Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
State Key Laboratory for Turbulence and Complex Systems, Department of Biomedical Engineering, College of Future Technology and Center for Quantitative Biology, Peking University, Beijing, China.
Front Cell Infect Microbiol. 2022 Feb 9;12:827129. doi: 10.3389/fcimb.2022.827129. eCollection 2022.
As a life-threatening disease, stroke is the leading cause of death and also induces adult disability worldwide. To investigate the efficacy of the integrated traditional Chinese medicine (ITCM) on the therapeutic effects of acute ischemic stroke (AIS) patients, we enrolled 26 patients in the ITCM [Tanhuo decoction (THD) + Western medicine (WM)] group and 23 in the WM group. Thirty healthy people were also included in the healthy control (HC) group. ITCM achieved better functional outcomes than WM, including significant reduction of the phlegm-heat syndrome and neurological impairment, and improvement of ability. These facts were observed in different pretreatment gut enterotypes. In this paper, we collected the stool samples of all participants and analyzed the 16S rRNA sequence data of the gut microbiota. We identified two enterotypes (Type-A and Type-B) of the gut microbial community in AIS samples before treatment. Compared to Type-B, Type-A was characterized by a high proportion of , relatively high diversity, and severe functional damage. In the ITCM treatment group, we observed better clinical efficacy and positive alterations in microbial diversity and beneficial bacterial abundance, and the effect of approaching healthy people's gut microbiota, regardless of gut enterotypes identified in pretreatment. Furthermore, we detected several gut microbiota as potential therapeutic targets of ITCM treatment by analyzing the correlations between bacterial abundance alterations and functional outcomes, where with the strongest correlation was known to produce anti-inflammatory metabolite and negatively linked to trimethylamine-N-oxide (TMAO), a biomarker of AIS. This study analyzed clinical and gut microbial data and revealed the possibility of a broad application independent of the enterotypes, as well as the therapeutic targets of the ITCM in treating AIS patients with phlegm-heat syndrome.
作为一种危及生命的疾病，中风是全球范围内导致死亡和成人残疾的主要原因。为了研究中药综合治疗（ITCM）对急性缺血性中风（AIS）患者治疗效果的影响，我们将 26 名患者纳入 ITCM[痰火汤（THD）+ 西药（WM）]组，23 名患者纳入 WM 组。还纳入了 30 名健康人作为健康对照组（HC）。ITCM 组在功能结局方面优于 WM 组，包括痰热症状和神经损伤的显著减少，以及能力的提高。这些事实在不同的预处理肠道肠型中都得到了观察。在本文中，我们收集了所有参与者的粪便样本，并分析了肠道微生物群的 16S rRNA 序列数据。我们在治疗前鉴定了 AIS 样本中肠道微生物群落的两种肠型（A型和 B 型）。与 B 型相比，A型的特征是相对较高比例的 ，较高的多样性和严重的功能损伤。在 ITCM 治疗组中，我们观察到更好的临床疗效和微生物多样性和有益细菌丰度的积极变化，并且这种效果接近健康人的肠道微生物群，而不管治疗前确定的肠道肠型如何。此外，我们通过分析细菌丰度变化与功能结局之间的相关性，检测到几种肠道微生物群作为 ITCM 治疗的潜在治疗靶点，其中与最强相关性的 被认为可以产生抗炎代谢物，并与 AIS 的生物标志物三甲胺 N-氧化物（TMAO）呈负相关。本研究分析了临床和肠道微生物数据，揭示了 ITCM 治疗痰热证 AIS 患者的广泛应用的可能性，以及独立于肠型的治疗靶点。
