基于代谢组学的冠心病患者气虚证识别模式

目的:筛选冠心病气虚证相关特征性代谢产物,尝试建立冠心病气虚证在代谢层面的识别模式。方法:氢核磁共振检测45例冠心病患者及15名正常人的血浆代谢产物,对数据进行PLS-DA、VIP及t检验/非参数检验分析,筛选出气虚证相关特征性代谢产物,聚类分析验证特征性代谢产物对气虚证的识别效果。结果:检测到冠心病患者和正常组血浆内源性代谢成分39种。PLS-DA积分矩阵图显示:冠心病患者与正常组,冠心病气虚证与非气虚证的分布区沿第一主成分t(1)轴方向完全分开。气虚证的特征性代谢产物包括乙酰谷氨酸、赖氨酸、缬氨酸和肉碱。结论:冠心病患者的异常代谢过程包括了氨基酸、糖、脂质及能量代谢、凝血过程及其他代谢过程;筛选出的4种生物标志物基本上实现了对冠心病气虚证的有效识别。     

代谢综合征患者胰岛素分泌功能、敏感性与中医证型的关系浅探

本文通过探讨代谢综合征胰岛素分泌功能及敏感性与中医证型的关系,观察与本病相关的危险因素及中医证型与相关危险因素的关系。结果显示,湿热困脾型代谢综合征患者体重指数及胰岛素抵抗均高于气阴两虚型及血瘀脉络型者(有统计学意义);证实了肥胖与胰岛素抵抗关系密切,湿热困脾型代谢综合征患者肥胖与胰岛素敏感性呈负相关,与中医肥满疾病的病机为脾胃功能异常及西医的"肥胖是代谢综合征的始动因素"的说法是一致的。     

基于液质联用技术的HIV/AIDS患者尿液代谢组学研究

目的:探寻艾滋病及人类免疫缺陷病毒携带(HIV/AIDS)患者尿液的代谢组变化,探讨代谢组学方法在预防和延缓HIV病毒感染者病程进展研究中的应用前景.方法:运用液质联用技术(LC-MS),检测55例HIV/AIDS患者和20例健康人的尿液代谢成分,结合主成分分析(PCA)和t检验分析技术,分析HIV/AIDS患者尿液的特异性代谢物质(或群谱).结果:HIV/AIDS患者组与健康对照组经代谢组学的方法在尿液代谢轮廓上得到了良好区分,发现了10个可能存在的潜在生物学标记物.结论:代谢组学的研究方法可以将HIV/AIDS患者与健康人进行良好的区分,综合代谢标记物变化趋势构成了HIV/AIDS的代谢特征,代谢组学的方法在预防和延缓HIV病毒感染者病程进展的研究中将有很好的应用前景.     

宽胸理肺汤联合三子养亲汤治疗AECOPD的GC-TOFMS血清代谢组学研究

目的观察宽胸理肺汤联合三子养亲汤对痰浊壅肺型慢性阻塞型肺疾病急性加重期(AECOPD)患者血清代谢组学的影响并探讨其作用机制。方法60例患者随机分为两组,治疗组在西医规范治疗基础上联合宽胸理肺汤加三子养亲汤,对照组采用西医规范治疗方案。采用气相色谱-飞行时间质谱联用(GC-TOFMS)技术检测两组患者治疗后及30名健康患者血清标本。结果治疗后,PCA图显示治疗组与健康组相关代谢产物接近。治疗组与对照组相关代谢产物存在明显差异,筛选并鉴定出12个差异代谢物,其中富马酸、生育酚、D-谷氨酸3种在治疗组中显著上调,而羟基丙酮、葡萄糖、琥珀半醛、亚油酸甲酯、2-脱氧-D-半乳糖、4-羟基丁酸乙酰酯、二十酸、硬脂酸、木糖9种显著下调。得到了4条相关代谢通路,按影响值从大到小依次为D-谷氨酰胺和D-谷氨酸代谢,丁酸盐代谢,丙氨酸、天冬氨酸和谷氨酸代谢,淀粉与蔗糖代谢。结论基于代谢组学的研究方法发现宽胸理肺汤联合三子养亲汤通过调节AECOPD患者的代谢产物(能量代谢、糖作用、脂肪代谢、氨基酸代谢及提高抗氧化、抗炎作用),对治疗起了一定作用。     

慢性浅表性胃炎脾气虚与脾胃湿热证患者尿液1H-NMR的代谢组学研究

目的观察慢性浅表性胃炎(chronic superficial gastritis,CSG)脾气虚及脾胃湿热证患者尿液代谢组学变化,为两种中医证型的科学辨证提供依据。方法分别收集CSG脾气虚证、脾胃湿热证患者(各10例)和健康志愿者(10名)的尿液进行核磁共振氢谱(proton nuclear magnetic resonance spectroscopy,~1HNMR)检测,综合采用多变量统计学方法中主成分分析(principal component analysis,PCA)、偏最小二乘判别分析(partial least square discriminant analysis,PLS-DA)及单变量统计分析方法测定相关代谢标志物的含量。结果 PLS-DA显示,脾气虚证、脾胃湿热证患者及健康志愿者尿液代谢状态可相互区分,在脾气虚证患者和健康志愿者尿液中共筛选得到谷氨酸、甲硫氨酸、α-酮戊二酸、二甲基甘氨酸、肌酐、牛磺酸及葡萄糖7种差异代谢产物;在脾胃湿热证患者和健康志愿者尿液中筛选得到2-羟基丁酸、氧化三甲胺、牛磺酸、马尿酸4种差异代谢产物;在脾气虚证和脾胃湿热证患者中筛选得到岩藻糖、β-羟基丁酸、丙氨酸、谷氨酸、甲硫氨酸、琥珀酸、柠檬酸、肌酐、葡萄糖、乳酸及马尿酸11种差异代谢产物。结论 CSG脾气虚证与脾胃湿热证患者的代谢差异主要体现在糖代谢、脂类代谢、氨基酸分解代谢方面,基于1H-NMR的代谢组学技术可用于临床不同中医证型的分类研究。     

中医治疗代谢综合征的临床研究进展

代谢综合征是一组由多种危险因素导致代谢紊乱的临床复杂症候群,日益危害人类生活质量和生命健康。目前现代医学治疗代谢综合征的主要方法是降血压、降血糖、纠正血脂紊乱等,不能从本质上改善患者的整体健康状态。近年来,有关中医学治疗代谢综合征的研究已经取得了很大的发展,其在改善患者的主观临床症状、客观实验室检查指标及远期疗效方面具有一定优势。中医学根据整体观念及辨证论治的特点,以患者的体质为基本,通过健脾疏肝、燥湿化痰、活血化瘀等方法治疗代谢综合征,疗效显著。文章通过查阅并整理近五年有关中医药治疗代谢综合征的期刊论文,从脏腑肝、脾、肾,病理因素痰、湿、瘀等方面论述代谢综合征的研究进展,结合中医辨证论治理论与现代药理分析共同阐明其在治疗代谢综合征方面的确切疗效,为中医临床治疗代谢综合征开拓新的思路和方法。     

中青年高血压病痰湿壅盛证患者尿液代谢组学分析

目的寻找中青年高血压病痰湿壅盛证患者的尿液生物标记群,探索其证候本质。方法运用1H NMR结合PLS-DA的方法对中青年高血压病三种证型患者及健康志愿者的尿液进行代谢组学分析,得出生物标记物群。结果中青年高血压病痰湿壅盛组与对照组、肝火亢盛组、阴虚阳亢组对比,痰湿壅盛组代谢物存在显著性变化,主要与三大代谢及嘌呤代谢关系密切。结论运用核磁共振代谢组学方法分析尿液代谢组学,可对中青年高血压病痰湿壅盛患者和健康者、肝火亢盛组、阴虚阳亢组进行区分。     

慢性心力衰竭肾阳虚证患者代谢组学研究

目的:研究慢性心力衰竭肾阳虚证患者的代谢模式,探讨代谢组学在中医证候学研究中的应用。方法:收集慢性心力衰竭患者54例(其中肾阳虚证27例、非肾阳虚证27例)及正常人24例的空腹晨尿尿样,通过气相色谱/质谱(GC/MS)联用及模式识别为主的代谢组学方法进行研究。结果:主成分分析和正交最小二乘法分析中慢性心力衰竭肾阳虚证组、非肾阳虚证组和正常组的代谢成分积分在空间分布上明显分开,且样本均投影到2SD(标准差)的区域内,表示其值可信,说明所建模型能准确区分3者。慢性心力衰竭患者与正常人比较还发现了柠檬酸、丙氨酸、3-甲基戊烯二酸、丙胺、组胺5种差异性代谢物质。结论:慢性心力衰竭肾阳虚证患者、非肾阳虚证患者和正常人具有不同的代谢模式,以GC/MS为技术特点的代谢组学研究方法能将3者区分。代谢组学是研究中医学证本质的有效方法。     

应用PFNA治疗老年股骨粗隆间骨折的观察及患者骨代谢和骨强度分析

目的分析研究老年股骨粗隆间骨折患者应用PFNA治疗对患者骨代谢及骨强度的影响。方法选择该院2017年2月—2018年6月治疗的股骨粗隆间骨折患者35例,所有患者均为年龄超过60岁的老年人,应用PFNA治疗,在患者术前及术后3个月随访中测定骨代谢及骨强度指标。结果患者术后3个月的骨代谢CTX指标、骨强度指标NN、IT、FS与术前指标比较差异有统计学意义(P0.05),患者术后3个月的骨代谢PINP指标与术前指标比较明显升高,差异有统计学意义(P0.05)。结论老年股骨粗隆间骨折应用PFNA治疗具有较好效果,能够缩短患者手术时间减少并发症,并且有效提高患者骨代谢指标,应在临床中广泛应用。     

经前平颗粒干预经前期综合征肝气逆证患者尿液代谢组学研究

目的：运用代谢组学方法,研究PMS肝气逆证患者尿样代谢物变化及经前平颗粒对其干预作用,探索与PMS肝气逆证发病机理密切相关的代谢组学特征和小分子标志化合物。方法：按照诊断标准、纳入标准、排除标准等纳入PMS肝气逆证病例。应用UPLC-Q-TOF结合PCA模式分析,对PMS肝气逆证患者不同时间点尿样进行代谢组学分析,区分代谢轮廓并寻找可能的生物标记物及代谢通路。结果：对照组、PMS肝气逆证组、PMS肝气逆证治疗组经前尿样代谢轮廓存在明显差异。PMS肝气逆证组经前尿样代谢轮廓显著偏离对照组经前、经后及PMS肝气逆证组经后尿样。PMS肝气逆证组尿样较对照组N-乙酰谷氨酸-γ-半醛显著降低;组氨酸、香草扁桃酸显著升高。结论：本研究首次从代谢组学角度研究了PMS肝气逆与对照组及给药组的代谢模式差异,经前平颗粒可以显著修复PMS肝气逆证内源性小分子代谢紊乱。从微观代谢物角度印证了PMS肝气逆证患者经前系列症状及“经前症状,经后消失”的特点。     

Anti‐obesity effect of plant diterpenes and their derivatives: A review

Obesity is a medical condition in which excess body fat is accumulated by a combination of excessive food intake, lack of physical activity, and genetic susceptibility. Obesity increases the risk of various diseases and conditions, including cardiovascular diseases, diabetes, cancer, and depression. This review focuses on most recent reports pertaining to the antiobesity activity of plant‐derived diterpenes in different databases. For this, a search (until August 2019) was conducted in the PubMed and Science Direct databases with the following keywords: “plant diterpenes” or “plant diterpenoids” paired with “obesity” or “antiobesity effects.” Overall, 729 references that used the aforementioned keywords were selected, among which 34 articles have been included in this review. Results from this search suggest that a number of diterpenes and their derivatives have been found to exert antiobesity effects through various mechanisms, such as overweight reduction or modification of body mass index, protein‐tyrosine phosphatase 1B inhibition, lipase activity inhibition, antiadipogenesis effect, among others. Carnosic acid, carnosol and the derivatives of abietic acid, steviol, and andrographolide are examples of important antiobesity diterpenes and their derivatives. Of note, plant‐derived diterpenes may be potential candidates for managing obesity and obesity‐related diseases and disorders in human and other animals.     

Korean red ginseng (Panax ginseng) improves insulin sensitivity in high fat fed Sprague-Dawley rats

Many studies have documented that ginseng has antidiabetic and antiobesity effects, but the mechanism of the effects has not been elucidated. The aim of this study was to determine the effect of Korean red ginseng (KRG, Panax ginseng) and investigate the mechanism of antidiabetic and antiobesity effects in obese insulin resistant animal models. Sprague‐Dawley (SD) rats were divided into three groups: a control group (group I) fed a normal diet, another group (group II) fed only high fat diet (HFD) and a third group (group III) fed HFD with KRG (200 mg/kg, oral) for 18 weeks. The body weight, food intake, adipose tissues, liver, kidney, pancreas, adiponectin, and leptin were measured. Blood glucose, insulin tolerance test, and hyperinsulinemic euglycemic clamp test were investigated. A significant weight reduction, especially fat mass reduction, was observed in the KRG treated group. Increased insulin sensitivity was found in the KRG treated group. We observed increased insulin signalling, increased phosphorylation of IR, IRS‐1, Akt, and membranous GLUT4 in muscle by Western blotting assay. In conclusion, KRG may have antidiabetic and antiobesity effects due to partly increased insulin sensitivity by increased adipokine and partly enhanced insulin signalling. Copyright © 2011 John Wiley & Sons, Ltd.     

针刺对肥胖大鼠作用的形态学观察

本文采用高脂饲料喂养大鼠制造肥胖模型。应用光学和电子显微镜观察肥胖大鼠脂肪组织、小肠粘膜、肝组织形态,以及针刺后发生的形态学变化。结果显示,肥胖大鼠脂肪组织、小肠粘膜、肝组织均出现了形态学的异常。褐色脂肪细胞体积增大、充盈,脂滴增大,胞质内线粒体减少,细胞间隙变窄,毛细血管减少。针刺治疗后,上述形态学的异常均出现逆转,这种变化是针刺通过减少能量摄入,增加能量消耗达到减肥效应的形态学依据。     

Traditional medicine Taeeumjowitangkagambang exerts antiobesity and hypolipidemic effects via antioxidant enzyme enhancement

Taeeumjowitangkagambang (ETJKB) is a traditional Korean medicine that has been clinically used for obesity with little mechanistic understanding. The present study investigated antiobesity and hypolipidemic effects of ETJKB in high fat diet fed rats as well as a 3T3-L1 pre-adipocyte differentiation model. ETJKB significantly inhibited the lipidogenesis in 3T3-L1 adipocytes in a concentration-dependent manner as well as reduced the cellular adipokine leptin level. Daily oral gavage of ETJKB to rats fed a high fat diet significantly attenuated body weight gain and abdominal and epididymal fat weights. ETJKB treatment also reduced the levels of total cholesterol, low density lipoprotein (LDL) and triglyceride as well as increased high density lipoprotein (HDL) in serum compared with the untreated control. Similarly, the ETJKB treatment decreased the levels of total lipid, triglyceride and cholesterol in liver tissue in high fat diet fed rats. Interestingly, ETJKB significantly increased the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase in liver tissue, while decreasing the hydroxyl radical, thiobarbituric acid reactive substances (TBARS), carbonyl concentration. An improvement of antioxidant enzymes was associated with improved body weight control and healthier lipid profiles and therefore may play an important role in the antiobesity and hypolipidemic effects of ETJKB.     

Decursin, an active compound isolated from Angelica gigas, inhibits fat accumulation, reduces adipocytokine secretion and improves glucose tolerance in mice fed a high-fat diet

Decursin (De), an active component of Angelica gigas, is known to exert anticancer and neuroprotective effects. However, its antiobesity and antidiabetic potential has not yet been investigated. This study evaluated the antiobesity effect of decursin, particularly focusing on its ability to inhibit adipocyte differentiation in 3T3-L1 cells. Decursin treatment resulted in the inhibition of adipocyte differentiation and the expression of fatty acid synthase. The study further investigated these antiobesity effects using mice fed a normal diet (ND), a high-fat diet (HFD) and a HFD plus decursin 200 mg/kg diet (HFD + De) for 7 weeks. Mice administered HFD plus decursin showed a drastic decrease in weight gain, triglyceride content, total cholesterol content and fat size compared with those that received the HFD alone; this was observed despite similar quantities of total food intake. Furthermore, decursin improved glucose tolerance in mice fed a HFD. Finally, administration of decursin along with the HFD significantly reduced the secretion of HFD-induced adipocytokines such as leptin, resistin, IL-6 and MCP-1. These results suggest that decursin might be useful for the treatment of obesity and diabetes.     

L-阿拉伯糖降血糖和减肥功能实验研究

目的探讨L-阿拉伯糖对动物(新西兰兔)降血糖和减肥的作用。方法以高糖高脂饲料诱导新西兰兔肥胖模型,然后将其随机分为4组:模型对照组及L-阿拉伯糖低剂量(0.3085g/kg)、中剂量(0.617g/kg)、高剂量(0.9255g/kg)3个给药组。连续喂养2个月后,空腹12h,各给药组按剂量口服L-阿拉伯糖后2h,分别口服蔗糖0、0.5、2h测新西兰兔耳缘静脉血糖值;L-阿拉伯糖干预1个月时测体重、进食量和排便量、脂肪指数的变化。结果高、中、低L-阿拉伯糖组空腹血糖与模型对照组存在明显差异(P0.05),在糖耐量作用中,L-阿拉伯糖各剂量组和模型对照组的曲线下面积(AUC)出现明显差别。在减肥功能的指标中(体重变化、日进食量和排便量、脂肪指数),L-阿拉伯糖各剂量组与模型对照组比较差异有统计学意义(P0.05),其中L-阿拉伯糖组与模型对照组的脂肪指数具有显著差异(P0.01)。结论L-阿拉伯糖有明显降血糖和减肥的作用。     

Comparison of the antiobesity effects of the protopanaxadiol- and protopanaxatriol-type saponins of red ginseng

A previous study demonstrated that ginseng crude saponins prevent obesity induced by a high-fat diet in rats. Ginseng crude saponins are known to contain a variety of bioactive saponins. The present study investigated and compared the antiobesity activity of protopanaxadiol (PD) and protopanaxatriol (PT) type saponins, major active compounds isolated from crude saponins. Male 4-week-old Sprague-Dawley rats were fed with normal diet (N) or high-fat diet (HF). After 5 weeks, the HF diet group was subdivided into the control HF diet, HF diet-PD and HF diet-PT group (50 mg/kg/day, 3 weeks, i.p.). Treatment with PD and PT in the HF diet group reduced the body weight, total food intake, fat contents, serum total cholesterol and leptin to levels equal to or below the N diet group. The hypothalamic expression of orexigenic neuropeptide Y was significantly decreased with PD or PT treatment, whereas that of anorexigenic cholecystokinin was increased, compared with the control HF diet group. In addition, PD type saponins had more potent antiobesity properties than PT saponins, indicating that PD-type saponins are the major components contributing to the antiobesity activities of ginseng crude saponins. The results suggest that the antiobesity activity of PD and PT type saponins may result from inhibiting energy gain, normalizing hypothalamic neuropeptides and serum biochemicals related to the control of obesity.     

Garcinia extract inhibits lipid droplet accumulation without affecting adipose conversion in 3T3-L1 cells

Garcinia extract was isolated from the fruit of the Garcinia cambogia and was used as a potential antiobesity agent. In week 3 of culture with insulin, the fat cells exhibited more numerous and larger intracytoplasmic lipid droplets (i.e. 30-40 microm(2)). When Garcinia extract and insulin were added simultaneously, the accumulation of lipid droplets was inhibited and the peak droplet area shifted to become smaller (10-20 microm(2)). The activities of glycerophosphate dehydrogenase, a marker of adipose differentiation, were not significantly inhibited by the Garcinia extract. These findings suggest that the Garcinia extract inhibits lipid droplet accumulation in fat cells without affecting adipose conversion.     

针刺减肥对单纯性肥胖女性脂肪含量、骨矿含量及瘦体重的影响

目的观察针刺减肥前后全身各部位脂肪含量、骨矿物质含量及瘦体重的变化。方法辨证针刺治疗37例单纯性肥胖患者,治疗前后检测相关肥胖指标、脂肪含量、骨矿物质含量及瘦体重,并对其差率进行统计学分析。结果针刺显著改善客观肥胖指标（体重指教、腰围、臀围、臂围）,显著降低脂肪含量（全身、上肢、躯干）,降低肌肉含量（全身、上肢、下肢）,对骨矿物质含量无明显影响。结论针刺减肥无降低骨密度的不良反应,尤其适合腹型肥胖患者（对躯干部位降脂不减瘦）。     

Vitamin C increases the fecal fat excretion by chitosan in guinea‐pigs,thereby reducing body weight gain

The aims of this study were to investigate the antiobesity properties of chitosan on its own, as well as in the presence of vitamin C, in vivo. Hartley guinea‐pigs were divided into Control (normal diet), F‐control (high fat diet), Chitosan (high fat diet with 5.0% chitosan) and Chito‐vit C (high fat diet with 5.0% chitosan containing 0.5% vitamin C) groups, respectively. The effects of chitosan, both alone and in the presence of vitamin C, on body weight, total fecal weight, fecal composition and plasma lipid level were studied for 5 weeks. The results of this study indicated that the fat‐binding and water‐holding capacity of chitosan might decrease body weight by reducing the absorption of cholesterol and fat, subsequently increasing total fecal weight, fecal fat excretion and fecal water excretion. Vitamin C increased the fecal fat excretion by chitosan in guinea‐pigs, thereby reducing body weight gain. Copyright © 2010 John Wiley & Sons, Ltd.