■包含草药配方的传统中药(TCM)已经使用了数千年来治疗各种疾病,比如失眠,基于不同的综合征类型。尽管在动物模型中已提出中药通过肠道菌群调节对失眠有效,人类研究仍然有限。因此,这项研究采用机器学习和整合网络技术来阐明肠道微生物组在两种中药配方-补中益气汤(CSQBD)和健脾益阴清热汤(STYHCD)-治疗被诊断为脾气不足和脾气虚胃热的失眠患者的疗效中的作用。
■纳入63例具有这两种特定中医证型的失眠患者,并接受CSQBD或STYHCD治疗4周。每2周使用匹兹堡睡眠质量指数(PSQI)和失眠严重程度指数(ISI)评估睡眠质量。此外,通过16SrRNA基因测序评估了肠道微生物群的变化。在治疗前和治疗后测量应激和炎症标志物。
■在基线时,仅表现出脾气虚的患者表现出轻微的严重失眠,较低的IFN-α水平,皮质醇水平高于脾气虚胃热者。尽管对PSQI进行了基线调整,但两种中医证型均显示出不同的肠道微生物组特征,ISI,和IFN-α评分。巢式分层10倍交叉验证随机森林分类器显示脾气虚型患者长双歧杆菌丰度高于脾气虚型胃热型患者,与血浆IFN-α浓度呈负相关。CSQBD和STYHCD治疗在2周内均显着改善了睡眠质量,持续了整个研究。此外,治疗后肠道微生物组和炎症标志物发生显著改变.纵向综合网络分析揭示了睡眠质量之间的相互联系,肠道微生物,如相低温芽孢杆菌和Ruminococcaceae,和炎症标志物。
这项研究揭示了与不同中医证型相关的独特微生物组特征,并强调了肠道微生物组和中药配方在改善失眠方面的功效之间的联系。这些发现加深了我们对与失眠有关的肠-脑轴的理解,并为利用中药草药的精确治疗方法铺平了道路。
UNASSIGNED: Traditional Chinese medicine (TCM) comprising herbal formulas has been used for millennia to treat various diseases, such as insomnia, based on distinct syndrome types. Although TCM has been proposed to be effective in insomnia through gut microbiota modulation in animal models, human studies remain limited. Therefore, this
study employs machine learning and integrative network techniques to elucidate the role of the gut microbiome in the efficacies of two TCM formulas - center-supplementing and qi-boosting decoction (CSQBD) and spleen-tonifying and yin heat-clearing decoction (STYHCD) - in treating insomnia patients diagnosed with spleen qi deficiency and
spleen qi deficiency with stomach heat.
UNASSIGNED: Sixty-three insomnia patients with these two specific TCM syndromes were enrolled and treated with CSQBD or STYHCD for 4 weeks. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) every 2 weeks. In addition, variations in gut microbiota were evaluated through 16S rRNA gene sequencing. Stress and inflammatory markers were measured pre- and post-treatment.
UNASSIGNED: At baseline, patients exhibiting only spleen qi deficiency showed slightly lesser severe insomnia, lower IFN-α levels, and higher cortisol levels than those with
spleen qi deficiency with stomach heat. Both TCM syndromes displayed distinct gut microbiome profiles despite baseline adjustment of PSQI, ISI, and IFN-α scores. The nested stratified 10-fold cross-validated random forest classifier showed that patients with spleen qi deficiency had a higher abundance of Bifidobacterium longum than those with spleen qi deficiency with stomach heat, negatively associated with plasma IFN-α concentration. Both CSQBD and STYHCD treatments significantly improved sleep quality within 2 weeks, which lasted throughout the
study. Moreover, the gut microbiome and inflammatory markers were significantly altered post-treatment. The longitudinal integrative network analysis revealed interconnections between sleep quality, gut microbes, such as Phascolarctobacterium and Ruminococcaceae, and inflammatory markers.
UNASSIGNED: This
study reveals distinct microbiome profiles associated with different TCM syndrome types and underscores the link between the gut microbiome and efficacies of Chinese herbal formulas in improving insomnia. These findings deepen our understanding of the gut-brain axis in relation to insomnia and pave the way for precision treatment approaches leveraging TCM herbal remedies.