基于中医证候研究白塞病患者肠道菌群的特征性变化及临床指标相关性的分析  

Characteristic changes of intestinal flora and its correlation with clinical indexes in patients with Behcet's disease based on TCM syndromes

作　　者：朴勇洙[1] 孙妲男[2] 邵音 张岩[3] 袁星星 PIAO Yong-zhu;SUN Dan-nan;SHAO Yin;ZHANG Yan;YUAN Xing-xing(The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, Heilongjiang, China;The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150001, Heilongjiang, China;Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, Heilongjiang, China;Nangang Branch of Heilongjiang Academy of Traditional Chinese Medicine, Harbin 1500006, Heilongjiang, China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001 [3]黑龙江中医药大学,黑龙江哈尔滨150040 [4]黑龙江省中医药科学院南岗分院,黑龙江哈尔滨150006

出　　处：《海南医学院学报》2020年第13期1012-1018,1027,共8页Journal of Hainan Medical University

基　　金：黑龙江省自然科学基金(面上项目)(H2017064)。

摘　　要：目的:利用16S rRNA技术分析湿热证白塞病(BD)患者肠道菌群的特征及其与临床指标的相关性。方法:49例白塞病患者按照中医证型分为湿热组(n=19)和非湿热组(n=30),另选择43例健康受试者作为健康组。收集各组基本信息及实验室检查指标,并采集粪便样本通过16S rRNA检测各组肠道菌群的多样性和丰度。结果:湿热证BD与非湿热证相比,眼部受累的发生率更高(P<0.05)。湿热证BD患者WBC、CRP、ESR和IgG均明显高于非湿热证患者(P<0.05)。Alpha多样性结果显示与健康组和非湿热组比较,湿热组Ace、Chao1和Shannon指数明显降低,Simpson指数明显升高(P<0.05)。与非湿热组相比,湿热组Actinobacteria门丰度增加(P<0.05);Collinsella、Intestinimonas和Enterobacteriaceae_unclassified属水平丰度增加,Clostridiales_unclassified、Ruminococcaceae_UCG009、Ruminococcaceae_UCG007和Ruminococcus_gauvre auii_group属水平丰度降低(P<0.05)。Pearson相关性分析结果显示,Oscillospira丰度与WBC、CRP、ESR和IgG水平均呈现正相关,Eubacterium和Cetobacterium丰度与WBC、CRP、ESR和IgG水平均呈现负相关。结论:肠道菌群的改变参与了BD的发病,同时不同中医证型BD患者肠道中菌群存在差异,此外肠道中特定的菌属还与BD血清炎症、免疫指标密切相关。Objective:To analyze the characteristics of intestinal microflora in Behcet's disease patients with damp heat syndrome by 16S rRNA technique and its correlation with clinical indexes;Methods A total of 49 patients with Behcet's disease were divided into damp heat syndrome group(n=19)and non-damp heat syndrome group(n=30),and 43 healthy subjects were selected as control group.The basic information and laboratory test indexes of three groups were collected,and fecal samples were analyzed to detect the diversity and abundance of intestinal flora in each group by 16S rRNA.Results:Compared with the group without damp heat,the incidence of ocular involvement was higher in the group with damp heat(P<0.05).Besides,WBC,CRP,ESR and IgG in the damp heat syndrome group were also significantly increased(P<0.05).The results of alpha diversity showed that the Ace,Chao 1 and Shannon indexes of the damp heat syndrome group were significantly decreased compared with the healthy group and the non-damp heat syndrome group,while the Simpson index was significantly elevated(P<0.05).Moreover,the abundance of Actinobacteria phylum,Collinsella,Intestinimonas and unclassified Enterobacteriaceae genus were increased in the damp heat group(P<0.05)while that of unclassified Clostridiales,Ruminococcaceae_UCG009,Ruminococcaceae_UCG007 and Ruminococcus gauvreauii group genus were decreased(P<0.05).Pearson correlation analysis showed that Oscillospira abundance was positively correlated with WBC,CRP,ESR and IgG levels,while Eubacterium and Cetobacterium abundance were negatively correlated with WBC,CRP,ESR and IgG levels.Conclusion:The change of intestinal flora is involved in the pathogenesis of Behcet's disease.There are differences in intestinal flora among different types of Behcet's disease patients.In addition,the specific flora in intestinal tract is closely related to the serum inflammation and immune indexes of Behcet's disease.

关 键 词：中医证型 白塞病 肠道菌群 多样性 

分 类 号：R259[医药卫生—中西医结合]