Effect of <italic style="font-style: italic">Shengjie Tongyu Decoction </italic>（升解通瘀汤） on Urine Metabolomics in Patients with Ischemic Cardiomyopathy-induced Chronic Heart Failure and <italic style="font-style: italic">Qi </italic>Deficiency and Blood Stasis Syndrome

SUN Ziyi; YAO Kuiwu; WANG Zihan; LIU Jingnan; SHI Zaixiang; FAN Jiarong; HUANG Li; LI Chunyan

doi:10.13288/j.11-2166/r.2023.07.009

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Effect of Shengjie Tongyu Decoction （升解通瘀汤） on Urine Metabolomics in Patients with Ischemic Cardiomyopathy-induced Chronic Heart Failure and Qi Deficiency and Blood Stasis Syndrome

更新时间：2023-04-17

- Effect of Shengjie Tongyu Decoction （升解通瘀汤） on Urine Metabolomics in Patients with Ischemic Cardiomyopathy-induced Chronic Heart Failure and Qi Deficiency and Blood Stasis Syndrome
- Journal of Traditional Chinese Medicine Vol. 64, Issue 7, Pages: 692-701(2023)
- 作者机构：
  
  1.北京中医药大学，北京市朝阳区北三环东路11号，100029
  2.中国中医科学院眼科医院
  3.中日友好医院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2023.07.009
  CLC：
- Received：21 September 2022，
  
  Revised：2023-02-07，
  
  Published：02 April 2023
- 稿件说明：
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孙梓宜,姚魁武,王子涵等.升解通瘀汤对缺血性心肌病致慢性心力衰竭气虚血瘀证患者尿液代谢组学的影响[J].中医杂志,2023,64(07):692-701.

SUN Ziyi,YAO Kuiwu,WANG Zihan,et al.Effect of Shengjie Tongyu Decoction （升解通瘀汤） on Urine Metabolomics in Patients with Ischemic Cardiomyopathy-induced Chronic Heart Failure and Qi Deficiency and Blood Stasis Syndrome[J].Journal of Traditional Chinese Medicine,2023,64(07):692-701.
孙梓宜,姚魁武,王子涵等.升解通瘀汤对缺血性心肌病致慢性心力衰竭气虚血瘀证患者尿液代谢组学的影响[J].中医杂志,2023,64(07):692-701. DOI： 10.13288/j.11-2166/r.2023.07.009.

SUN Ziyi,YAO Kuiwu,WANG Zihan,et al.Effect of Shengjie Tongyu Decoction （升解通瘀汤） on Urine Metabolomics in Patients with Ischemic Cardiomyopathy-induced Chronic Heart Failure and Qi Deficiency and Blood Stasis Syndrome[J].Journal of Traditional Chinese Medicine,2023,64(07):692-701. DOI： 10.13288/j.11-2166/r.2023.07.009.

摘要

目的

探讨升解通瘀汤治疗缺血性心肌病致慢性心力衰竭气虚血瘀证的可能作用机制。

方法

20例缺血性心肌病致慢性心力衰竭气虚血瘀证患者随机分为治疗组与对照组各10例。对照组予常规西药治疗，治疗组在此基础上加用升解通瘀汤口服治疗，每日1剂，两组疗程均为4周。采用氢-核磁共振谱（

H-NMR）检测技术分别对两组患者治疗前后的尿液样本进行分析，应用主成分分析法（PCA）和正交偏最小二乘法判别分析（OPLS-DA）对治疗前后组内与组间的差异性代谢物进行筛选，并利用MetaboAnalyst对差异代谢物进行代谢通路分析。

结果

治疗前两组间无差异代谢物；治疗后两组间有果糖和α-羟基异戊酸酯2个差异代谢物，且两种差异代谢物在治疗组的含量均较对照组更低。两组治疗前后组内比较共筛选出差异代谢物20种，其中对照组3种，分别为乳酸、酪氨酸、色氨酸，含量均较治疗前降低；治疗组17种，其中缬氨酸、3

4-二羟扁桃酸、吲哚磺酸盐、烟酸、马尿酸含量较治疗前升高，精氨酸、α-葡萄糖、β-葡萄糖、乙酰乙酸、胆碱、异亮氨酸、亮氨酸、胍基乙酸、甘露醇、尿素、蛋氨酸、天冬氨酸含量较治疗前降低。代谢通路分析结果显示，仅在治疗组治疗前后的差异代谢物中富集出4条代谢通路，分别为氨酰-tRNA生物合成，缬氨酸、亮氨酸、异亮氨酸生物合成，缬氨酸、亮氨酸、异亮氨酸降解，精氨酸生物合成。

结论

升解通瘀汤治疗缺血性心肌病致慢性心力衰竭气虚血瘀证的作用机制可能涉及对果糖、支链氨基酸代谢和异亮氨酰-tRNA生物合成的调节。

Abstract

Objective

To investigate the possible mechanism of

Shengjie Tongyu Decoction

（升解通瘀汤， STD） for treating chronic heart failure （CHF） with

deficiency and blood stasis syndrome induced by ischemic cardiomyo-pathy （ICM）.

Methods

In a randomized controlled trial， 20 patients with ICM-induced CHF and

deficiency and blood stasis syndrome were divided into a treatment group and a control group with 10 cases in each group. The control group was treated with conventional western medicine， and the treatment group was given STD， one dose daily， additionally. The duration of treatment for both groups was 4 weeks. Urine samples from both groups before and after treatment were analyzed using hydrogen nuclear magnetic resonance spectroscopy （

H-NMR） detection technique， and principal component analysis （PCA） and orthogonal partial least squares discriminant analysis （OPLS-DA） were applied to screen for differential metabolites within and between groups before and after treatment. Metabolic pathway analysis was performed using MetaboAnalyst.

Results

No differential metabolites waw found between groups before treatment. There were two differential metabolites， that is fructose and α- Hydroxyisovalerate， between the two groups after the treatment， and their levels were lower in the treatment group. A total of 20 differential metabolites were screened out in the intra-group comparison before and after treatment， of which there were three in the control group， including lactate， tyrosine， and tryptophan， all at reduced levels compared to the pre-treatment period. In the treatment group， 17 metabolites were screened out， including valine， 3

4-dihydroxymandelic acid， indole sulfonate， nicotinic acid， and hippuric acid， whose levels were higher after treatment， and arginine， α-glucose， β-glucose， acetoacetic acid， choline， isoleucine， leucine， guanidinoacetic acid， mannitol， urea， methionine， and aspartic acid， whose levels were lower after treatment. The metabolic pathway analysis showed that only the differential metabolites before and after treatment in the treatment group were enriched for four metabolic pathways， which were aminoacyl-tRNA biosynthesis， biosynthesis of valine， leucine and isoleucine， degradation of valine， leucine， and isoleucine， and arginine biosynthesis.

Conclusion

The mechanism of STD for the treatment of CHF and

deficiency and blood stasis syndrome induced by ISC may involve the regulation of fructose and branched-chain amino acid metabolism and isoleucine-tRNA biosynthesis.

关键词

Keywords

references

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Hunan University of Chinese Medicine

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Effect of Shengjie Tongyu Decoction （升解通瘀汤） on Urine Metabolomics in Patients with Ischemic Cardiomyopathy-induced Chronic Heart Failure and Qi Deficiency and Blood Stasis Syndrome

DOI：10.13288/j.11-2166/r.2023.07.009

摘要

Abstract

关键词

Keywords

references