基于肠道菌群-代谢组学探讨归脾汤治疗心脾两虚型孤独症谱系障碍的作用及机制OA

Objective It is to observe the clinical efficacy of Guipi Decoction in the treatment of children with autism spectrum disorder(ASD)and its effects on gut microbiota and plasma metabolites.Methods Sixty-two children with ASD of heart-spleen deficiency type who met the inclusion criteria and underwent treatment at the Children's Rehabilitation Cen-ter of the First Affiliated Hospital of Hunan University of Chinese Medicine from September 2023 to June 2024,as well as those who received free ASD screening for children aged 0-6 years were selected and randomly assigned to an observation group and a control group,with 31 cases in each group.The control group was treated with rehabilitation training,while the observation group was treated with both rehabilitation training and Guipi Decoction via oral administration,both groups were treated for 12 weeks.The scores of Childhood Autism Rating Scale(CARS),Psychological Education Profile-3rd Edition(PEP-3),and Spleen-Stomach Disease Symptom Scale before and after treatment,as well as clinical efficacy after treat-ment were observed and compared between the two groups.On the day of the final treatment,16S rDNA gut microbiota se-quencing and plasma metabolomics testing were performed in the children of the two groups,and the correlation between gut microbiota and plasma metabolomics was analyzed.Results A total of 30 children in each group completed the study.The CARS scores of both groups and the Spleen-Stomach Disease Symptom Scale scores of the observation group were signifi-cantly decreased,while the scores of each part in PEP-3 of both groups were significantly increased after treatment com-pared with those before treatment(all P<0.05);the CARS scores and Spleen-Stomach Disease Symptom Scale scores of the observation group were significantly lower,while the scores of each part in PEP-3 were significantly higher than those of the control group after treatment(all P<0.05).After treatment,the overall response rate in the observation group was sig-nificantly higher than that in the control group[93.3%(28/30)vs 66.7%(20/30),P<0.05].Gut microbiota sequen-cing revealed that the relative abundances of the phylum Actinobacteriota,as well as the genera Dubosiella,Eubacterium,and Bifidobacterium in the observation group were all significantly higher than those in the control group(all P<0.05),while the relative abundance of the genus Prevotellaceae was significantly lower than that in the control group(P<0.05).Metabolomics analysis identified a total of 8 significantly differential metabolites,which were associated with pathways such as amino acid metabolism,choline metabolism,catecholamine synthesis and sphingolipid metabolism.Spearman's correla-tion analysis showed that the level of L-glutamine was negatively correlated with Prevotellaceae,the level of L-arginine was positively correlated with Prevotellaceae,and the level of L-tyrosine was negatively correlated with Monoglobus.Conclusion Guipi Decoction can significantly improve core symptoms in children with ASD,it can regulate the abundance of gut micro-biota such as Dubosiella,and influences the levels of plasma metabolites associated with pathways such as amino acid me-tabolism,choline metabolism,catecholamine synthesis and sphingolipid metabolism.