基于肠道菌群-胆汁酸途径研究“痰湿调体方”干预痰湿体质糖脂代谢的作用机制

代谢性疾病高发是全球性公共卫生问题。中医学认为痰湿体质是代谢性疾病发生的土壤，从调理痰湿体质入手可为代谢性疾病的防治提供新思路。痰湿调体方是王琦国医大师积数十年临床经验所创制的痰湿体质调体专方，临床应用疗效确切，但具体机制则尚未明确。肠道菌群与人体代谢密切相关，肠道菌群-胆汁酸是调控糖脂代谢的重要途径。课题组前期初步研究发现痰湿体质可能存在特异的肠道菌群，痰湿调体方可调整痰湿体质肠道菌群结构。本项目拟在前期基础上扩大临床样本，运用肠道菌群基因组测序、靶向代谢组学等技术手段，阐明痰湿体质肠道菌群和胆汁酸谱的内在特征，揭示痰湿调体方经“肠道菌群-胆汁酸”途径对痰湿体质糖脂代谢的干预机制，并结合体内肠菌移植和体外肠菌培养技术展开多层次、多维度的验证。这一研究为中医药基于调节肠道菌群策略实现代谢性疾病的有效防治奠定基础，有助于践行中医治未病的学术理念。

The high incidence of metabolic diseases is an urgent global public health issue. Phlegm-dampness constitution (PC), according to the Chinese medicine theory, is the soil of multiple metabolic diseases. Therefore, modifying PC can provide new approaches for the prevention of metabolic diseases. Tanshi-tiaoti decoction (TTD), a specific formula for PC, was created by Prof. Qi Wang based on his profound clinical experience. This formula has been proved to be effective in clinical practice, however, the detailed mechanism is still elusive. The intestinal microbiota is closely involved in the host metabolism, and intestinal microbiota-bile acid is a significant pathway regulating the glucolipid metabolism. Our previous data suggested that PC may have distinct gut microbiota composition, and it could be manipulated by TTD. The current study, by enlarging the clinical sample volume, applying genomic sequencing and targeted metabolomic approaches, aims to unveil the inherent characteristics of PC from the perspective of gut microflora and bile acid profile; it also attempts to reveal the intervention mechanism of TTD on the glucolipid metabolism of PC by the intestinal microbiota-bile acid pathway. In vitro and in vivo validating experiments should be performed in multiple dimensions to achieve a concrete conclusion. This study will lay a solid foundation for the early prevention of various metabolic diseases through the adjustment of enteric microbiota of PC with Chinese medicine approaches, which will profit the preventive treatment of Chinese medicine.