宽胸理肺汤联合三子养亲汤治疗AECOPD的GC-TOFMS血清代谢组学研究

Serum Metabolomic Study of Kuanxiong Lifei Decoction Combined with Sanzi Yangqin Decoction on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Based on GC-TOFMS Technique

目的观察宽胸理肺汤联合三子养亲汤对痰浊壅肺型慢性阻塞型肺疾病急性加重期(AECOPD)患者血清代谢组学的影响并探讨其作用机制。方法60例患者随机分为两组,治疗组在西医规范治疗基础上联合宽胸理肺汤加三子养亲汤,对照组采用西医规范治疗方案。采用气相色谱-飞行时间质谱联用(GC-TOFMS)技术检测两组患者治疗后及30名健康患者血清标本。结果治疗后,PCA图显示治疗组与健康组相关代谢产物接近。治疗组与对照组相关代谢产物存在明显差异,筛选并鉴定出12个差异代谢物,其中富马酸、生育酚、D-谷氨酸3种在治疗组中显著上调,而羟基丙酮、葡萄糖、琥珀半醛、亚油酸甲酯、2-脱氧-D-半乳糖、4-羟基丁酸乙酰酯、二十酸、硬脂酸、木糖9种显著下调。得到了4条相关代谢通路,按影响值从大到小依次为D-谷氨酰胺和D-谷氨酸代谢,丁酸盐代谢,丙氨酸、天冬氨酸和谷氨酸代谢,淀粉与蔗糖代谢。结论基于代谢组学的研究方法发现宽胸理肺汤联合三子养亲汤通过调节AECOPD患者的代谢产物(能量代谢、糖作用、脂肪代谢、氨基酸代谢及提高抗氧化、抗炎作用),对治疗起了一定作用。

Objective:To study the effect of Kuanxiong Lifei Decoction combined with Sanzi Yangqin Decoction(KXLFD-SZYQD)on patients of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with syndrome of phlegm and turbid accumulated in lung based on metabonomics.Methods:60 patients were randomly divided into the treatment group and the control group.The treatment group were treated with KXLFD-SZYQD combined with the routine therapy of Western medicine,while the control group were treated with single Western medicine.The serum samples of 30 healthy patients and two groups after treatment were detected by GC-TOFMS.Results:After treatment,PCA showed that the related metabolites in the treatment group were close to those in the healthy group;there were significant differences between the treatment group and the control group,and 12 different metabolites were screened and identified.Among them,fumaric acid,tocopherol and D-glutamic acid were significantly up-regulated in the treatment group,while hydroxyacetone,glucose,succinic semialdehyde,methyl linoleic acid,2-deoxy-d-galactose,4-hydroxybutyrate acetyl ester,eicosic acid,stearic acid and xylose were significantly down regulated in the treatment group,and four related metabolic pathways were obtained.Conclusion:KXLFD-SZYQD has some therapeutic effects on AECOPD patients through regulating metabolites based on metabonomics research method.