Metabolic Profiling Analysis of Patients With Coronary Heart Disease Undergoing Xuefu Zhuyu Decoction Treatment
Metabolic Profiling Analysis of Patients With Coronary Heart Disease Undergoing Xuefu Zhuyu Decoction Treatment
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血府逐瘀汤治疗冠心病患者代谢特征分析
DOI：
10.3389/fphar.2019.00985
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发表时间：
2019-09-10
影响因子：
5.6
通讯作者：
Liu, Xiuhua
中科院分区：
文献类型：
--
作者：
Tao, Tianqi;He, Tao;Liu, Xiuhua
冠心病（CHD）仍然是全球发病率和死亡率的主要原因。中医药是改善冠心病患者预后的有效补充和替代疗法之一。血府逐瘀汤是一种具有理气活血作用的经典中药，临床上对冠心病有一定疗效，但其作用机制尚不清楚。近年来研究发现，冠心病气阴两虚证患者体内参与氨基酸代谢和三羧酸循环的代谢物发生改变。研究调气活血药治疗冠心病过程中与气有关的差异代谢产物，对认识气的物质基础具有重要意义。本研究采用非靶向代谢组学方法，对冠心病患者血清代谢谱进行研究，以检测心复增饮组与安慰剂组之间的代谢差异。10例冠心病患者采用随机、双盲对照的方法，分别给予安慰剂颗粒和仙府逐瘀汤颗粒治疗。所有患者的血清样本均通过非靶向高效液相色谱串联质谱代谢组学进行评价。冠心病患者血清中共检测到513种代谢产物，其中6种代谢产物参与7条代谢途径，在心复滋阴汤治疗组与安慰剂组间差异有统计学意义。在6种差异代谢产物中，与安慰剂组相比，参与脂肪酸代谢的FA（20：2）-H和四羧酸（24：0）、参与三羧酸循环的顺乌头酸、参与葡萄糖代谢的2-脱氧-D-葡萄糖和参与氨基酸代谢的N-乙酰甘氨酸减少，而参与氨基酸代谢的精胺增加。结合生物学功能的观点，我们认为2-脱氧-D-葡萄糖和精胺可能构成了冠心病患者服用仙府逐瘀汤后“气”的部分物质基础。
Coronary heart disease (CHD) remains the leading cause of morbidity and mortality worldwide. Traditional Chinese medicine (TCM) is one of the effective complementary and alternative therapies used to improve the prognosis of CHD patients. Xuefu Zhuyu (XFZY) decoction, a classical traditional Chinese medication for regulating Qi and promoting blood circulation, has a clinical benefit in CHD; however, the underlying mechanism is not clear. Recently, it was found that the metabolites involved in amino acid metabolism and the tricarboxylic acid cycle were altered in CHD patients with Qi and Yin deficiency syndrome. To understand the material foundation of Qi, it is of great significance to study the differential metabolites involved in Qi during treatment of CHD with Qi-regulating and blood-promoting herbs. In this study, we investigated the metabolic profiles of serum in CHD patients by nontargeted metabolomics analysis to detect differential metabolites between the XFZY decoction group and placebo group. Ten CHD patients were enrolled and treated with placebo granules or XFZY decoction granules in a random and double-blind manner. Serum samples of all patients were evaluated by untargeted high-performance liquid chromatography with tandem mass spectrometry-based metabolomics. In total, 513 metabolites were detected in the serum of CHD patients, and six of these metabolites participating in seven metabolic pathways were significantly different between CHD patients treated with XFZY decoction and the placebo group. Among the six differential metabolites, FA (20:2)-H and tetracarboxylic acid (24:0), involved in fatty acid metabolism; cis-aconitic acid, which participates in the tricarboxylic acid cycle; 2-deoxy-D-glucose, involved in glucose metabolism; and N-acetylglycine, involved in amino acid metabolism, were decreased, whereas spermine, which participates in amino acid metabolism, was increased as compared with the placebo group. Our findings, combined with the perspective of biological functions, indicate that 2-deoxy-D-glucose and spermine might constitute the partial material foundation of Qi in CHD patients treated with XFZY decoction.