基于代谢组学的隔药灸脐法治疗脾虚型肠易激综合征机制研究
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摘要
目的:从代谢组学的角度探讨隔药灸脐法治疗脾虚型肠易激综合征(IBS)的机制。方法:将24例脾虚型IBS患者随机分成隔药灸脐组和隔淀粉灸脐组,对治疗前、后两组患者尿样进行处理和代谢组学分析,检测治疗前后的尿液代谢产物,比较两组之间的差异。结果:两组治疗前后尿样代谢谱均发生了明显变化。两组共同变化较为显著的是色氨酸代谢、组氨酸代谢、精氨酸代谢、胆汁酸代谢。隔药灸脐组还调节了儿茶酚胺类代谢物、大麻素代谢物、酪氨酸代谢。这些代谢物涉及到体内的氨基酸代谢、神经递质代谢等过程。结论:两组治疗脾虚型IBS均有显著疗效。隔药灸脐法调节的代谢物质更多,影响代谢的趋势更有利于抑制内脏高敏性,改善肠道神经、免疫、内分泌网络失调状况,缓解脾虚型IBS患者的临床症状,提高其生活质量。
Objective: To explore the mechanism of medicinal-separated moxibustion on umbilical cord in treating irritable bowel syndrome(IBS) of spleen deficiency type from the perspective of metabonomics. Methods: Twenty-four cases of IBS with spleen deficiency were randomly divided into two groups: medication-separated moxibustion umbilical cord group and starch-separated moxibustion umbilical cord group. Urine samples were processed and metabolomics was analyzed before and after treatment. Urine metabolites were detected before and after treatment, and the differences between the two groups were compared. Results: The metabolic profiles of urine samples in the umbilical cord moxibustion group separated by medicine and the umbilical cord moxibustion group separated by starch changed significantly before and after treatment. Tryptophan, histidine,arginine and bile acid had significant changes in both groups. The umbilical cord moxibustion group also regulated catecholamine,cannabinoid and tyrosine metabolites. These metabolites involve the metabolism of amino acids and neurotransmitters in the body. Conclusion: Both groups have significant curative effect on IBS of spleen deficiency type. The umbilical moxibustion with medicine-separated moxibustion regulates more metabolic substances, and the trend of affecting metabolism is more conducive to inhibiting visceral hypersensitivity, improving the disorder of intestinal nerve, immune and endocrine network, alleviating the clinical symptoms of IBS with spleen deficiency and improving its quality of life.
Objective: To explore the mechanism of medicinal-separated moxibustion on umbilical cord in treating irritable bowel syndrome(IBS) of spleen deficiency type from the perspective of metabonomics. Methods: Twenty-four cases of IBS with spleen deficiency were randomly divided into two groups: medication-separated moxibustion umbilical cord group and starch-separated moxibustion umbilical cord group. Urine samples were processed and metabolomics was analyzed before and after treatment. Urine metabolites were detected before and after treatment, and the differences between the two groups were compared. Results: The metabolic profiles of urine samples in the umbilical cord moxibustion group separated by medicine and the umbilical cord moxibustion group separated by starch changed significantly before and after treatment. Tryptophan, histidine,arginine and bile acid had significant changes in both groups. The umbilical cord moxibustion group also regulated catecholamine,cannabinoid and tyrosine metabolites. These metabolites involve the metabolism of amino acids and neurotransmitters in the body. Conclusion: Both groups have significant curative effect on IBS of spleen deficiency type. The umbilical moxibustion with medicine-separated moxibustion regulates more metabolic substances, and the trend of affecting metabolism is more conducive to inhibiting visceral hypersensitivity, improving the disorder of intestinal nerve, immune and endocrine network, alleviating the clinical symptoms of IBS with spleen deficiency and improving its quality of life.
引文
[1]王影,李贞贞,李先峰,等.肠道菌群与肠易激综合征的研宄进展.中国微生态学杂志,2016,28(1):117-120
[2]苏冬梅,张声生,刘建平,等.中医药治疗腹泻型肠易激综合征的系统评价研究.中华中医药杂志,2009,24(4):532-535
[3]辛琦,杜冬青,马玉侠.隔药灸脐法治疗脾虚型肠易激综合征临床研究.上海针灸杂志,2011,30(8):517
[4]Drossman D A.The functional gastrointestinal disorders and the RomeⅢprocess.Gastroenterology,2006,130:1377
[5]CFDA.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002:139
[6]陆寿康.刺法灸法学.2版.北京:中国中医药出版社,2008:82
[7]谢勇,黄缘,王崇文,等.肠易激综合征乙状结肠粘膜内胃肠激素及一氧化氮的变化.中国内镜杂志,1997,3(6):17-18
[8]张慧,何胜东,胡幼平,等.电针预处理对偏头痛大鼠三叉神经尾核CB1和C-fos蛋白表达的影响.中华中医药杂志,2017,32(1):324-328
[2]苏冬梅,张声生,刘建平,等.中医药治疗腹泻型肠易激综合征的系统评价研究.中华中医药杂志,2009,24(4):532-535
[3]辛琦,杜冬青,马玉侠.隔药灸脐法治疗脾虚型肠易激综合征临床研究.上海针灸杂志,2011,30(8):517
[4]Drossman D A.The functional gastrointestinal disorders and the RomeⅢprocess.Gastroenterology,2006,130:1377
[5]CFDA.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002:139
[6]陆寿康.刺法灸法学.2版.北京:中国中医药出版社,2008:82
[7]谢勇,黄缘,王崇文,等.肠易激综合征乙状结肠粘膜内胃肠激素及一氧化氮的变化.中国内镜杂志,1997,3(6):17-18
[8]张慧,何胜东,胡幼平,等.电针预处理对偏头痛大鼠三叉神经尾核CB1和C-fos蛋白表达的影响.中华中医药杂志,2017,32(1):324-328