Clinical And Experimental Study Of Yangyin Tiluo Decoction On Gut Microbiota In Elderly Patients With Metabolic Syndrome(Yin Deficiency And Blood Stasis)

Background:Alterations in gut microbiota have been to play a critical role in metabolic syndrome.However,the microbial features in elderly patients with metabolic syndrome remain unclear.A traditional Chinese Herbal Formula,Yangyin Tiluo Decoction(YTD),can alleviate metabolic syndrome and cardiovascular disease.However,its effect on the gut microbiota of patients with metabolic syndrome and its possible mechanism are still unclear.Objective:To verify the effect of YTD on senile metabolic syndrome patients with Yin deficiency and blood stasis,and to clarify the characteristics of intestinal flora and the effect of YTD on intestinal flora of senile metabolic syndrome patients,the study was designed and carried out.Methods:Clinical study:60 elderly patients with Yin deficiency and blood stasis metabolic syndrome were randomly divided into control group(30 cases)and treatment group(30 cases).The control group received basic treatment.Treatment group's,treated with YTD on the basement of contaol group.The period of observation is four weeks.The serum lipids,fasting blood glucose,insulin sensitivity index,TCM clinical symptom score,blood pressure,coccus/bacillus ratio of fecal smear were observed.Experimental research parts:a total of 23 people involved in this study.11 healthy person collectedl feces samples.12 MS patients accept the treatment of YTD 4 weeks.We collectd the feces samples before and after the treatment.The microbial composition in healthy control,pre-and post-YTD treatment group were analyzed by 16S rRNA sequencing of fecal DNAs.Result:Clinical research:After treatment,the improvement of various indicators in the treatment group was better than that in the control group.There were significant differences in clinical scores of TCM,LDL-C,insulin sensitivity index(IAI)and fecal coccus/bacillus ratio.At the same time,there were significant differences in TCM clinical symptom score,LDL-C and IAI before and after treatment in the treatment group,while there were no significant differences in all indicators before and after treatment in the control group.Experimental research:The results showed a high inter-individual variation of gut microbiota in elderly persons.The gut microbiota was dominated by phylum Firmicutes and Actinobacteria,which was distinct from the previously defined microbiota in Irish elderly persons.The elderly patients with metabolic syndrome had higher proportions of Lactobacillus and Bifidobacterium,and lower proportions of Anaerostipes,Coprococcus,Ruminococcus than healthy controls.YTD treatment reduced the abundance of genus Bacteroidales Incertae Sedis and species Enterobacteriaceae Incertae Sedis.These results reveal a remarkable dominance of Firmicutes and Actinobacteria,and highlight the distinct gut microbiota in elderly patients with metabolic syndrome,which may be involved in pathogenesis.Furthermore,the benefits of YTD treatment were observed,providing an approach to improve metabolic syndrome in elderly patients.Conclusion:1.YTD can significantly reduce LDL-C and increase insulin sensitivity in MS patients,which can also increase the bacillus/coccus ratio of feces in MS patients.2.YTD can effectively improve the clinical symptoms of elderly MS patients.3.Compared with the healthy control group,the diversity of intestinal microorganism has no significantly changed in elderly MS patients,but the abundance of actinomycetes was significantly increased.4.The treatment of YTD can significantly improve the gut microbiota of MS patients.5.The treatment of MS patients by YTD may be achieved by regulating gut microbiota,which provides a new approach in the treatment of MS in elderly patients.