慢性萎缩性胃炎阴虚证病位证素分布特点与肠道菌群关联性研究  

Distribution Characteristics of Disease Location Syndrome Elements in Chronic Atrophic Gastritis with Yin Deficiency and Their Correlation with Intestinal Flora

作　　者：胡莹莹 林雪娟[1,2] 黄琰钰 朱龙[1,2] 丁珊珊[1,2] 李星慧 黄伟荣 HU Yingying;LIN Xuejuan;HUANG Yanyu;ZHU Long;DING Shanshan;LI Xinghui;HUANG Weirong(Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China;TCM Research Base of Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China;Jinjiang Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine,Jinjiang,Fujian 362200,China)

机构地区：[1]福建中医药大学,福建福州350122 [2]福建中医药大学中医证研究基地,福建福州350122 [3]福建中医药大学附属晋江中医院,福建晋江362200

出　　处：《福建中医药》2023年第12期1-6,共6页Fujian Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81973752);福建省自然科学基金项目(2021J01931)。

摘　　要：目的分析慢性萎缩性胃炎(CAG)阴虚证患者的病位证素分布特点及肠道菌群特征并探讨二者之间的相关性,以期对CAG的发病机制及治疗提供新的思路。方法收集2022年3月—2023年1月就诊于福建中医药大学附属晋江中医院脾胃科门诊及体检中心CAG患者及健康人,共纳入CAG阴虚证患者50例(阴虚证组)、非阴虚证患者50例(非阴虚证组)和健康人30例(健康组)。采集四诊信息,运用证素辨证方法获取CAG阴虚证患者的证素分布情况;采集3组受试者粪便进行16S rRNA高通量测序,分析3组肠道菌群特征以及阴虚证的常见病位证素与肠道菌群的相关性。结果①阴虚证组证素分布情况:阴虚证组常见病位证素依次为胃、肝和脾。②肠道菌群分布差异:与健康组比较,阴虚证组在拟杆菌目未知菌属丰度减少(P<0.01),经黏液真杆菌属及Hungatella菌属丰度增加;非阴虚证组在拟杆菌目未知菌属及毛旋螺菌科UCG-010群、梭菌纲未知菌属丰度减少(P<0.05)。与非阴虚证组比较,阴虚证组在臭味杆菌属丰度明显增加(P<0.05)。LEfSe分析共获得11个生物标记物,其中,阴虚证组有4个重要微生物类群,非阴虚证组有2个重要微生物类群,健康组有5个重要微生物类群。③肠道菌群与证素的相关性:阴虚证主要与放线菌属呈正相关;胃主要与厚壁菌门、毛螺旋菌科呈负相关;肝主要与普雷沃氏菌属呈正相关,与Eggerthella呈负相关;脾主要与Eisenbergiella呈正相关,与链球菌属呈负相关。结论CAG阴虚证常见病位证素为胃、肝、脾。CAG阴虚证会影响肠道菌群的构成,降低有益菌丰度。肠道菌群与CAG阴虚证存在生物学联系,拟杆菌目未知菌属、臭味杆菌属丰度变化引起的代谢物改变可能作为CAG阴虚证的生物学基础之一。Objective:To explore the distribution characteristics of disease location syndrome elements,and intestinal flora in patients with chronic atrophic gastritis(CAG)Yin deficiency,as well as the correlation between the two,in order to provide reference for the Traditional Chinese Medicine differentiation and treatment of CAG with Yin deficiency.Methods:CAG patients and healthy individuals who visited the Spleen and Stomach Outpatient Department or Physical Examination Center of Jinjiang Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine from March 2022 to January 2023 were collected.A total of 50 CAG patients with Yin deficiency were selected as observation objects;50 CAG patients with non Yin deficiency and 30 healthy individuals were selected as controls.Information on the Four Diagnoses of Traditional Chinese Medicine of the patient is collected and used"Traditional Chinese Medicine Health Status Identification System"to obtain the distribution of disease location syndrome elements in CAG patients with Yin deficiency;the fecal samples of the three groups of subjects were collected for 16S rRNA high-throughput sequencing,and analyzed the characteristics of intestinal flora of three groups as well as the correlation between common disease location syndrome elements of CAG Yin deficiency syndrome and intestinal flora were analyzed.Results:The distribution of disease location syndrome elements in the CAG Yin deficiency:The common syndrome elements of disease locations in the Yin deficiency were stomach,liver,and spleen.Differences in intestinal flora distribution:Compared with the healthy group,the Yin deficiency group showed a significant decrease in abundance of the Bacteroidales|g_(P<0.01),while the abundance of mucinous Eubacterium and Hungatella genera were increased;the non Yin deficiency group the abundance of Bacteroidales,Lachnospiraceae_UCG-010 and Clostridia were decreased(P<0.05).Compared with the non Yin deficiency group,the abundance of Odoribacter in

关 键 词：慢性萎缩性胃炎 阴虚证 证素 肠道菌群 

分 类 号：R259[医药卫生—中西医结合]