北京中医药2025，Vol.44Issue(9)：1099-1105,7.DOI:10.16025/j.1674-1307.2025.09.003
心肾缓衰方对慢性肾脏病合并心力衰竭患者心肾功能的作用及代谢组学研究
Clinical observation and metabolomics study of the improvement of cardiac and renal function in patients with chronic kidney disease complicated with heart failure by Xinshen Huanshuai Formula
摘要
Abstract
Objective To observe the clinical efficacy of Xinshen Huanshuai Formula in improving cardiac and renal function in patients with chronic kidney disease complicated by heart failure(CKD-HF)through a self-controlled study,and to compare baseline metabolomic differences in patients with different renal prognoses using non-targeted metabolomics.Methods Thirty-six CKD-HF patients who attended the Department of Nephrology at Guang'anmen Hospital,China Academy of Chinese Medical Sciences,from June to December 2023,were enrolled.On the basis of standard integrated Western therapy,all patients received Xinshen Huanshuai Formula for 12 weeks.Clinical outcomes were assessed by physicochemical indicators such as estimated glomerular filtration rate(eGFR)and N-terminal pro-B-type natriuretic peptide(NT-proBNP),traditional Chinese medicine(TCM)syndrome scores,and Minnesota Living with Heart Failure Questionnaire(MLHFQ)scores to provide objective and subjective evaluations.Metabolomic profiling using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry(UHPLC-MS/MS)was performed on baseline serum samples from 16 patients(8 per group)stratified by renal prognosis to analyze metabolic differences.Result Thirty-three patients completed follow-up.After 12 weeks of treatment with Xinshen Huanshuai Formula,eGFR significantly improved(P<0.01),with a total effective response rate of 69.70%.NT-proBNP and MLHFQ scores decreased significantly(P<0.05 and P<0.01,respectively),and TCM syndrome scores also decreased(P<0.01),with a total effective rate of 72.73%.Non-targeted metabolomics analysis identified 37 differential metabolites.Amino acid metabolites,including tryptophan and arginine,as well as lipids such as unsaturated free fatty acids and medium-chain acylcarnitines,were associated with poor CKD-HF prognosis.Pathway enrichment analysis revealed 12 dysregulated pathways,including fatty acid biosynthesis,reflecting the underlying pathophysiological mechanisms of CKD-HF in patients with different renal prognoses.Conclusion Xinshen Huanshuai Formula effectively improves cardiac and renal function in CKD-HF patients,delays renal function deterioration,alleviates clinical symptoms,and enhances quality of life.Significant baseline differences in amino acid and lipid metabolism exist between patients with different renal prognoses,with marked enrichment of the fatty acid biosynthesis pathway.关键词
慢性肾脏病/心力衰竭/心肾缓衰方/临床观察/代谢组学Key words
chronic kidney disease/heart failure/Xinshen Huanshuai Formula/clinical observation/metabolomics引用本文复制引用
刘晨璇,路晓光,郑利华,成庭柱,郭传,李金璞,饶向荣,赵宇..心肾缓衰方对慢性肾脏病合并心力衰竭患者心肾功能的作用及代谢组学研究[J].北京中医药,2025,44(9):1099-1105,7.基金项目
国家自然科学基金面上项目(81973683) （81973683）
国家自然科学基金青年项目(82104666) （82104666）
中国中医科学院科技创新工程项目(CI2023C051YLL) （CI2023C051YLL）
中国中医科学院优秀青年科技人才培养专项(ZZ15-YQ-025) （ZZ15-YQ-025）
