[1]高欢,王文晓 张桥 李佳佳 乐世俊.从COVID-19与肠道菌群关系探讨中医药 治疗的潜在作用机制[J].陕西中医药大学学报,2023,(02):063-69.[doi:10.13424/j.cnki.jsctcm.2023.02.009 ]
　GAO Huan WANG Wenxiao ZHANG Qiao LI Jiajia YUE ShijunTANG Yuping.Potential Mechanism of Chinese Medicine Treatment fromRelationship Between COVID-19 and Intestinal flora[J].Journal of Shaanxi University of Traditional Chinese Medicine,2023,(02):063-69.[doi:10.13424/j.cnki.jsctcm.2023.02.009 ]
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从COVID-19与肠道菌群关系探讨中医药 治疗的潜在作用机制
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《陕西中医药大学学报》[ISSN:2096-1340/CN:61-1501/R]

卷:
期数:
2023年02期
页码:
063-69
栏目:
出版日期:
2023-05-13

文章信息/Info

Title:
Potential Mechanism of Chinese Medicine Treatment from Relationship Between COVID-19 and Intestinal flora
文章编号:
2096-1340(2023)02-0063-07
作者:
高欢1; 2;  王文晓1 张桥1 李佳佳1 乐世俊1
1.陕西中医药大学，陕西 咸阳 712046； 2.榆林市星元医院，陕西 榆林 719000
Author(s):
GAO Huan1; 2 WANG Wenxiao1 ZHANG Qiao1 LI Jiajia1 YUE Shijun1TANG Yuping1
1.Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712046,China;
2.Xingyuan Hospital of Yulin,Shaanxi Yulin 719000,China
关键词:
关键词：COVID-19; SARS-CoV-2; 中医药; 肠道菌群; 血管紧张素转化酶2
Keywords:
Key words： COVID-19; SARS-CoV-2; Traditional Chinese medicine; Intestinal flora; Angiotensin converting enzyme 2
分类号:
R256.3
DOI:
10.13424/j.cnki.jsctcm.2023.02.009
文献标志码:
A
摘要:
摘 要：新型冠状病毒肺炎（COVID-19）仍肆虐全球，尚未研发出针对COVID-19的特效药。疫情伊始，我国对COVID-19患者积极采用中医药疗法，效果显著。大量临床证据表明，COVID-19患者普遍存在肠道菌群失调症，且与不良预后相关，而对肠道菌群进行有效干预可以一定程度上改善其临床症状。中医药（如金花清感颗粒、连花清瘟颗粒（胶囊）、血必净注射液、清肺排毒汤、麻杏石甘汤）治疗COVID-19已被临床实践证明是安全有效的，而组方中共有的中药如甘草、金银花、黄芩、黄芪等对肠道菌群、免疫系统和血管紧张素转化酶2均有一定的调节作用。更重要的是，清肺排毒汤、麻杏石甘汤和血必净注射液已被证实可以调节肠道菌群。据此，我们提出肠道菌群可能是中医药防治COVID-19及其并发症的重要“靶点”。
Abstract:
Abstract： COVID-19 is still rampant around the world,and no specific drug has been developed for it.At the beginning of the epidemic,China actively adopted Chinese medicine treatment for COVID-19 patients,with remarkable results.A large amount of clinical evidence shows that COVID-19 patients generally have intestinal flora disorder,which is related to poor prognosis,and effective intervention of intestinal flora can improve their clinical symptoms to a certain extent.Traditional Chinese medicine (such as Jinhua Qinggan Granule,Lianhua Qingwen Granule (capsule),Xuebijing Injection,Qingfei Detox Decoction,Maxing Shigan Decoction) has been proved to be safe and effective in the treatment of COVID-19 by clinical practice,while the traditional Chinese medicine commonly used in the formula,such as Licorice,Honeysuckle,Scutellaria baicalensis,and Astragalus membranaceus,have certain regulatory effects on intestinal flora,immune system and angiotensin converting enzyme 2.More importantly,Qingfei Jiedu Decoction,Maxing Shigan Decoction and Xuebijing Injection have been proved to regulate intestinal flora.It is suggested that intestinal flora may be an important “target” for the prevention and treatment of COVID-19 and its complications by traditional Chinese medicine.

参考文献/References:

［1］Conte L，Toraldo DM.Targeting the gut-lung microbiota axis by means of a high-fibre diet and probiotics may have anti-inflammatory effects in COVID-19 infection[J].Therapeutic Advances in Respiratory Disease，2020，14：1753466620937170.
［2］Johns Hopkins Coronavirus Resource Center：Home［EB/OL］.（2022-06-10）.https://coronavirus.jhu.edu/.
［3］Zhang J，Xie B，Hashimoto K.Current status of potential therapeutic candidates for the COVID-19 crisis[J].Brain，Behavior，and Immunity，2020，87：59-73.
［4］Jin YH，Cai L，Cheng ZS，et al.A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)[J].Military Medical Research，2020，7(1)：1-23.
［5］Zhang D，Zhang B，Lv JT，et al.The clinical benefits of Chinese patent medicines against COVID-19 based on current evidence[J].Pharmacological Research，2020，157：104882.
［6］Yang Y，Islam MS，Wang J，et al.Traditional Chinese medicine in the treatment of patients infected with 2019-New Coronavirus (SARS-CoV-2)：A review and perspective[J].International Journal of Biological Sciences，2020，16(10)：1708-1717.
［7］王饶琼，杨思进，谢春光，等.清肺排毒汤治疗新型冠状病毒肺炎的临床疗效观察[J].中药药理与临床，2020，36(1)：13-18.
［8］Ren J，Zhang AH，Wang XJ.Traditional Chinese medicine for COVID-19 treatment[J].Pharmacological Research，2020，155：104743.
［9］Li C，Wang L，Ren L.Antiviral mechanisms of candidate chemical medicines and traditional Chinese medicines for SARS-CoV-2 infection[J].Virus Research，2020，286：198073.
［10］Yue SJ，Wang WX，Yu JG，et al.Gut microbiota modulation with traditional Chinese medicine：A system biology-driven approach[J].Pharmacological Research，2019，148：104453.
［11］Guo M，Tao W，Flavell RA，et al.Potential intestinal infection and faecal-oral transmission of SARS-CoV-2[J].Nature Reviews Gastroenterology & Hepatology，2021，18(4)：269-283.
［12］Zuo T，Zhang F，Lui G，et al.Alterations in gut microbiota of patients with COVID-19 during time of hospitalization[J].Gastroenterology，2020，159(3)：944-955.
［13］Zuo T，Zhan H，Zhang F，et al.Alterations in fecal fungal microbiome of patients with COVID-19 during time of hospitalization until discharge[J].Gastroenterology，2020，159(4)：1302-1310.
［14］Xu J，Chen HB，Li SL.Understanding the molecular mechanisms of the interplay between herbal medicines and gut microbiota[J].Medicinal Research Reviews，2017，37(5):1140-1185.
［15］Shi Z，Gewirtz AT.Together forever：Bacterial-viral interactions in infection and immunity[J].Viruses，2018，10(3)：122.
［16］Hanada S，Pirzadeh M，Carver KY，et al.Respiratory viral infection-induced microbiome alterations and secondary bacterial pneumonia[J].Frontiers in Immunology，2018，9：2640.
［17］Gu S，Chen YF，Wu ZJ，et al.Alterations of the gut microbiota in patients with coronavirus disease 2019 or H1N1 influenza[J].Clinical Infectious Diseases，2020，71(10)：2669-2678.
［18］Zuo T，Liu Q，Zhang F，et al.Depicting SARS-CoV-2 faecal viral activity in association with gut microbiota composition in patients with COVID-19[J].Gut，2021，70(2)：276-284.
［19］Mazzarelli A，Giancola ML，Farina A，et al.16S rRNA gene sequencing of rectal swab in patients affected by COVID-19[J].PLoS One，2021，16(2)：e0247041.
［20］Yeoh YK，Zuo T，Lui GC，et al.Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19[J].Gut，2021，70(4)：698-706.
［21］Ren Z，Wang H，Cui G，et al.Alterations in the human oral and gut microbiomes and lipidomics in COVID-19[J].Gut，2021，70(7)：1253-1265.
［22］Tang L，Gu S，Gong Y，et al.Clinical significance of the correlation between changes in the major intestinal bacteria species and COVID-19 severity[J].Engineering，2020，6(10)：1178-1184.
［23］Chen Y，Gu S，Chen Y，et al.Six-month follow-up of gut microbiota richness in patients with COVID-19[J].Gut，2022，71(1)：222-225.
［24］Zhang F，Wan Y，Zuo T，et al.Prolonged impairment of short-chain fatty acid and L-isoleucine biosynthesis in gut microbiome in patients with COVID-19[J].Gastroenterology，2022，162(2)：548-561.
［25］Xu R，Liu P，Zhang T，et al.Progressive deterioration of the upper respiratory tract and the gut microbiomes in children during the early infection stages of COVID-19[J].Journal of Genetics and Genomics，2021，48(9)：803-814.
［26］Zhang G，Hu C，Luo L，et al.Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan，China[J].Journal of Clinical Virology，2020，127：104364.
［27］Cao J，Wang C，Zhang Y，et al.Integrated gut virome and bacteriome dynamics in COVID-19 patients[J].Gut Microbes，2021，13(1)：1887722.
［28］Zuo T，Liu Q，Zhang F，et al.Temporal landscape of human gut RNA and DNA virome in SARS-CoV-2 infection and severity[J].Microbiome，2021，9(1)：1-16.
［29］Cheng H，Wang Y，Wang GQ.Organ-protective effect of angiotensin-converting enzyme 2 and its effect on the prognosis of COVID-19[J].Journal of Medical Virology，2020，92(7)：726-730.
［30］Tseng YH，Yang RC，Lu TS.Two hits to the renin-angiotensin system may play a key role in severe COVID-19[J].The Kaohsiung Journal of Medical Sciences，2020，36(6)：389-392.
［31］Zou X，Chen K，Zou J，et al.Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection[J].Frontiers of Medicine，2020，14：185-192.
［32］Yang T，Chakraborty S，Saha P，et al.Gnotobiotic rats reveal that gut microbiota regulates colonic mRNA of Ace2，the receptor for SARS-CoV-2 infectivity[J].Hypertension，2020，76(1)：e1-e3.
［33］Penninger JM，Grant MB，Sung JJ.The role of angiotensin converting enzyme 2 in modulating gut microbiota，intestinal inflammation，and coronavirus infection[J].Gastroenterology，2021，160(1)：39-46.
［34］Hashimoto T，Perlot T，Rehman H，et al.ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation[J].Nature，2012，487(7408)：477-481.
［35］Peng Y，Zhao J，Tun HM.The new foe and old friends：Are we ready for microbiota-based therapeutics in treating COVID-19 patients?[J].Gastroenterology，2021，160(6)：2192-2193.
［36］Tao W，Zhang G，Wang X，et al.Analysis of the intestinal microbiota in COVID-19 patients and its correlation with the inflammatory factor IL-18[J].Medicine in Microecology，2020，5：100023.
［37］Jin X，Lian JS，Hu JH，et al.Epidemiological，clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms[J].Gut，2020，69(6)：1002-1009.
［38］国家卫生健康委，国家中医药管理局.《新型冠状病毒肺炎诊疗方案(试行第六版)》\[EB/OL\].(2020-02-19).http://www.nhc.gov.cn/xcs/zhengcwj/202002/8334a8326dd94d329df351d7da8aefc2.shtml.
［39］dEttorre G，Ceccarelli G，Marazzato M，et al.Challenges in the management of SARS-CoV2 infection：The role of oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19[J].Frontiers in Medicine，2020，7：389.
［40］Ivashkin V，Fomin V，Moiseev S，et al.Efficacy of a probiotic consisting of Lacticaseibacillus rhamnosus PDV 1705，Bifidobacterium bifidum PDV 0903，Bifidobacterium longum subsp.infantis PDV 1911，and Bifidobacterium longum subsp.longum PDV 2301 in the treatment of hospitalized patients with COVID-19：a randomized controlled trial[J].Probiotics and Antimicrobial Proteins，2021：1-9.
［41］Zhang FM.Washed microbiota transplantation for patients with 2019-nCoV infection：A randomized，double-blind，placebo-controlled study［EB/OL］.［2022-06-13］.https://clinicaltrials.gov/ct2/show/NCT04251767/draw=3.
［42］Oxner A,Zhao L,NBT-NM 108 as an Early Tneatment for suspected or Confirmed Symptomatic COVID-19 Patients (COVGUT20)［EB/OL］.［2022-06-13］.http://clinicaltrails.gov/ct 2/show/NCT04540406/term:NCTO45406&draw=2&rank=1.
［43］Luo E，Zhang D，Luo H，et al.Treatment efficacy analysis of traditional Chinese medicine for novel coronavirus pneumonia (COVID-19)：an empirical study from Wuhan，Hubei Province，China[J].Chinese Medicine，2020，15(1)：1-13.
［44］Liu PP，Blet A，Smyth D，et al.The science underlying COVID-19：Implications for the cardiovascular system[J].Circulation，2020，142(1)：68-78.
［45］Zhu LH，She ZG，Cheng X，et al.Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes[J].Cell metabolism，2020，31(6)：1068-1077.
［46］Zheng YY，Ma YT，Zhang JY，et al.COVID-19 and the cardiovascular system[J].Nature Reviews Cardiology，2020，17(5)：259-260.
［47］Zhang P，Zhu L，Cai J，et al.Association of inpatient use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers with mortality among patients with hypertension hospitalized with COVID-19[J].Circulation Research，2020，126(12)：1671-1681.
［48］Driggin E，Madhavan MV，Bikdeli B，et al.Cardiovascular considerations for patients，health care workers，and health systems during the COVID-19 pandemic[J].Journal of the American College of Cardiology，2020，75(18)：2352-2371.
［49］Chen J，Wang Y，Gao Y，et al.Protection against COVID-19 injury by Qingfei paidu decoction via anti-viral，anti-inflammatory activity and metabolic programming[J].Biomedicine & Pharmacotherapy，2020，129：110281.
［50］Yang R，Liu H，Bai C，et al.Chemical composition and pharmacological mechanism of Qingfei Paidu Decoction and Ma Xing Shi Gan Decoction against Coronavirus Disease 2019 (COVID-19)：In silico and experimental study[J].Pharmacological Research，2020，157：104820.
［51］Zhong LLD，Lam WC，Yang W，et al.Potential targets for treatment of Coronavirus disease 2019 (COVID-19)：A review of Qing-Fei-Pai-Du-Tang and its major herbs[J].The American Journal of Chinese Medicine，2020，48(5)：1051-1071.
［52］傅晓霞，林路平，谭行华.透解祛瘟颗粒治疗新型冠状病毒肺炎临床观察[J].中国实验方剂学杂志，2020，26(12)：44-48.
［53］Wang Z，Chen X，Lu Y，et al.Clinical characteristics and therapeutic procedure for four cases with 2019 novel coronavirus pneumonia receiving combined Chinese and Western medicine treatment[J].Bioscience Trends，2020，14：64-68.
［54］杨明博，党双锁，黄胜，等.热炎宁合剂治疗新型冠状病毒肺炎的多中心临床观察[J].中国实验方剂学杂志，2020，26(14)：7-12.
［55］Zhang AH，Ren JL，Wang XJ.Reply to “The use of traditional Chinese medicines to treat SARS-CoV-2 may cause more harm than good”[J].Pharmacological Research，2020，157：104775.
［56］Deng W，Xu Y，Kong Q，et al.Therapeutic efficacy of Pudilan Xiaoyan Oral Liquid (PDL) for COVID-19 in vitro and in vivo [J].Signal Transduction and Targeted Therapy，2020，5(1)：1-3.
［57］Chen X，Wu Y，Chen C，et al.Identifying potential anti-COVID-19 pharmacological components of traditional Chinese medicine Lianhuaqingwen capsule based on human exposure and ACE2 biochromatography screening[J].Acta Pharmaceutica Sinica B，2021，11(1)：222-236.
［58］Su H，Yao S，Zhao W，et al.Anti-SARS-CoV-2 activities in vitro of Shuanghuanglian preparations and bioactive ingredients[J].Acta Pharmacologica Sinica，2020，41(9)：1167-1177.
［59］吴高松，钟婧，郑宁宁，等.清肺排毒汤对大鼠整体代谢及肠道菌群的调节作用研究[J].中国中药杂志，2020，45(15)：3726-3739.
［60］张俊杰，张淑静，董瑞娟，等.高通量测序研究中药经方对正常小鼠肠道菌群的影响[J].世界中医药，2019，14(5)：1123-1132.
［61］Qiang W，Xuan H，Yu S，et al.Impact of the gut microbiota on heat stroke rat mediated by Xuebijing metabolism[J].Microbial Pathogenesis，2021，155：104861.
［62］黄耀星，严清青，苏伟，等.血必净注射液对ANP大鼠肠道菌群及肠黏膜屏障功能的影响[J].广州医药，2020，51(3)：14-20.
［63］梁泳淋，巫园园，陈飞龙，等.麻杏石甘汤对邪热壅肺证小鼠肠道菌群的影响研究[J].世界科学技术-中医药现代化，2021，23(3)：671-677.
［64］Lyu M，Fan G，Xiao G，et al.Traditional Chinese medicine in COVID-19[J].Acta Pharmaceutica Sinica B，2021，11(11)：3337-3363.

备注/Memo

备注/Memo:
基金项目：国家自然科学基金青年基金项目（81903786）；陕西省自然科学基金项目（2021JQ-731）；陕西中医药大学学科创新团队项目（2019-YL10）
更新日期/Last Update: 2023-03-27