温胆汤对奥氮平所致代谢综合征患者肠道菌群的影响

Effects of Wendan decoction on intestinal flora in patients with metabolic syndrome induced by olanzapine

目的探讨温胆汤对奥氮平所致代谢综合征患者肠道菌群的影响。方法将符合入组标准的患者随机分为温胆汤组和二甲双胍组,各30例,分别予温胆汤及二甲双胍治疗,疗程3个月;同时选择健康志愿者30例为正常对照组。采用荧光定量PCR检测正常对照组及温胆汤组、二甲双胍组治疗前、治疗后1、3个月肠道菌群的拷贝数;同时检测温胆汤组、二甲双胍组治疗前、治疗后糖脂代谢、肥胖指标及血压的情况。结果温胆汤组、二甲双胍组治疗前双歧杆菌属、梭杆菌属、乳酸杆菌属、B/E比值低于正常对照组,肠球菌属、肠杆菌属高于正常对照组(P<0.01)。治疗3个月后,温胆汤组、二甲双胍组双歧杆菌属、梭杆菌属、乳酸杆菌均有升高,肠球菌属、肠杆菌属有下降(P<0.01);温胆汤组乳酸杆菌的升高较二甲双胍组明显,肠球菌属、肠杆菌属的下降较二甲双胍组明显(P<0.01)。治疗3个月后,温胆汤组、二甲双胍组各项代谢指标异常均有改善(P<0.05);温胆汤组在改善脂代谢方面较二甲双胍组明显(P<0.05),改善高密度脂蛋白优势更明显(P<0.01)。结论奥氮平所致代谢综合征患者存在肠道菌群失衡,温胆汤可能通过调节肠道菌群平衡起到改善各项代谢综合征指标。

Objective To investigate the effect of Wendan decoction on intestinal flora in patients with metabolic syndrome caused by olanzapine.Methods Patients who met the inclusion criteria were randomly divided into Wendan group and metformin group(n=30).Meanwhile,30 healthy volunteers were selected as the normal control group.The Wendan group was treated with Wendan decoction,while the metformin group was treated with metformin for 3 months.Fluorescence quantitative PCR was used to assess the copy number of intestinal flora before and after treatment.The changes of glucose and lipid metabolism,obesity index and blood pressure in Wendan group and metformin group before and after treatment were also assessed.Results Before treatment,the ratio of bifidobacteria,fusobacteria,lactobacillus and B/E in the Wendan group and metformin group was significantly lower than that in the normal control group,while the ratio of enterococcus and enterobacillus was significantly higher than that in the normal control group(P<0.01).After 3 months treatment,the copies of bifidobacteria,fusobacteria and lactobacillus in the Wendan group and metformin group were significantly increased,while the copies of enterococcus and enterobacillus significantly decreased(P<0.01).The increase of lactobacillus in Wendan group was more obvious than that in metformin group,while the decrease of enterococcus and enterobacter was more obvious than that in metformin group(P<0.05).After 3 months of treatment,the metabolic abnormalities were improved in the Wendan group and metformin group(P<0.05).The improvement of lipid metabolism in the Wendan tang group group was significantly more obvious than that in the metformin group(P<0.05).The advantage of improving HDL is more obvious(P<0.01).Conclusion Patients with metabolic syndrome caused by olanzapine have intestinal flora imbalance.Wendan decoction may improve the metabolic syndrome caused by olanzapine by regulating the balance of intestinal flora.