补中益气汤治疗慢性浅表性胃炎脾气虚证的代谢组学研究

Metabolomics Study of Buzhong Yiqi Decoction for Treatment of Chronic Superficial Gastritis Patients with Spleen-qi Deficiency Syndrome

【目的】研究补中益气汤对慢性浅表性胃炎脾气虚证患者尿液代谢组学的影响。【方法】记录26例慢性浅表性胃炎脾气虚证患者四诊资料,并收集其治疗前、治疗4周和8周后的尿液进行核磁共振氢谱(1H-NMR)检测,综合使用多变量统计分析方法 [主成分分析(PCA)、偏最小二乘判别分析(PLS-DA)和重复测量资料的方差分析]探讨相关代谢标志物的含量变化。【结果】(1)26例患者中,10例仅坚持治疗4周,16例完整随访8周。治疗4周后的总有效率为84.6%,治疗8周后的总有效率为100.0%,治疗8周后的疗效优于治疗4周后(P<0.05)。(2)证候积分方面,治疗4周和8周后均较治疗前显著改善,差异有统计学意义(P<0.05)。(3)主成分分析法(PCA)和偏最小二乘判别分析法(PLS-DA)分析结果显示,补中益气汤治疗前后患者尿液代谢表型有明显差异,并在尿液中鉴定了与补中益气汤治疗相关的10种生物标志物。【结论】补中益气汤治疗慢性浅表性胃炎脾气虚证的作用机制可能与提高机体能量代谢、调整肠道菌群代谢有关。

Objective To study the effect of Buzhong Yiqi Decoction （BYD） on urinary metabolites of chronic superficial gastritis （CSG） patients with spleen-qi deficiency syndrome. Methods The data of 26 spleen-qi deficiency CSG patients obtained by four diagnostic methods was recorded. Urine of the patients was sampled and then was detected by hydrogen proton nuclear magnetic resonance spectroscopy （1H-NMR） before treatment, and after BYD treatment for 4 and 8 weeks. The changes of metabolic biomarker contents were analyzed by statistical analysis methods such as principal component analysis （PCA） , partial least squares-discriminant analysis （PLS-DA） and repeated measures analysis of variance. Results （1） Of 26 patients, only 10 finished the treatment course of 4 weeks, and 16 finished the whole follow-up of 8 weeks. Total effective rate was 84.6% after treatment for 4 weeks, and was 100.0% after treatment for 8 weeks, the effective rate after treatment for 8 weeks being superior to that after treatment for 4 weeks （P〈0.05） . （2） Symptoms scores showed that clinical symptoms after treatment for 4 and 8 weeks were improved significantly （P〈0.05 compared with those before treatment）. （3） PCA and PLS-DA results showed that the phenotypes of metabolites were significantly different before and after BYD treatment （P〈0.05）, and 10 biomarkers had been identified from urine in CSG spleen-qi deficiency patients treated with BYD. Conclusion The mechanism of BYD for spleen-qi deficiency CSG may be related with enhancing the body energy metabolism and regulating intestinal flora metabolism.