痰火方对急性缺血性卒中痰热证患者舌苔菌群的影响OA
Effects of Tanhuo Prescription on Tongue Coating Microbiota in Patients with Phlegm-heat Syndrome of Acute Ischemic Stroke
目的 探究痰火方对急性缺血性卒中(AIS)痰热证患者的临床疗效及对舌苔菌群的调节作用.方法 采用随机数字表法将112例AIS痰热证患者分为治疗组和对照组各56例.2组均给予常规抗血小板、降脂稳斑等治疗,治疗组在常规治疗基础上给予痰火方加减口服,2组疗程均为10～14 d.评估2组临床有效率,比较2组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、中医证候评分、日常生活能力(ADL)评分及舌苔菌群变化.结果 治疗组脱落3例、对照组脱落1例.治疗组临床总有效率为92.5%(49/53),对照组临床总有效率为72.7%(40/55),治疗组疗效优于对照组(P<0.05).与本组治疗前比较,治疗组治疗后NIHSS评分、ADL评分、中医证候评分明显改善(P<0.05),mRS评分差异无统计学意义(P>0.05);对照组治疗后NIHSS评分、中医证候评分明显改善(P<0.05),mRS评分、ADL评分差异无统计学意义(P>0.05).2组治疗后比较,治疗组NIHSS评分、ADL评分、中医证候评分改善优于对照组(P<0.05),mRS评分差异无统计学意义(P>0.05).治疗组治疗后颗粒链球菌属、小单胞菌属相对丰度较对照组降低,巨球型菌属相对丰度较对照组升高(P<0.05).治疗组治疗后舌苔菌群无水肽聚糖回收、半乳糖降解,以及N-乙酰葡萄糖胺、N-乙酰甘露糖胺和N-乙酰神经氨酸的降解较对照组减少,精氨酸合成较对照组增加(P<0.05).结论 痰火方对AIS痰热证患者具有较好的临床疗效,对患者神经功能缺损症状有良好的改善作用,其机制可能与调节舌苔菌群丰度及代谢途径相关.
Objective To explore the clinical efficacy of Tanhuo Prescription in patients with phlegm-heat syndrome of acute ischemic stroke(AIS)and its regulatory effect on tongue coating microbiota.Methods Totally 112 AIS patients with phlegm-heat syndrome were divided into the treatment group and the control group(56 cases per group)by means of random number table method.Both groups were treated with conventional antiplatelet therapy,lipid-lowering and plaque stabilization therapy.In addition to this conventional therapy,the treatment group received the modified Tanhuo Prescription orally.The treatment course was 10-14 days for both groups.The following outcomes were compared between the two group:clinical efficacy rate,National Institute of Health stroke scale(NIHSS)score,modified Rankin Scale(mRS)score,TCM syndrome score,activities of daily living(ADL)score,and changes in tongue coating microbiota.Results There were 3 dropouts in the treatment group and 1 dropout in the control group.The total clinical efficacy rate was 92.5%(49/53)in the treatment group and 72.7%(40/55)in the control group,and the efficacy of treatment group was superior to that of the control group(P<0.05).Compared with before treatment,the NIHSS score,ADL score and TCM syndrome score in the treatment group were significantly improved after treatment(P<0.05).There was no statistical difference in mRS score between before and after treatment in the treatment group(P>0.05);in the control group,the NIHSS score and the TCM syndrome score were significantly improved after treatment(P<0.05),while mRS score and ADL score showed no statistically significant differences(P>0.05).After treatment,the improvement of NIHSS score,ADL score,TCM syndrome score in the treatment group was better than that in the control group(P<0.05),and there was no significant difference in mRS score between the two groups(P>0.05).After treatment,the relative abundance of Granulicatella and Parvimonas in the treatment group was lower than that in the control group,while the relative abundance of Megasphaera was higher than that in the control group(P<0.05).After treatment,the recovery of anhydrous peptidoglycan,the degradation of galactose and the degradation of N-acetylglucosamine,N-acetylmannosamine and N-acetylneuraminic acid in the treatment group were lower than those in the control group,and the synthesis of arginine was higher than that in the control group(P<0.05).Conclusion Tanhuo Prescription has good clinical efficacy in patients of AIS with phlegm-heat syndrome.It has a good improvement effect on patients'neurological deficits,and the mechanism may be related to the modulation of the abundance of tongue coating microbiota and their metabolic pathways.
龙金瑶;高利;王宁群
首都医科大学宣武医院,北京 100053首都医科大学宣武医院,北京 100053首都医科大学宣武医院,北京 100053
医药卫生
急性缺血性卒中痰热证舌苔菌群痰火方
acute ischemic strokephlegm-heat syndrometongue coating microbiotaTanhuo Prescription
《中国中医药信息杂志》 2026 (5)
110-116,7
首都卫生发展科研专项(首发2022-2-2018)
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