补肾活血汤治疗肾虚血瘀证慢性心力衰竭的代谢组学研究

Metabonomics Study of Bushen Huoxue Decoction in Treating Chronic Heart Failure with Kidney Deficiency and Blood Stasis Syndrome

目的基于代谢组学方法探讨补肾活血汤治疗慢性心力衰竭肾虚血瘀证病人的作用机制。方法选取2018年6月—2019年6月就诊于青岛市海慈医疗集团心血管一科、心血管二科、干部保健科的慢性心力衰竭肾虚血瘀证病人共70例,随机分为试验组和对照组,各35例;另外选取2018年6月—2019年6月在青岛市海慈医疗集团体检中心的健康体检者35名为健康组。采用核磁共振波谱技术检测试验组、对照组及健康组血清代谢物变化,并结合多变量数据统计方法分析补肾活血汤改善慢性心力衰竭病人的血清生物标志物,解析内源性代谢通路。结果在入选对象血液样品中共鉴定出苯丙氨酸、酪氨酸等19个潜在生物标志物。与健康组相比,对照组中有13个差异代谢物发生显著变化,而补肾活血汤给药后可逆转其中9个差异代谢物,包括苯丙氨酸、酪氨酸、葡萄糖等,通路分析研究表明,这些差异代谢物主要与苯丙氨酸代谢、酪氨酸代谢、精氨酸生物合成、淀粉和蔗糖代谢有关。结论补肾活血汤能有效改善慢性心力衰竭肾虚血瘀证病人部分紊乱的代谢物水平,主要涉及苯丙氨酸代谢、酪氨酸代谢、精氨酸生物合成、淀粉和蔗糖代谢等。

Objective To explore the mechanism of Bushen Huoxue Decoction in the treatment of chronic heart failure patients with kidney deficiency and blood stasis syndrome based on the method of metabonomics.Methods Seventy chronic heart failure patients with kidney deficiency and blood stasis syndrome were randomly divided into experimental group and control group,with 35 cases in each group.Another 35 healthy subjects were selected as healthy group.Nuclear magnetic resonance spectroscopy was used to detect changes of serum metabolites in experimental group,control group,and healthy group.Combined with multivariate statistical methods,the serum biomarkers of Bushen Huoxue Decoction for improving chronic heart failure were analyzed,and the endogenous metabolism path were analyzed.Results A total of 19 potential biomarkers such as phenylalanine and tyrosine were identified in the blood samples of the selected subjects.Compared with healthy group,13 differential metabolites in control group changed significantly,and the administration of Bushen Huoxue Decoction could reverse 9 different metabolites,including phenylalanine,tyrosine,and glucose,etc.Pathway analysis studies showed that these differential metabolites were mainly related to phenylalanine metabolism,tyrosine metabolism,arginine biosynthesis,starch and sucrose metabolism.Conclusion Bushen Huoxue Decoction can effectively improve the level of some disordered metabolites in chronic heart failure patients with kidney deficiency and blood stasis syndrome,mainly involving phenylalanine metabolism,tyrosine metabolism,arginine biosynthesis,starch and sucrose metabolism.