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基于肠道菌群结合代谢组学探讨桃红四物汤治疗血虚血瘀证的机制

Exploring the mechanism of Taohong Siwu Decoction on the treatment of blood deficiency and blood stasis syndrome by gut microbiota combined with metabolomics.

作者信息

He Yao, Jiang Huajuan, Du Kequn, Wang Shengju, Li Minmin, Ma Chuan, Liu Fang, Dong Yan, Fu Chaomei

机构信息

State Key Laboratory of Southwestern Chinese Medicine Resources, Pharmacy College, Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, 611137, Sichuan, China.

Guizhou Yibai Pharmaceutical Co., Ltd, 550008, Guiyang, China.

出版信息

Chin Med. 2023 Apr 23;18(1):44. doi: 10.1186/s13020-023-00734-8.

DOI:10.1186/s13020-023-00734-8
PMID:37088809
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10122815/
Abstract

BACKGROUND

Taohong Siwu Decoction (THSWD) is a prescription which included in the "List of Ancient Classic Prescriptions (First Batch)" issued by the National Administration of Traditional Chinese Medicine (TCM) and the National Medical Products Administration of the People's Republic of China. THSWD is effective and widely applied clinically for many diseases caused by blood deficiency and stasis syndrome in TCM, such as primary dysmenorrhea, menopausal syndrome, coronary heart disease, angina pectoris, and diabetes.

METHODS

The TCM model of blood deficiency and blood stasis syndrome was prepared by ice water bath combined with cyclophosphamide, and the rats were randomly divided into control group, blood deficiency, and blood stasis model group, positive group, and THSWD treatment group. Pharmacodynamics measured the blood routine, blood coagulation, and other related indexes in rats. UHPLC-MS technology was used to analyze the changes in the fingerprints of metabolites in the plasma of rats with blood deficiency and blood stasis syndrome, and combined with mass spectrometry information and public database retrieval, to find potential biomarkers for screening metabolites. At the same time, 16S rDNA sequencing technology was used to identify intestinal flora, and statistical analysis was used to find differences in strain diversity between groups.

RESULTS

THSWD administration can significantly improve the physical signs, blood routine, and hematopoietic factors caused by the blood deficiency and blood stasis syndrome model, and improve the symptoms of blood deficiency. The results of the general pharmacological studies showed THSWD groups improved changes in blood plasma viscosity and coagulation-related factors caused by modeling, and improved coagulation function significantly. The metabolomic analysis found that compared to the model group, THSWD exerted better effects on β-alanine, taurine, L-tyrosine, L-arginine, Eugenol, sodium deoxycholate, and deethylatrazine. Twenty-three potential differential metabolites showed intervention effects, mainly involved in eight metabolic pathways, including amino acid metabolism, taurine and hypotaurine metabolism, vitamin metabolism, and nucleotide metabolism. Gut microbiota data showed that, compared to the control group, the relative abundance and value of Firmicutes and Bacteroidota of the blood deficiency and blood stasis model group was significantly reduced, while the relative abundance of Actinobacteria, Spirochaetota, Proteobacteria, Campilobacterota, and other pathogenic bacteria was significantly increased. Following THSWD intervention, the abundance of beneficial bacteria increased, and the abundance of pathogenic bacteria decreased. Correlation analysis between the gut microbiota and differential metabolites showed that the two are closely related. THSWD affected the host blood system through mutual adjustment of these two factors, and improved blood deficiency and blood stasis syndrome in rats.

CONCLUSION

The blood deficiency and blood stasis syndrome model of TCM disease caused by ice bath combined with cyclophosphamide lead to changes in the pharmacology, metabolomics, and gut microbiota. The intervention of THSWD can improve the symptoms caused by blood deficiency and blood stasis. The mechanism is mainly through the regulation of platelet function and amino acid metabolism.

摘要

背景

桃红四物汤是被国家中医药管理局和国家药品监督管理局发布的《古代经典名方目录(第一批)》收录的方剂。桃红四物汤在临床上对多种中医血虚血瘀证所致疾病有效且应用广泛,如原发性痛经、更年期综合征、冠心病、心绞痛和糖尿病等。

方法

采用冰水浴联合环磷酰胺制备中医血虚血瘀证模型,将大鼠随机分为对照组、血虚血瘀模型组、阳性组和桃红四物汤治疗组。药效学检测大鼠血常规、凝血等相关指标。采用超高效液相色谱 - 质谱联用(UHPLC-MS)技术分析血虚血瘀证大鼠血浆中代谢产物指纹图谱的变化,并结合质谱信息和公共数据库检索,寻找潜在的代谢产物筛选生物标志物。同时,采用16S rDNA测序技术鉴定肠道菌群,通过统计分析找出各组间菌株多样性的差异。

结果

给予桃红四物汤可显著改善血虚血瘀证模型所致的体征、血常规及造血因子,改善血虚症状。一般药理学研究结果显示,桃红四物汤组可改善造模引起的血浆黏度及凝血相关因子的变化,显著改善凝血功能。代谢组学分析发现,与模型组相比,桃红四物汤对β-丙氨酸、牛磺酸、L-酪氨酸、L-精氨酸、丁香酚、脱氧胆酸钠和去乙基莠去津有较好的作用效果。23种潜在差异代谢产物呈现干预效应,主要涉及氨基酸代谢、牛磺酸和低牛磺酸代谢、维生素代谢和核苷酸代谢等8条代谢途径。肠道微生物群数据显示,与对照组相比,血虚血瘀模型组厚壁菌门和拟杆菌门的相对丰度和数值显著降低,而放线菌门、螺旋体门、变形菌门、弯曲杆菌门等病原菌的相对丰度显著增加。桃红四物汤干预后,有益菌丰度增加,病原菌丰度降低。肠道微生物群与差异代谢产物的相关性分析表明二者密切相关。桃红四物汤通过这两个因素的相互调节影响宿主血液系统,改善大鼠血虚血瘀证。

结论

冰水浴联合环磷酰胺所致的中医血虚血瘀证模型导致了药理学、代谢组学和肠道微生物群的变化。桃红四物汤的干预可改善血虚血瘀所致症状。其机制主要是通过调节血小板功能和氨基酸代谢。

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