血府逐瘀胶囊对冠心病心绞痛气滞血瘀证患者舌苔菌群变化的临床研究

Clinical study on changes of tongue coating cicrobiota in patients with coronary heart disease and angina pectoris of qi-stagnation and blood stasis syndrome treated with Xuefu Zhuyu Capsule

关键词:  冠心病心绞痛  气滞血瘀证  血府逐瘀胶囊  舌苔菌群

Key words:  coronary heart disease-related angina pectoris  qi-stagnation and blood-stasis syndrome  Xuefu Zhuyu Capsule  tongue coating microbiota

摘要:

[目的] 本研究采用16S rDNA测序技术，探究血府逐瘀胶囊对冠心病心绞痛气滞血瘀证舌苔菌群的影响，为血府逐瘀胶囊临床应用提供依据。[方法] 采用前瞻性、多中心的临床试验设计，基于是否服用血府逐瘀胶囊，将冠心病心绞痛气滞血瘀证患者分为血府逐瘀胶囊治疗组（联合西医常规治疗）、西医常规治疗组与正常对照组，每组各30例。收集血府逐瘀胶囊治疗组和西医常规治疗组0周与8周舌苔样本，以及正常对照组0周舌苔样本。应用16S rDNA扩增子测序技术，分析冠心病心绞痛气滞血瘀证患者的舌苔菌群结构，以期筛选疾病相关差异菌群，并明确血府逐瘀胶囊调节的关键菌群。[结果] 与正常对照组相比，冠心病心绞痛气滞血瘀证患者体内变形杆菌属与放线菌门相对丰度显著升高，经血府逐瘀胶囊治疗后菌群丰度均出现下调；拟杆菌门、厚壁菌门、梭杆菌门聚集较少，经血府逐瘀胶囊治疗后菌群丰度上调。菌群LEfSe分析结果发现血府逐瘀胶囊调节的标志物是罗斯氏菌属、微球菌科、微球菌目、放线菌门和放线菌属。[结论] 血府逐瘀胶囊可改善冠心病心绞痛气滞血瘀证患者的临床症状，该过程伴随有舌苔菌群结构的改变，提示舌苔菌群可能成为评估血府逐瘀胶囊对冠心病心绞痛气滞血瘀证疗效的一个潜在微观指标。

Abstract:

[Objective]This study employed 16S rDNA sequencing technology to investigate the effects of Xuefu Zhuyu Capsules on the tongue coating microbiota in patients with coronary heart disease-related angina pectoris(qi-stagnation and blood-stasis syndrome), providing experimental evidence for its clinical application.[Methods]A prospective, multicenter clinical trial design was adopted. Patients with coronary heart disease and angina pectoris of qi-stagnation and blood stasis pattern were divided into the Xuefu Zhuyu Capsule treatment group(Xuefu Zhuyu Capsules combined with conventional Western medicine treatment), the conventional Western medicine treatment group, and a healthy control group, with 30 cases in each group. Tongue coating samples were collected at 0 week and 8 week from the two treatment groups, and at week 0 from the healthy group. 16S rDNA amplicon sequencing was used to profile the tongue coating microbiota in patients with coronary heart disease and angina pectoris of qi-stagnation and blood stasis syndrome, in order to identify disease-related taxa and key microbiota modulated by Xuefu Zhuyu Capsules.[Results]Compared with healthy individuals, patients showed increased enrichment of Proteobacteria and Actinobacteria, which decreased after Xuefu Zhuyu Capsules treatment. Conversely, reduced enrichment of Bacteroidetes, Firmicutes and Fusobacteria was observed, with their abundance increasing post-treatment. LEfSe analysis identified Roseburia, Micrococcaceae, Micrococcales, Actinobacteria and Actinomyces as biomarkers regulated by Xuefu Zhuyu Capsules.[Conclusion]Xuefu Zhuyu Capsules alleviate clinical symptoms in patients with coronary heart disease and angina pectoris(qi-stagnation and blood stasis syndrome), accompanied by tongue coating flora structural alterations and suggested the flora may serve as a potential microcosmic indicator for evaluating the drug's efficacy in this condition.