Effect of Buyang Huanwu Tang on Qi Deficiency and Blood Stasis Syndrome in Ischemic Cardio-Cerebrovascular Diseases Based on Metabolomics

ZHANG Guoyuan; LI Ying; WANG Ziyan; LIN Li; SUN Mingqian; LIU Jianxun

doi:10.3969/j.issn.1006-3250.2026.02.008

Abstract：Objective Using plasma metabolomics methods to investigate the pathogenesis of ischemic cardio-cerebrovascular diseases with the syndrome of Qi deficiency and blood stasis(QDBS)in rat models,and to elucidate the intervention effects of Buyang Huanwu Tang(BYHWT)on both models.Methods The coronary heart disease QDBS(CHD-QDBS)model was established by sleep deprivation combined with ligation of the left anterior descending coronary artery,while the cerebral infarction QDBS(CI-QDBS)model was established by microsphere-induced multiple cerebral infarctions combined with sleep deprivation.Each model was divided into four groups:sham-operated group,model group,BYHWT group,and aspirin positive control group.BYHWT was administered by gavage at clinical doses(CHD-QDBS:13 g/kg;CI-QDBS:21 g/kg)for 14 consecutive days.Model evaluation included grip strength testing,coagulation function,echocardiography,and histopathological observation of brain tissues.Differential metabolites were identified using metabolomics analysis,and the metabolic pathways of CHD-QDBS and CI-QDBS were explored to analyze the shared and unique metabolic mechanisms of the two conditions under QDBS.Results BYHWT obviously improved the grip strength(P<0.01),and coagulation function(P<0.05)in the model rats,and regulated cardiac function(P<0.05)and brain tissue morphology.Metabolomics analysis revealed that the CHD-QDBS model induced significant abnormalities in 76 plasma metabolites,involving disorders in glycerophospholipid metabolism,linoleic acid metabolism,and sphingolipid metabolism.The CI-QDBS model,on the other hand,resulted in significant abnormalities in 39 metabolites,mainly related to amino acid metabolism.After intervention with BYHWT,37 metabolites in the CHD-QDBS model were restored,primarily regulating lipid metabolism pathways.In the CI-QDBS model,11 metabolites showed improvement mainly involving amino acid metabolism pathways.The common differential metabolites between the two models include 7 types such as glutamic acid and pyroglutamic acid,indicating that oxidative stress,energy metabolism disorders,inflammatory reactions,and vascular dysfunction are common characteristics of Qi deficiency and blood stasis syndrome in the two diseases.CHD-QDBS drives inflammation and thrombus formation through lipid metabolism disorders,while CI-QDBS exacerbates cerebral hypoxia through amino acid metabolism disorders.Conclusion This study reveals that there exist common metabolic disorders and specific pathways in the Qi deficiency and blood stasis syndrome of ischemic cardio-cerebrovascular diseases,which embodies the scientificity of the Traditional Chinese Medicine(TCM)theory of"treating different diseases with the same method"and provides evidence for the analysis of the biological connotation of TCM syndromes.BYHWT regulates metabolic networks through multiple targets,restores lipid homeostasis,and reduces oxidative stress and inflammation.This study can provide a basis for analyzing the biological basis of Qi deficiency and blood stasis syndrome in ischemic cardio-cerebrovascular diseases and developing precise treatment strategies combining disease and syndrome.