2型糖尿病痰湿热互结证患者肠道菌群特征分析  

Analysis the characteristics of Intestinal Flora Characteristics on T2DM with Phlegm-Dampness-Heat Syndrome

作　　者：于斌[1] 王敏[1,2] 李丹 厉启芳[2] 张梅[2] 王乐荣[3] 刘志华[3] 魏超[1] 孙冰 YU Bin;WANG Min;LI Dan;LI Qi-fang;ZHANG Mei;WANG Le-rong;LIU Zhi-hua;WEI Chao;SUN Bing(Jining Medical University,Jining Shandong 202067;The Affiliated Hospital of Jining Medical University,Jining Shandong 272029;Jining Hospital of Traditional Chinese Medicine,Jining Shandong 272037)

机构地区：[1]济宁医学院,山东济宁272067 [2]济宁医学院附属医院,山东济宁272029 [3]济宁市中医院,山东济宁272037

出　　处：《世界中西医结合杂志》2020年第11期2102-2107,2111,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金项目(81603509);山东省自然科学基金项目(ZR2016HM65,ZR2014HQ051);济宁市科技重点研发计划项目(2017SMNS005)。

摘　　要：目的比较2型糖尿病(type 2 diabetes mellitus,T2DM)痰湿热互结证患者与健康人群的肠道菌群差异,分析糖尿病发病与肠道菌群的相关性。方法招募健康志愿者9例,按照既定的纳入、排除标准,随机筛选符合痰湿热互结证的T2DM患者16例,之后采集患者的粪便,通过16s rRNA技术分析肠道菌群Alpha多样性、Beta多样性及基于门、属种水平的物种组成。结果T2DM痰湿热互结证患者的菌群多样性呈现降低趋势,Alpha多样性指标ACE稀释曲线和Rank-abundance数据低于健康人群,Shannon指数和Simpson指数呈现降低趋势;Beta多样性指标NMDS法显示个体菌群差异较大。与健康人群比较,T2DM患者Actinobacteria、Proteobacteria呈现升高趋势,而Bacteroidetes、Firmicutes呈现降低趋势,其中Proteobacteria和Firmicutes/Bacteroidetes比值比较差异有统计学意义(P<0.01);属水平Bifidobacterium含量增高,Lactobacillus含量降低(P<0.05),Faecalibacterium、Bacteroides和Prevotella-9呈现降低趋势;种水平方面,T2DM组Bifidobaterium、Lactobacillus、Bacterium含量高于健康人群(P<0.05,P<0.01),Bacteroides低于健康人群(P<0.01)。结论T2DM痰湿热互结证患者肠道菌群的多样性呈现降低趋势,表现为菌群种属等方面的差异,说明证型与肠道菌群存在相关性。Objective To compare the intestinal flora between patients with type 2 diabetes mellitus(T2DM)accompanied by phlegm-dampness-heat syndrome and healthy people,and to analyze the correlation between the occurrence of diabetes and the intestinal flora.Methods Nine healthy volunteers were recruited.Additionally,according to the established inclusion and exclusion criteria,16 T2DM patients with phlegm-dampness-heat syndrome were randomly selected.Then,feces werecollected from the patients,and Alpha and Beta diversity of the intestinal flora and species composition based on phylum and species levels were analyzed by 16 srRNA technique.Results The bacterial diversity in T2DM patients with phlegm-dampness-heat syndrome showed a decreasing trend.Alpha diversity indexes ACE dilution curve and rank-abundance data in the patients were lower than those of healthy people.Shannon index and Simpson index showed a decreasing trend in the patients.The Beta diversity index(NMDS method)revealed great differences among individual floras.Compared with the healthy people,Actinobacteria and Proteobacteria in the T2DM patients showed an upward trend,while Bacteroidetes and Firmicutes showed a downward trend.The ratio of Proteobacteria and Firmicutes/Bacteroidetes presented a statistical difference(P<0.01).At the genus level,the level of Bifidobacterium increased,and Lactobacillus content decreased(P<0.05),Faecalibacterium,Bacteroides and Prevotella-9 showed a decreasing trend;in terms of species level,the content of Bifidobaterium,Lactobacillus and Bacterium in T2 DM group was higher than that in healthy people(P<0.05,P<0.01),and Bacteroides was lower than that in healthy people(P<0.01).Conclusion The diversity of the intestinal flora in T2 DM patients with phlegm-dampness-heat syndrome shows a decreasing trend.A correlation is found between the occurrence of diabetes and flora at the genus and species level.

关 键 词：糖尿病 宏基因组测序 双歧杆菌 厚壁菌门 拟杆菌 

分 类 号：R587.1[医药卫生—内分泌]