止颤汤对肝肾不足型帕金森病患者肠道菌群影响的随机对照研究

Effect of Zhichan decoction on intestinal flora in patients with liver and kidney deficiency Parkinson’s disease

目的探讨止颤汤对肝肾不足型帕金森病(Parkinson’s disease,PD)的临床疗效及对肠道菌群的影响。方法纳入72例肝肾不足型PD患者,采用随机、双盲、安慰剂对照临床设计,治疗组36例,对照组36例,两组均常规服用西药,治疗组加服止颤颗粒,对照组加服止颤安慰剂,疗程12周。观察统一PD评分量表(unified PD rating scale,UPDRS)积分及肠道菌群变化。结果治疗12周后,治疗组UPDRS积分较对照组下降(P<0.05);治疗12周后,两组内普雷沃菌属、布劳特菌属、粪杆菌属及拟杆菌属丰度均无显著差异,治疗组布劳特菌属有上升趋势;治疗组嗜血杆菌呈上升趋势且丰度差异显著(P<0.05),对照组呈下降趋势;治疗组阿克曼菌属呈下降趋势,对照组呈上升趋势;治疗组卟啉单胞菌属呈下降趋势,对照组呈上升趋势且丰度差异显著(P<0.05)。结论止颤汤于治疗12周后可改善PD临床症状,并显著增加嗜血杆菌丰度水平,降低阿克曼菌属和卟啉单胞菌属丰度水平。

Objective To investigate the clinical effect of Zhichan decoction on Parkinson’s disease(PD)with liver and kidney deficiency and its effect on intestinal flora.Methods 72 PD patients with liver and kidney deficiency were included in the study.A randomized,double-blind,placebo-controlled clinical design was adopted.There were 36 cases in the treatment group and 36 cases in the control group.Both groups were routinely given western medicine,the treatment group was given Zhichan decoction granules,and the control group was given Zhichan decoction placebo.The course of treatment was 12 weeks.The scores of unified PD rating scale(UPDRS)and the changes of intestinal flora were observed.Results After 12 weeks of treatment,the UPDRS scores in the treatment group was lower than the control group(P<0.05).There was no significant difference in the abundance of Prevotella,Blautia,Faecalibacterium and Bacteroides between the two groups after 12 weeks of treatment,while the abundance of Blautia in the treatment group showed an increasing trend.The abundance of Haemophilus in the treatment group increased and was significantly different from that before treatment(P<0.05),while showed a downward trend in the control group.After treatment,the abundance of Akkermansia reduced in the treatment group and increased in the control group.The abundance of Porphyromonas reduced in the treatment group,while significantly increased in the control group after treatment(P<0.05).Conclusion Zhichan decoction granule can improve the clinical symptoms of PD,and can significantly increase the abundance level of Haemophilus,reduce the abundance level of Akkermansia and Porphyromonas.