi: 10.1038/aps.2017.101. Epub 2017 Oct 26.
Fuzheng-Huayu formula (FZHY), a Chinese herbal mixture prescription, has been proven effective in treating liver fibrosis and cirrhosis in both clinical trials and animal experiments. In this study we assessed the metabolic mechanisms of traditional Chinese medicine (TCM) syndrome-based FZHY treatment in liver cirrhosis (LC). A total of 113 participants, including 50 healthy controls and 63 LC patients, were recruited. According to the diagnosis and differentiation of the TCM syndromes, the LC patients were classified into 5 TCM syndrome groups including the liver stagnation syndrome (LSS), spleen deficiency and damp overabundance syndrome (SDDOS), damp-heat accumulation syndrome (DHAS), liver-kidney Yin deficiency syndrome (LKYDS), and blood stagnation syndrome (BSS), and administered FZHY for 6 months. FZHY treatment significantly decreased serum levels of hyaluronic acid (HA), a biochemical marker for LC, as well as TCM syndrome scores (the TCM syndrome scores were decreased in all the groups with significant decreases in the LSS and LKYDS groups). Furthermore, FZHY treatment gradually shifted the metabolic profiles of LC patients from a pathologic state to a healthy state, especially in LC patients with LSS and LKYDS. Twenty-two differently altered metabolites (DAMs) were identified, including carbohydrates, amino acids, fatty acids, etc with 9 DAMs in LSS patients, 9 in LKYDS patients, and 4 in other patients. The metabolic pathways involved in the conversion of amino acids and the body's detoxification process were regulated first, followed by the pathways involved in the body's energy supply process. In conclusion, the evaluation of the effect of TCM syndrome-based FZHY treatment show that FZHY has a better effect on LKYDS and LSS than on the other TCM syndromes, and the metabolic mechanisms might be involved in the increased detoxification function in LKYDS and the improvement of energy supply in LSS, which provides important evidence for the clinical application of TCM syndrome-based treatment.
扶正化瘀方（FZHY）是一种中药复方，已在临床试验和动物实验中被证明可有效治疗肝纤维化和肝硬化。在这项研究中，我们评估了基于中医证候的 FZHY 治疗肝硬化（LC）的代谢机制。共招募了 113 名参与者，包括 50 名健康对照者和 63 名 LC 患者。根据中医证候的诊断和辨证，将 LC 患者分为 5 个中医证候组，包括肝郁证（LSS）、脾虚湿盛证（SDDOS）、湿热蕴结证（DHAS）、肝肾阴虚证（LKYDS）和血瘀证（BSS），并给予 FZHY 治疗 6 个月。FZHY 治疗显著降低了血清透明质酸（HA）水平，HA 是 LC 的生化标志物，以及中医证候评分（所有组的中医证候评分均降低，LSS 和 LKYDS 组的降低更为显著）。此外，FZHY 治疗逐渐使 LC 患者的代谢谱从病理状态转变为健康状态，尤其是在 LSS 和 LKYDS 的 LC 患者中。共鉴定出 22 种不同改变的代谢物（DAMs），包括碳水化合物、氨基酸、脂肪酸等，其中 LSS 患者有 9 种 DAMs，LKYDS 患者有 9 种，其他患者有 4 种。参与氨基酸转化和机体解毒过程的代谢途径首先被调节，然后是参与机体供能过程的代谢途径。总之，基于中医证候的 FZHY 治疗效果的评估表明，FZHY 对 LKYDS 和 LSS 的疗效优于其他中医证候，其代谢机制可能与 LKYDS 解毒功能增强和 LSS 能量供应改善有关，为中医证候治疗的临床应用提供了重要依据。
