胃癌气阴两虚证患者舌苔菌群与血清炎症代谢的相关性分析  

Correlation between tongue coating flora and serum inflammatory metabolism in gastric cancer patients of qi and yin deficiency syndrome

作　　者：秦媛媛 徐硕 向春婕 吴娟[1] 王瑞平[2] 吴震峰 詹瑧[1] 张军峰[1] Qin Yuanyuan;Xu Shuo;Xiang Chunjie;Wu Juan;Wang Ruiping;Wu Zhenfeng;Zhan Zhen;Zhang Junfeng(School of Medicine&Holistic Integrative Medicine,Nanjing University of Chinese Medicine,Jiangsu 210023,China; Department of Oncology,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu 210029,China; Department of Oncology Surgery,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu 210029,China)

机构地区：[1]南京中医药大学医学院·整合医学学院,江苏210023 [2]南京中医药大学附属医院肿瘤内科 [3]南京中医药大学附属医院肿瘤外科

出　　处：《北京中医药大学学报》2020年第4期334-342,共9页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(No.81473458,No.81473593);国家中医临床研究基地业务建设科研专项(No.JDZX2015091)。

摘　　要：目的探讨胃癌气阴两虚证患者舌苔菌群变化的炎症代谢机制。方法基于医院开展病例-对照研究,纳入13例胃癌气阴两虚证患者,以23例健康人为对照组,高通量测序分析舌苔菌群,电化学发光技术检测血清20种炎症因子,气相色谱质谱联用检测血清代谢组学。结果与对照组相比,胃癌气阴两虚证患者舌苔细菌Shannon指数降低(P<0.05),而舌苔真菌Alpha多样性差异无统计学意义(P>0.05)。判别分析显示,舌苔的3个细菌属(柄细菌属、巨单胞菌属、木洞菌属)和1个真菌属(裂壳属)是胃癌气阴两虚证的标志菌群。胃癌气阴两虚证患者血清谷氨酸、L-组氨酸、肌酸等15种代谢分子水平升高(P<0.05),IL-17α、TNF-α、IL-6等8种血清炎症因子水平升高(P<0.05)。相关性分析发现,IL-17α、IL-6、TNF-α与梭杆菌属、卟啉单胞菌属显著负相关(r<-0.4,P<0.05),梭杆菌属、消化链球菌属与血清谷氨酸代谢水平显著负相关(r<-0.4,P<0.05)。结论胃癌气阴两虚证患者舌苔菌群与血清炎症因子、代谢分子相关,为阐明气阴两虚证的形成机制提供了新的切入点。Objective To explore the association between the inflammatory metabolic mechanism and tongue coating flora among the gastric cancer patients of qi and yin deficiency syndrome. Methods A hospital-based case-control study was conducted. 13 gastric cancer(GC) patients with Qi and Yin deficiency syndrome(QYDS) were selected as cases and 23 healthy subjects matched as controls. The tongue coating flora was measured by using high-throughput sequencing. The levels of 20 serum inflammatory factors were detected by using electro chemiluminescence immunoassay(ECLIA). Gas chromatography-mass spectrometer(GC-MS) was used to detect the serum metabolomics. Results Compared with the control group, the Shannon index of bacterial diversity of tongue coating in GC patients with QYDS was lower(P<0.05), but there was no significant difference in the alpha diversity of the tongue coating fungi(P>0.05). Based on LDA analysis, 3 bacterial genera(Caulobacter, Megamonas, Woodsholea) and 1 fungal genus(Schizothecium) seemed to be the marker flora of QYDS of GC. Levels of 15 metabolic molecules including serum glutamate, L-histidine and creatine were significantly higher in GC patients with QYDS. Compared with the control group, 8 serum inflammatory factors including IL-17α, TNF-α and IL-6 were significantly higher in GC patients with QYDS. Association analysis indicated IL-17α, IL-6, and TNF-α were inversely correlated with Fusobacterium and Porphyromonas(r<-0.4, P<0.05), Fusobacterium and Peptostreptococcus had significant negative correlation with serum glutamate metabolism(r<-0.4, P<0.05). Conclusions The structural difference of the tongue coating flora in GC patients with QYDS was related to serum inflammatory factors and metabolism, which could be used to explore the formation mechanism of qi and yin deficiency syndrome.

关 键 词：胃癌 气阴两虚证 舌苔菌群 代谢组学 炎症因子 

分 类 号：R273[医药卫生—中西医结合]