Effects of integrated traditional Chinese and Western medicine on intestinal microecology of liver failure

doi:10.19871/j.cnki.xfcrbzz.2023.02.003

Abstract

Abstract: Objective To observe the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of liver failure and its influence on the abundance and diversity of intestinal microbiota. Method In a randomized controlled clinical study, 77 patients with liver failure who were hospitalized at Chengdu Public Health Clinical Medical Center from June 2019 to December 2020 were randomly divided into experimental group (39 cases) and control group(38 cases), 20 healthy control groups were also established. The experimental group was treated with integrated Traditional Chinese and Western medicine, and the control group was treated with western medicine. The course of treatment was 4 weeks.The changes of intestinal flora abundance and diversity before and after treatment were observed in the two groups. Result Compared with healthy control group, the abundance of bacteria in patients with liver failure was significantly different（P<0.05）. Firmicutes decreased and proteobacteria increased at phylum level, and Klebsiella, Streptococcus and Eschia increased at phylum level.β-diversity analysis showed that there was a difference in intestinal microbiota diversity before and after treatment in experimental groups（P<0.05）. The LEfSe analysis showed that after treatment, the relative abundance of beneficial bacteria such as lactobacillus increased, while the relative abundance of opportunistic pathogens such as Klebsiella and Escherichia decreased in the experimental group. Conclusion Patients with liver failure have intestinal microecology disorder, which is manifested by the increase of conditional pathogenic bacteria and the decrease of beneficial bacteria. After treatment with integrated Traditional Chinese and Western medicine, the relative abundance of beneficial bacteria such as lactobacillus can be increased, the relative abundance of conditional pathogenic bacteria can be reduced, and the intestinal micro-ecology can be improved.

Key words: Liver failure, Traditional Chinese medicine, Intestinalmicroflora, Lntestinal microecology

CLC Number:

R575
R574

Li Jike, Luo Mei, Chen Zhu, Li Shoujuan, Mao Chuangjie, Gao Feng, Duan Meng, Ye Qing, Wang Yuelian, Pang Wenxiao. Effects of integrated traditional Chinese and Western medicine on intestinal microecology of liver failure[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(2): 13-17.

References

[1] 中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2018年版)[J]. 中华肝脏病杂志, 2019, 21(1):18-26.
[2] 邱自辉, 李其彪, 陈宇, 等. 血浆置换联合胆红素吸附治疗肝衰竭的临床研究[J/CD]. 新发传染病电子杂志, 2016, 1(1):45-47.
[3] LEY RE, PETERSON DA, GORDON JI.Ecological and evolutionary forces shaping microbial diversity in the human intestine[J]. Cell, 2006, 124:837-848.
[4] ZE X, BEN DY, LAVERDE JA, et al.Unique organization of extra-cellular amylases into amylosomes in the resistant starch-utilizing human colonic firmicutes bacterium ruminococcusbromii[J]. MBio, 2015, 6(5):e01058-15.
[5] ECKBURG PB, BIKE M, BERNSTEIN CN, et al.Diverity of the humanintestinal microbial flora[J]. Science, 2005, 308:1635-1638.
[6] 陈木兴, 王少扬. 肠道菌群失调在乙型肝炎相关慢加急性肝衰竭发病机制中的作用[J]. 临床肝胆病杂志, 2019, 35(3):665-668.
[7] 王芳昭, 崔茜如, 曾雨浓,等. 肠道菌群——肝脏疾病的重要参与者[J]. 南方医科大学学报, 2020, 40(4):595-600.
[8] 刘茵. 肠道菌群失调与肝衰竭的关系及中医治疗研究进展[J].广西中医药, 2019, 42(4):76-78.
[9] 牛亚蒙, 刘江凯. 中医药对肝硬化患者肠道菌群的影响[J]. 中西医结合肝病杂志, 2021, 31(9):861-864
[10] 莫小艾, 蒋开平, 马晓军, 等. 防风通圣散对肝衰竭患者肠道微生态影响的临床研究[J]. 深圳中西医结合杂志, 2022, 32(12): 14-17.
[11] 褚璨灿,师为人,陈云志,朱星.从调节肠道菌群探讨中医药治疗慢性阻塞性肺疾病的相关性[J].贵阳中医学院学报, 2019, 41(1):64-69.
[12] 陈健, 张梁坤, 谷文超, 等. 半夏泻心汤对DSS诱导的溃疡性结肠炎小鼠肠道微生态及Th17/Treg细胞平衡的影响[J]. 世界科学技术-中医药现代化, 2022, 24(7):2695-2709.
[13] 欧国森, 游德森, 张霖浩, 等. 参苓白术散治疗脾虚型功能性腹泻的肠道微生态机制探讨[J]. 广州中医药大学学报, 2020, 37(11):2232-2236.
[14] 关婷,黄海阳,黄纯美,等.不同药性归脾经中药对肝郁脾虚证动物模型肠道微环境的影响[J]. 中药新药与临床药理,2021,32(4):511-517.
[15] FAN S,NIE S,HUANG X,et al.Protective properties of combined fungal polysaccharides from Cordyceps sinensis and Ganoderma atrum on colon immune dysfunction[J].Inter J Biolo Macromol,2018,114:1049–1055.
[16] 王一帆,范恒.氧化苦参碱调控RhoA/ROCK信号通路介导溃疡性结肠炎E–cadherin及TGF–β的影响[J].中国实验方剂学杂志,2019,25(6):73-80.
[17] CAO C, LIU M, QU S, et al.Chinese medicine formula Kai-Xin-San ameliorates depression-like behaviours in chronic unpredictable mild stressed mice by regulating gut microbiota-inflammation-stress system[J]. J Ethnopharmacol, 2020, 261:113055.
[18] 贾林森, 王建光, 关洪全, 等. 中药免疫调节对肠道微生态的影响[J].时珍国医国药, 2021, 32(5):1181-1182.
[19] 龚梦鹃, 李春苑, 巫圣乾, 等. 16S rRNA高通量测序研究藿香正气口服液对湿困脾胃证大鼠肠道菌群的影响[J].中药新药与临床药理, 2019, 30(4):391-395
[20] GUO M,DING S,ZHAO C,et al.Red Ginseng and Semen Coicis can improve the structure of gut microbiota and relieve the symptoms of ulcerative colitis[J].J Ethnopharmacol,2015,162:7-13.
[21] 曹婷. 中医药调节慢性肝病肠道微生态的文献分析及临床研究[D].武汉:湖北中医药大学,2016.
[22] 刘茵,毛德文,王明刚,等.解毒化瘀颗粒对慢加急性肝衰竭患者肠道菌群及肠道屏障功能的影响[J]. 时珍国医国药,2018,29(12):2841-2843.
[23] 安永辉,孙燕,张雪,等. 茵陈四苓散加减调节慢性乙肝患者肠道功能及对肠道菌群作用机制研究[J]. 亚太传统医药,2020,16(4):142-145.
[24] 李海凤,罗芳,吴其恺,等.赤芍承气汤高位保留灌肠对肝衰竭患者肠道微生态失衡的影响[J]. 中西医结合肝病杂志,2019,29(1):21-22,37.