| Objective: To explore the curative effect of "Dahuang Wumei Decoction" in the treatment of MHE from the perspective of enterogenic endotoxemia,and to find an effective external treatment method of traditional Chinese medicine for the treatment of MHE.Methods: Thirty-four patients who were hospitalized in the Department of Liver Diseases of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from June 2021 to December 2021 were selected and enrolled in the group.Randomly divided into two groups,the two groups were treated with conventional Chinese and Western medicine,the experimental group was treated with rhubarb decoction enema on this basis,and the control group was treated with rifaximin for a total of two weeks.The NCT-A score,DST score,IL-6,IL-1β,TNF-α,blood ammonia,and TCM syndrome scores of patients in each group before and after treatment were collected;fresh feces before and after treatment were detected by 16 S r DNA highthroughput pyrosequencing.Results:(1)There was a statistically significant difference in the score of damp-heat syndrome between the two groups before and after treatment(p<0.05).better than the control group.Among them,the spleen deficiency syndromes(fatigue,anorexia,mental fatigue,diarrhea/dry stool)were significantly different(p=0.002).(2)The difference of bilirubin levels between the two groups before and after treatment was statistically significant(p<0.05),and there was no significant difference in bilirubin between the two groups after treatment.There was a statistically significant difference in blood ammonia values between the two groups before and after treatment(p<0.05).After treatment,the difference between the experimental group and the control group was statistically significant(p<0.05),that is,the experimental group reduced blood ammonia levels better than the control group.There were statistically significant differences in NCT-A and DST scores between the two groups before and after treatment,and the difference between the experimental group and the control group was statistically significant after treatment(p<0.05).(3)The differences of inflammatory factors(IL-6,IL-1β,TNF-α)between the two groups before and after treatment were statistically significant(p<0.05),that is,the levels were lower than those before treatment;after treatment,there was no difference in inflammatory factors between the two groups.Statistical significance(p>0.05).(4)The petal diagram was drawn for the unique otu sequences of the two groups.There was no significant difference in the number of otu before treatment between the two groups,and the number of otu was significantly increased after treatment.There were differences in the structure of intestinal flora before and after treatment between the two groups.Both groups could increase the number of otu.Enrich the structure of intestinal flora.(5)In the alpha diversity index analysis,the difference in Shannon in the experimental group before and after treatment was statistically significant(p=0.036),which proved that the retention enema of traditional Chinese medicine increased the diversity of intestinal flora,while the difference in Shannon in the control group before and after treatment was not statistically significant(p=0.036).>0.05).The difference of Chao1 in the control group before and after treatment was statistically significant(p=0.008),and there was no statistical significance in the treatment group before and after treatment(p=0.304);the observed increase in the control group was statistically significant(p=0.008),and the experimental group There was no statistical difference between before and after treatment(p = 0.290),and rifaximin enriched the structure of intestinal flora.(6)NSDM analysis was performed based on the weighted Unweighted Unifrac distance.Before treatment,there were large differences within each group,that is,individual differences were obvious.Compared with before and after treatment,the difference between the two groups became larger,that is,the composition of intestinal flora was different before and after treatment.After treatment,the differences between the two groups tended to be smaller,that is,the composition of intestinal flora in the two groups was similar after treatment.(7)At the phylum level,the difference of Cyanobacteria in the experimental group after treatment was statistically significant(p=0.002);the difference of Microparasitic phylum of glycolytic was statistically significant(p=0.035),that is,the richness increased.There was no significant difference in the abundance of Firmicutes and Clostridium(p>0.05).(8)At the genus level,Bacteroides,Enterococcus,Klebsiella,Prevotella,Veillonella,Streptococcus enrichment.The difference of the top 20 genera in abundance before and after treatment was not statistically significant.(9)Correlation analysis: On the main bacterial genera,IL-1β significantly affected bacterial community composition;Phascolarctobacterium was negatively correlated with IL-1β,IL-6 and TNF-α.Eggerthella was negatively correlated with IL-6 and TNF-α.Conclusion: Dahuang Wumei Decoction enema treats MHE from the perspective of clearing away heat and removing dampness and strengthening the spleen.Dahuang Wumei Decoction enema improves the structure and total number of intestinal flora,regulates intestinal endotoxemia,reduces the level of inflammatory factors,and improves neurocognitive function. |
PDF Full Text Request