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Abstract：
UNASSIGNED: This paper presents a preliminary study on whether repetitive transcranial magnetic stimulation (rTMS) can modulate the nutritional status of persistent vegetative state (PVS) patients (the primary endpoint) by regulating the intestinal flora and the metabolites, with the correlation between them also investigated.
UNASSIGNED: Seventy-six patients with PVS were selected and divided into the observation group (n = 38) and the control group (n = 38) by random numerical grouping. All subjects\' stool samples were examined for metabolites and analyzed regarding the short-chain fatty acids (SCFAs) content. All subjects\' serum albumin, prealbumin, and hemoglobin levels were measured before and after the treatment. Nutrition risk screening 2002 was performed on all the subjects before and after the treatment and on the 30th and 90th days of the follow-up.
UNASSIGNED: (1) Intestinal flora structure: the Chao index, Ace index, and Shannon index of the observation group and the control group were significantly higher (p < 0.05), while the Simpson index was significantly lower (p < 0.05) following the treatment. (2) Metabolites of the intestinal flora: the observation group had significantly higher levels of acetic acid, butyric acid, and valeric acid (p < 0.05), as well as lower levels of propionic acid (p < 0.05) following the treatment. (3) Nutritional status (the primary endpoint): following the treatment, the above serum nutritional indices were significantly higher in both groups (p < 0.05), while the indices of the observation group were significantly higher than those of the control group (p < 0.05).
UNASSIGNED: The rTMS method may improve the nutritional status of patients with PVS by regulating the structure of the intestinal flora and affecting the level of SCFAs through the microbiota-gut-brain axis. The possible mechanism involves how high-frequency rTMS can cause increased excitation in the frontal lobe of the right side of the brain, thus regulating the 5-hydroxytryptamine and norepinephrine levels.
UNASSIGNED: Seventy-six patients with PVS were selected and divided into the observation group (n = 38) and the control group (n = 38) by random numerical grouping. All subjects\' stool samples were examined for metabolites and analyzed regarding the short-chain fatty acids (SCFAs) content. All subjects\' serum albumin, prealbumin, and hemoglobin levels were measured before and after the treatment. Nutrition risk screening 2002 was performed on all the subjects before and after the treatment and on the 30th and 90th days of the follow-up.
UNASSIGNED: (1) Intestinal flora structure: the Chao index, Ace index, and Shannon index of the observation group and the control group were significantly higher (p < 0.05), while the Simpson index was significantly lower (p < 0.05) following the treatment. (2) Metabolites of the intestinal flora: the observation group had significantly higher levels of acetic acid, butyric acid, and valeric acid (p < 0.05), as well as lower levels of propionic acid (p < 0.05) following the treatment. (3) Nutritional status (the primary endpoint): following the treatment, the above serum nutritional indices were significantly higher in both groups (p < 0.05), while the indices of the observation group were significantly higher than those of the control group (p < 0.05).
UNASSIGNED: The rTMS method may improve the nutritional status of patients with PVS by regulating the structure of the intestinal flora and affecting the level of SCFAs through the microbiota-gut-brain axis. The possible mechanism involves how high-frequency rTMS can cause increased excitation in the frontal lobe of the right side of the brain, thus regulating the 5-hydroxytryptamine and norepinephrine levels.
摘要：
■本文对重复经颅磁刺激（rTMS）是否可以通过调节肠道菌群和代谢产物来调节持续性植物状态（PVS）患者的营养状况（主要终点）进行了初步研究，它们之间的相关性也进行了调查。选择
■76例PVS患者，采用随机数字分组法分为观察组(n=38)和对照组(n=38)。检查所有受试者的粪便样品的代谢物并分析短链脂肪酸(SCFA)含量。所有受试者的血清白蛋白，前白蛋白,在治疗前后测量血红蛋白水平。在治疗前后以及随访的第30天和第90天对所有受试者进行营养风险筛查2002。
■(1)肠道菌群结构：Chao指数，Ace指数,观察组和对照组的Shannon指数明显高于对照组(p<0.05),而辛普森指数在治疗后显著降低(p<0.05)。(2)肠道菌群代谢产物:观察组的乙酸水平明显高于对照组,丁酸,和戊酸（p<0.05），以及治疗后较低水平的丙酸（p<0.05）。（3）营养状况（主要终点）：治疗后，两组血清营养指标均显著高于对照组(p<0.05),观察组各项指标明显高于对照组(p<0.05)。
■rTMS方法可能通过调节肠道菌群的结构并通过微生物群-肠-脑轴影响SCFA的水平来改善PVS患者的营养状况。可能的机制涉及高频rTMS如何引起大脑右侧额叶的兴奋，从而调节5-羟色胺和去甲肾上腺素的水平。
■76例PVS患者，采用随机数字分组法分为观察组(n=38)和对照组(n=38)。检查所有受试者的粪便样品的代谢物并分析短链脂肪酸(SCFA)含量。所有受试者的血清白蛋白，前白蛋白,在治疗前后测量血红蛋白水平。在治疗前后以及随访的第30天和第90天对所有受试者进行营养风险筛查2002。
■(1)肠道菌群结构：Chao指数，Ace指数,观察组和对照组的Shannon指数明显高于对照组(p<0.05),而辛普森指数在治疗后显著降低(p<0.05)。(2)肠道菌群代谢产物:观察组的乙酸水平明显高于对照组,丁酸,和戊酸（p<0.05），以及治疗后较低水平的丙酸（p<0.05）。（3）营养状况（主要终点）：治疗后，两组血清营养指标均显著高于对照组(p<0.05),观察组各项指标明显高于对照组(p<0.05)。
■rTMS方法可能通过调节肠道菌群的结构并通过微生物群-肠-脑轴影响SCFA的水平来改善PVS患者的营养状况。可能的机制涉及高频rTMS如何引起大脑右侧额叶的兴奋，从而调节5-羟色胺和去甲肾上腺素的水平。
