Exploring The Repulatory Effeets Of Bifidobacteria Combined With Chinese Herbal Medicine Cistanche On Depreslonand Dementia in Patients With Parkinson’s Disease Based On The Brain-Gut Axis Theory
Oct 09, 2024
CAO Nannan. Neurology Department ll, 0ingyang Second People's Hospital,0ingyang City, Gansu Pouince 745000
ABSTRACT
Objective:' To explore the regulatory effects of bifidobacteria combined with Chinese herbal medicine Cistancheon depression and dementia in patients with Parkinson's disease ( PD) and the possible mechanisms.
HERB CISTANCHE FOR PATIENTS WITH PARKINSON'S DISEASE ( PD)
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Methods; A total of o112 PD patients treated in our hospital from January 2022 to February 2023 were selected and randomly divided into two groups, 56 cases in each group. The control group received routine treatment, while the experimental group received bifidobacteria combined with Cistanche treatment based on the control group. The general data, clinical symptoms, depression degree, cognitive function, serum neurotrophic factor ( BN!), intestinal flora structure, and other indicators of the patients were observed and recorded. Results; After treatment, the motor symptoms of both groups were improved to different degrees, but the improvement degree of the experimental group was greater, and the total score and each item score of the Unified Parkinson's disease rating scale ( UPDRS) were lower than those of the control group (P <0. 05). The depression degree and cognitive function of the experimental group were also significantly better than those of the control group, and the hamilton depression scale ( HAM!D) score and Montreal cognitive assessment Seale ( MoCA) score were better than those of the control group respectively ( P <0. 05 ). "The serum BDNF level of the experimental group was significantly higher than that the control group ( P <0.05), indicating that the neuroprotective effect was enhanced. The intestinal flora structure of the experimental group also changed favorably, compared with the control group, the proportion of beneficial! bacteria such as bifidobacteria, and lactobacilli decreased, while the proportion of harmful bacteria such as anaerobes, and hydrogen sulfide-producing bacteria decreased ( P <0 . 05). Conclusion: Bifidobacteria combined with Cistanche can effectively improve the motor symptoms, depression degree and cognitive function of Pl patients, and its mechanism may be related to enhancing neuroproteclivelfeet and regulating intestinal flora imbalance. This method provides a new idea and means for the comprehensive treatment of PD.
KEYWORDS: Parkinson's disease Bifidobacteria Cistanche Brain-gut axis Depression Dementia
Parkinson's disease (PD) is a degenerative disease of the nervous system in middle-aged and elderly people, characterized by degeneration of dopaminergic neurons in the substantia nigra and movement disorders [1]. Parkinson's disease patients are often accompanied by non-motor symptoms such as depression and dementia, which seriously affect the quality of life and prognosis [2]. The pathogenesis of Parkinson's disease is still unclear, and it may be related to factors such as genetics, environment, oxidative stress, mitochondrial dysfunction, protein metabolism disorders, and neuroinflammation [3]. In recent years, the relationship between intestinal flora and Parkinson's disease has attracted attention, and intestinal flora imbalance may be one of the risk factors for Parkinson's disease. The intestinal flora is the largest microecological system in the human body and plays an important role in human digestion and absorption, immune regulation, and metabolic balance. There is a complex two-way communication mechanism between the intestinal flora and the central nervous system, namely the brain-gut axis. The brain-gut axis transmits and regulates information through signal molecules such as neurotransmitters, neurohormones, cytokines, and metabolites [4]. The intestinal flora can affect the structure and function of the central nervous system through the brain-gut axis, thereby affecting cognitive and emotional states. Conversely, the central nervous system can also regulate the composition and activity of the intestinal flora through the brain-gut axis feedback. Therefore, the brain-gut axis plays an important role in maintaining the neuroendocrine-immune balance of the human body.
Disturbance of the brain-gut axis may lead to intestinal flora imbalance and central nervous system dysfunction, thereby inducing or aggravating Parkinson's disease and its non-motor symptoms [5]. At present, the treatment of Parkinson's disease is mainly based on dopamine replacement therapy, but as the disease progresses, the efficacy of the drug gradually weakens, and drug-induced motor complications and non-motor complications are prone to occur [6]. Therefore, it is urgent to find a safe and effective treatment method that can delay the progression of Parkinson's disease and improve non-motor symptoms. In recent years, intestinal flora regulation therapy has received increasing attention as an emerging treatment method. Intestinal flora regulation therapy mainly includes probiotics, prebiotics, fecal microbiota transplantation, and other methods. Its purpose is to regulate the balance of the brain-gut axis and improve the structure and function of the central nervous system by improving the composition and function of the intestinal flora. This study aimed to explore the regulatory effect of Bifidobacterium combined with the traditional Chinese medicine Cistanche deserticola on improving depression and dementia in patients with Parkinson's disease.
1 Materials and methods
1.1 General data
A total of 112 patients with Parkinson's disease who were treated in our hospital from January 2022 to February 2023 were randomly divided into two groups, with 56 cases in each group. There was no statistical difference in the general data between the two groups (P ＞ 0.05), and the two groups were comparable, as shown in Table 1. This study was by ethical principles and was approved by the ethics committee of our hospital. Informed consent was obtained from the patients or their families. Inclusion criteria: (1) Meet the diagnostic criteria for Parkinson's disease established by the International Parkinson's Disease and Movement Disorders Society (MDS) [7]; (2) Aged over 50 years; (3) Disease course of more than 3 years; (4) Hoehn-Yahr stage 2 to 4; (5) Clinical manifestations or assessment results of depression or cognitive impairment; (6) Willing to participate in this study and sign the informed consent form. Exclusion criteria: (1) Other factors that affect intestinal flora, such as long-term use of antibiotics, laxatives, immunosuppressants, etc.; (2) Other serious organ dysfunctions such as heart, liver, and kidney; (3) Pregnant or lactating women.
Table 1 Comparison of general information of the two groups of patients
1.2 Methods
The control group was given conventional treatment, including anti-Parkinson's disease drugs such as levodopa and dopamine receptor agonists, as well as necessary psychological support and rehabilitation training. The experimental group was treated with Bifidobacterium combined with the Chinese medicine Cistanche deserticola based on the control group. The specific method was: oral administration of 2 capsules of Bifidobacterium live bacteria capsules (Lizhu Changle) per day, each capsule containing 0.5 × 109 CFU of live bacteria; oral administration of 6g of Cistanche deserticola concentrated pills once a day. Both groups were treated for 8 weeks.
1.3 Observation indicators
(1) Motor symptoms: The Unified Parkinson's Disease Rating Scale [8] (UPDRS) was used for evaluation, which includes four parts: Part I is for psychological behavior, Part II is for daily living activities, Part III is for motor examination, and Part IV is for motor complications. The higher the score, the more severe the disease. (2) Depression level: The Hamilton Depression Rating Scale (HAMD) [9] was used for evaluation, which includes 17 items, and each item is given 0 to 4 points according to the severity. The higher the total score, the more severe the depression. (3) Cognitive function: The Montreal Cognitive Assessment Scale [10] (MoCA) was used for evaluation, which includes 8 areas and a total of 30 points.
The higher the score, the better the cognitive function. (4) Serum BDNF level: Enzyme-linked immunosorbent assay (ELISA) was used for detection, and the unit is ng/mL. The higher the BDNF level, the stronger the neuroprotective effect.
(5) Intestinal flora structure: High-throughput sequencing was used to analyze the relative abundance and diversity of intestinal flora. The balance of intestinal flora is related to human health.
1. 4 Statistical methods
The data were statistically analyzed using SPSS 26.0 software. The quantitative data were expressed as (x ± s) and the t-test was performed; the enumeration data were expressed as frequency or percentage (n or %) and the χ2 test was performed. P < 0.05 indicated that the difference was statistically significant.
