隔药灸脐法治疗脾虚型肠易激综合征的尿液代谢组学机制

Effect of Medicine-partition Navel Moxibusiton on Urinary Metabonomics of Spleen-deficiency Irritable Bowel Syndrome Patients

【目的】通过采用四极杆—飞行时间质谱(Q-TOF)技术检测脾虚型肠易激综合征(irritable bowel syndrome,IBS)患者隔药灸脐法治疗前后尿样的代谢产物谱变化,发现潜在的生物标记物,推导其相关代谢通路,探讨脐疗可能的有效作用靶点。【方法】选取12例脾虚型IBS患者,对治疗前后该组患者尿样进行处理,根据Simca-P 11.5软件包的处理数据,通过HMDB、KEGG数据库寻找有贡献的代谢物组分,寻找相关代谢通路。【结果】隔药灸脐法治疗脾虚型IBS,患者的代谢谱发生了显著性变化,其中变化较为显著的是氨基酸、胆汁酸、儿茶酚胺类及内源性大麻素代谢物,这些代谢物涉及到体内的氨基酸代谢、神经递质代谢及内源性大麻素代谢等过程。【结论】脐疗可显著抑制脾虚型IBS患者的内脏高敏性,改善肠道神经、免疫、内分泌网络失调状况,从而改善患者的生活质量。

Objective The changes of urinary metabolites in spleen-deficiency irritable bowel syndrome （IBS） patients before and after medicine-partition navel moxibustion were observed by quadrupole-time of flight mass spectrometry （Q-TOF）, thus to identify the potential biomarkers and to infer the related metabolic pathway and the possible targets of navel therapy. Methods Urine was sampled from 12 spleen-deficiency IBS patients before and after medicine-partition navel moxibustion. The urine samples were processed and analyzed with Simca-P 11.5 software package, and then the related metabolic pathway was investigated by searching the contributory metabolite fractions in human metabolome database （HMDB） and metabolite mass spectral database （METLIN） . Results After treatment with medicine-partition navel moxibustion, great changes happened in the urinary metabolites of the 12 spleen-deficiency IBS patients, particularly in the metabolites of amino acids, bile acids, catecholamines and endogenous cannabinoid metabolites. All of these metabolites were involved in amino acid metabolism, neurotransmitter metabolism and endogenous cannabinoids metabolism. Conclusion The medicine-partition navel moxibustion therapy shows certain effect on significantly inhibiting the visceral hypersensitivity of IBS patients, and on improving intestinal nerves, immune function, endocrine disorder and the quality of life.