大柴胡汤对冠心病不稳定型心绞痛血清Ghrelin和Obestatin的表达及肠道菌群构成的影响

目的:考察大柴胡汤对冠心病不稳定型心绞痛(UA)患者的治疗靶点,预测其对心绞痛治疗作用的通路。方法:进行前瞻性研究,患者共计110例,均为辽宁中医药大学附属医院心内一科2016年9月至2017年9月收治的患者,将入选的患者按照入院先后顺序排序,采用随机数字表达法分为治疗组与对照组,各55例,分别采用基础西药加大柴胡汤(治疗组)及基础西药(对照组)进行治疗。通过对纳入本研究患者的胃饥饿素(Ghrelin)及肥胖抑制素(Obestatin)表达水平及肠道菌构成进行分析。结果:经过基础治疗配合大柴胡汤,UA患者的总有效率大幅提高(P0.05);结果提示,大柴胡汤可以明显的改善UA患者的临床症状,同时,进一步对患者的Ghrelin,Obestatin表达情况进行测定发现,大柴胡汤治疗组对UA患者Ghrelin的上升和Obestatin的下调均起到了加速的作用;肠道菌群构成的结果提示,大柴胡汤可使UA患者的拟杆菌门(Bacteroidetes)和厚壁菌门(Firmicutes)两种细菌的构成会发生了变化。结论:大柴胡汤可以显著的影响UA患者的血清Ghrelin,Obestatin表达,可调节UA患者的肠道菌群,并增加患者有益菌的种类与丰度。

Effect of Da Chaihutang on Expression of Serum Ghrelin and Obestatin and Intestinal Flora in Unstable Angina of Coronary Heart Disease

Objective: To investigate the therapeutic targets of Da Chaihutang in the patients with unstable angina pectoris (UA) of coronary heart disease and predict the pathway in the treatment of angina pectoris. Method: This prospectivestudy had a total of 110 patients admitted in Cardiovascular Department 1 in the Affiliated Hospitalof Liaoning University of Traditional Chinese Medicine between September 2016 to September 2017.The patients were arranged in order according to their order of admission, and were divided into treatment group and control group by random number table method, 55 cases in each group. Basic western medicine was given in control group, and the basic medicine + Da Chaihutang was given in treatment group. Then the expression levels of Ghrelin and Obestatin and the composition of intestinal flora were analyzed in this study. Result: After basic treatment combined with Da Chaihutang, the total effective rate in patients with coronary heart disease unstable angina was increased significantly (P< 0.05).Results suggested that Da Chaihutang can significantly improve the clinical symptoms in patients with UA, and the further determination of Obestatin and Ghrelin expression levels showed that Da Chaihutang treatment promoted the up-regulation of Ghrelin and down-regulation of Obestatin in UA patients. The results of intestinal flora suggested that Da Chaihutang could change the compositions of Bacteroidetes and Firmicutes in UA patients. Conclusion: Da Chaihutang can significantly affect the expression of serum Ghrelin and Obestatin in UA patients, regulate the intestinal flora of UA patients, and increase the species and abundance of beneficial bacteria.