基于16S rDNA测序探讨补阳还五汤辅助治疗缺血性脑卒中患者肠道菌群的影响

Effect of Buyang Huanwu Decoction as an Adjuvant Therapy on Gut Microbiota in Ischemic Stroke Patients: A Study Based on 16S rDNA Sequencing

摘要: 本研究旨在探讨补阳还五汤对缺血性脑卒中患者肠道菌群的影响，并基于16S rDNA测序技术揭示其潜在改善机制。研究纳入52例符合标准的缺血性脑卒中患者，随机分为西医治疗组(33例)和补阳还五汤辅助治疗组(19例)，另选取21名健康志愿者作为正常对照组。西医治疗组接受脑梗死常规治疗(含抗血小板聚集、调脂稳斑等)，补阳还五汤辅助治疗组在上述治疗基础上加用补阳还五汤。本研究将上述三组人群的16S rDNA测序数据，与公开数据库中中国地区健康中老年人群、长寿老人及百岁老人的同类数据进行标准化处理后合并，开展肠道菌群对比分析。结果显示，与健康对照组相比，缺血性脑卒中患者肠道菌群结构存在显著差异，表现为α多样性(如Chao1指数)升高，部分被报道与炎症相关的菌属(如Actinomyces、Ileibacterium、Corynebacterium和Desulfovibrio等)丰度呈升高趋势；而长寿老人肠道菌群中，部分产短链脂肪酸(SCFA)相关菌属(如Coprococcus、Alistipes、Blautia、Lachnospira和Eubacterium等)丰度较高，与SCFA的益生作用特征相符。补阳还五汤为治疗中风相关病症的经典中药方剂，本研究发现其辅助治疗可改变脑卒中患者的肠道菌群结构，其中部分被认为具有潜在益生功能的菌属(如Lactobacillus)丰度升高，且能改善肠道炎症状态，这种菌群结构的调整可能为患者神经功能恢复创造有利条件。

Abstract: This study aimed to investigate the effects of Buyang Huanwu decoction (BHD) on the gut microbiota in patients with ischemic stroke and to elucidate its potential ameliorative mechanisms using 16S rDNA sequencing. Fifty-two eligible ischemic stroke patients were enrolled and randomly assigned to either the conventional Western medicine treatment group (n = 33) or the BYHWD adjunctive therapy group (n = 19). Additionally, 21 healthy volunteers were recruited as a normal control group. The conventional treatment group received standard therapy for cerebral infarction, including antiplatelet aggregation and lipid-regulating/plaque-stabilizing agents. The BHD adjunctive therapy group received BHD in addition to the conventional treatment. The 16S rDNA sequencing data from these three groups were standardized and merged with comparable data from publicly available databases containing information on healthy middle-aged and elderly individuals, long-lived elderly individuals, and centenarians from China for comparative analysis of the gut microbiota. The results revealed significant differences in the gut microbiota structure between ischemic stroke patients and the healthy controls. The patient group exhibited increased alpha diversity (e.g., Chao1 index) and an elevated abundance of certain genera reported to be associated with inflammation (such as Actinomyces, Ileibacterium, Corynebacterium, and Desulfovibrio). In contrast, the gut microbiota of long-lived elderly individuals showed a higher abundance of short-chain fatty acid (SCFA)-producing genera (e.g., Coprococcus, Alistipes, Blautia, Lachnospira, and Eubacterium), which aligns with the beneficial characteristics of SCFAs. As a classic traditional Chinese medicine formula for stroke-related conditions, BYHWD, when used as an adjunctive therapy, was found to alter the gut microbiota structure in stroke patients. This alteration included an increased abundance of genera considered to have potential probiotic functions (such as Lactobacillus) and an improvement in intestinal inflammation status. These adjustments in the microbial community structure may create a favorable environment for the recovery of neurological function in patients.