从肠道菌群改善胰岛素抵抗机制探讨降糖调脂方治疗代谢综合征（胃肠实热证）的机理

The gut microbiota in human body has amazing diversity, those individual differences affect the health of host with obesity, type 2 diabetes and other metabolic disorder, The relationship between them has gradually been recognized. Past studies have shown that Jiangtangtiaozhi decoction , which was mainly composed of Dahuanghuanglianxiexin decoction and has the efficacy of qingweijiangzhuo,can effectively reduce blood glucose， blood lipids, body weight in patients with metabolic syndrome, and can improve insulin resistance. Berberine can effectively adjust the intestinal flora to treat "dysentery" , rhubarb and change the intestinal microbial structure to" relaxing" intestinal tract. We consider whether those adjustment of the intestinal flora are the one of the mechanism of the treatment of metabolic syndrome. Hypothesis is that the gut microbiota which are regulated the structure by those herbs can increase the role of intestinal barrier protection, reducing the blood levels of LPS, reducing the level of inflammation in the system, adjust level of appetite factors to achieve its role of improving insulin resistance. We hope this experiment will confirm this hypothesis to find a new target of Chinese herbs for treatment of metabolic syndrome and provide a new basis, opening up new research ideas and methods.

人体内微生物具有惊人的多样性，肠道微生物的个体差异影响着宿主的健康，肠道菌群与肥胖、2型糖尿病等代谢性疾病之间的关系已经逐渐被人们认识。既往研究显示，降糖调脂方以清胃降浊为基本治法，以大黄黄连泻心汤为基础方，能有效改善胰岛素抵抗，降低代谢综合征患者血糖、血脂、体重。既往研究显示，黄连能有效调整肠道菌群而"止痢"，大黄能"通腑"而改变肠道微生物结构，本研究从其作用的病理中心-胃肠着手，考虑其调整肠道菌群菌群的作用是否与治疗代谢综合征的机制有关。假说其通过调节肠道菌群结构，增加肠屏障保护作用，降低血液LPS水平，降低系统水平炎症，实现其改善胰岛素抵抗的作用。我们希望通过这一实验证实这一假说，为中药治疗代谢综合征、及肥胖2型糖尿病找到新靶点、提供新依据、开辟新的科研思路和方法。

人体内微生物具有惊人的多样性，肠道微生物的个体差异影响着宿主的健康，也与肥胖、2型糖尿病等代谢性疾病息息相关。降糖调脂方以清胃降浊为基本治法，以经典名方大黄黄连泻心汤为基础方，本研究从其作用的病理中心-胃肠入手，采用基于16S rRNA 基因V3-V4 区Illumina 测序的方法，将降糖调脂方与阳性药物二甲双胍为对照，结果表明，降糖调脂方能有效改善胰岛素抵抗，降低代谢综合征患者的血糖、血脂、体重；可以增加Megamonas、Faecalibacterium、Roseburia、Gemmiger、Coprococcus、Blautia和Anaerostipes等有益菌的含量，显著改变肠道菌群结构，且其调节作用大于二甲双胍。这可能是降糖调脂方治疗代谢综合征（胃肠实热证）、改善胰岛素抵抗的机制之一，为中医药治疗代谢综合征、肥胖及2型糖尿病找到了新的靶点、提供了新的依据，开辟了新的科研思路和方法。