目的基于代谢组学探讨中药(复方/单味)治疗不同物种冠心病血瘀证所筛选到的差异代谢物,总结中药干预冠心病血瘀证后的生物标志物及相关代谢通路。方法从中国知网、万方数据库、维普数据库、Embase、PubMed、the Cochrane Library、Web of Science数据库中检索中药(复方/单味)治疗冠心病血瘀证的代谢组学研究。对纳入研究的差异代谢物进行汇总,采用HMDB、PubChem-Subs、KEGG对代谢物进行分子注释,对代谢产物路径可视化采用metPA网络软件进行分析。结果共有8篇文献纳入本研究,计算两个物种中重复出现的代谢物后共统计89个差异代谢物主要参与了132条代谢路径。通过通路拓扑分析并对重复出现的代谢通路进行统计后选出了16条P值小于0.05的代谢通路作为中药(复方/单味)治疗不同物种冠心病血瘀证的代谢通路。对于富集于各条差异性代谢通路上的代谢物,在不同研究中重复筛选到的代谢物包括:苯丙氨酸,谷氨酰胺,甘氨酸,柠檬酸盐,胆碱,肌酸,乳酸,葡萄糖,花生四烯酸。结论各项研究中用于冠心病血瘀证治疗的中药(复方/单味)以血府逐瘀汤、桃红四物汤、养心通脉方、苏合香为代表。基于代谢组学的中药(复方/单味)治疗冠心病血瘀证的生物信息学分析显示其作用机制涉及糖代谢、氨基酸代谢、能量代谢、胆碱代谢、脂肪酸代谢等多个方面,基本的三羧酸循环参与其中。总结了包括乳酸、葡萄糖、柠檬酸、花生四烯酸、肌酸、苯丙氨酸、胆碱、谷氨酰胺以及甘氨酸在内的与冠心病血瘀证证候相关的差异代谢物。
血瘀证是冠心病发病的主要因素之一,肠道菌群可以影响冠心病血瘀证的发生与发展。“心与小肠相表里”是《黄帝内经》对二者关系的总结概括,小肠代谢失常,导致津液输布障碍,成痰成瘀,痹阻心脉可以导致胸痹的发生。活血化瘀药物的应用对其有显著疗效,防止冠心病血瘀证的进一步发展,也使小肠的生理功能恢复正常。该文旨在从“心与小肠相表里”视角探讨心脏、小肠和冠心病血瘀证的相关性,为防治冠心病血瘀证提供理论基础和新的思路方法。Blood stasis is one of the main factors in the development of coronary heart disease, and intestinal flora can affect the occurrence and development of blood stasis in coronary heart disease. “The heart and the small intestine are mutually exclusive” is the “Huangdi Neijing” on the relationship between the two summarized, the small intestine metabolic disorders, resulting in fluid distribution obstacles, into phlegm into blood stasis, paralysis of the cardiac veins can lead to the occurrence of thoracic paralysis. The application of drugs to activate blood circulation and eliminate blood stasis can have significant therapeutic effects, preventing the further development of blood stasis in coronary heart disease and restoring the physiological function of the small intestine to normal. The aim of this article is to discuss the correlation between heart, small intestine and coronary blood stasis from the perspective of “heart and small intestine are mutually exclusive”, so as to provide theoretical basis and new ideas and methods for the prevention and treatment of coronary blood stasis.
