摘要
目的:观察芪参汤对非酒精性脂肪性肝炎(NASH)患者的临床疗效及对肠道菌群稳态的影响。方法:30例NASH患者随机分为治疗组(15例)和安慰剂组(15例),其中治疗组给予芪参汤治疗,安慰剂组给予芪参汤模拟剂治疗,疗程4周。分别观察2组患者治疗前后生化及纤维化指标的变化。另选取15例健康受试者作为对照,收集粪便样本通过16S rRNA检测各组肠道菌群的多样性和丰度。结果:与组内治疗前比较,芪参汤组治疗后AST、ALT、GGT、TC、TG、HA、LN、PⅢNP、CⅣ、LSM和CAP明显降低,HDL明显升高,差异有统计学意义(P<0.05),2组治疗后组间比较,芪参汤组均明显优于安慰剂组,差异均有统计学意义(P<0.05)。相关性分析结果显示,Phascolarctobacterium、Lactobacillus、Bifidobacterium、Akkermansia的丰度分别与LN、HA、PⅢNP、CIV、CAP、LSM和GGT水平呈现显著负相关,而Fusobacterium、Coprococcus、Bilophila和Prevotella的丰度分别与LN、HA、PⅢNP、CIV、CAP、LSM和GGT水平呈现显著正相关。此外,芪参汤组治疗后OTU、Chao1和Shannon指数与同组治疗前及健康受试者比较均明显增加,Simpon指数明显降低,差异均有统计学意义(P<0.05)。同时,与同组治疗前比较,芪参汤能够显著增加Clostridium、Roseburia、Eubacterium、Phascolarctobacterium、Lactobacillus、Parabacteroides、Pseudomonas、Bifidobacterium、Corynebacterium和Akkermansia菌属丰度,降低Faecalibacterium、Peptostreptococcus、Erysipelatoclostridium、Flavobacterium、Bilophila和Escherichia菌属丰度,差异均有统计学意义(P<0.05)。结论:芪参汤能通过增加NASH肠道菌群多样性和稳态,从而改善肝功能、血脂异常和纤维化水平,达到治疗NASH的作用。
Objective: To observe the clinical efficacy of Qishen decoction on patients with nonalcoholic steatohepatitis(NASH) and its influence on gut microbiota. Methods: Thirty patients with NASH were randomLy divided into treatment group(n=15) and placebo group(n=15). The treatment group was treated with Qishen decoction, and the placebo group was treated with Qishen decoction simulant for 4 weeks. The changes of biochemical and fibrosis indexes were observed before and after treatment. Another 15 healthy subjects were selected as the control group. Fecal samples were collected and the diversity and abundance of gut microbiota in each group were detected by 16 S rRNA. Results: Compared with before treatment, AST, ALT, GGT, TC, TG, HA, LN, PⅢNP, CⅣ, LSM and CAP levels in Qishen decoction group were decreased, and the level of HDL was increased, differences were statistically significant(P<0.05), and the Qishen decoction group was significantly better than placebo group after treatment(P<0.05). The results of correlation analysis showed that the abundance of Phascolarctobacterium, Lactobacillus, Bifidobacterium, and Akkermansia were significantly negatively correlated with LN, HA, PⅢNP, CIV, CAP, LSM, and GGT levels(P<0.05), while the abundance of Fusobacterium, Coprococcus, Bilophila, and Prevotella were positively correlated with LN, HA, PⅢNP, CIV, CAP, LSM, and GGT respectively, and these differences were statistically significant(P<0.05). In addition, after treatment, OTU, Chao1 and Shannon index of Qishen decoction group were significantly increased, while Simpon index was significantly decreased when compared with those before treatment and healthy subjects(P<0.05). At the same time, Qishen decoction can significantly increase the abundance of Clostridium, Roseburia, Eubacterium, Phascolarctobacterium, Lactobacillus, Parabacteroides, Pseudomonas, Bifidobacterium, Corynebacterium, and Akkermansia, and reduce the abundance of Faecalibacterium, Peptostreptococcus, Erysipelatoclostrium, Flavobacterium, Bilophila, and Escherichia, and these differences were statistically significant(P<0.05). Conclusion: Qishen decoction can improve liver function, dyslipidemia and fibrosis by increasing the diversity and restoring the homeostasis of NASH gut microbiota.
作者
袁维
王炳予
杨磊
张雅丽
袁星星
YUAN Wei;WANG Bingyu;YANG Lei;ZHANG Yali;YUAN Xingxing(Department of Hepatology,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Discipline Construction Project of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha,410007,China;Department of Gastroenterology,Nan-gang Branch,Heilongjiang College of Traditional Chinese Medicine)
出处
《中国中西医结合消化杂志》
CAS
2021年第6期383-391,共9页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
国家自然科学基金青年基金(No:81904182)
湖南省自然科学基金(No:2020JJ5441)
黑龙江省中医药科研项目(No:ZHY18-029,ZHY19-061,ZHY19-062,ZHY2020-041)。
关键词
芪参汤
非酒精性脂肪性肝炎
临床疗效
肠道菌群
Qishen decoction
nonalcoholic steatohepatitis
clinical efficacy
gut microbiota
