慢性胃炎阴虚证证素分布及肠道菌群差异性研究  

Study on the Distribution of Syndrome Elements and the Difference of Gut Microbiota in Yin Deficiency Syndrome of Chronic Gastritis

作　　者：谢嵛嵛 朱龙[1] 胡莹莹 黄琰钰 黄伟荣 林雪娟[1] XIE Yuyu;ZHU Long;HU Yingying;HUANG Yanyu;HUANG Weirong;LIN Xuejuan(Fujian University of Traditional Chinese Medicine,TCM Research Base of Fujian University of Traditional Chinese Medicine,2011 Collaborative Innovation Center for TCM Health Management,Fuzhou 350122,China;Jinjiang Hospital of Traditional Chinese Medicine affiliated to the Fujian University of Chinese Medicine,Jinjiang 362200,China)

机构地区：[1]福建中医药大学,福建中医药大学中医证研究基地,福建省2011中医健康管理协同创新中心,福建福州350122 [2]福建中医药大学附属晋江中医院,福建晋江362200

出　　处：《云南中医药大学学报》2024年第2期33-39,共7页Journal of Yunnan University of Chinese Medicine

基　　金：国家自然科学基金项目(81973752)。

摘　　要：目的 探讨慢性胃炎阴虚证患者的证素分布情况及肠道菌群差异性,为慢性胃炎患者临床诊断提供参考依据。方法 共收集慢性胃炎阴虚证患者52例,其中慢性萎缩性胃炎(chronic atrophic gastritis,CAG)阴虚证患者35例,慢性非萎缩性胃炎(chronic non-atrophic gastritis,CNAG)阴虚证患者17例,以及健康人31例。采用证素辨证方法分析慢性萎缩性胃炎与慢性非萎缩性胃炎阴虚证的证素分布差异,并运用16S rRNA高通量测序方法进行肠道微生物检测,寻找差异菌群,分析慢性萎缩性胃炎与慢性非萎缩性胃炎阴虚证的证素分布与肠道菌群差异性的关系。结果 (1)证素分布情况:慢性萎缩性胃炎阴虚证的常见病位证素为胃、肝、脾;常见兼夹病性证素为热、气滞、痰、湿、食积、气虚、阳虚、阳亢。慢性非萎缩性胃炎阴虚证的常见病位证素为胃、肝、脾;常见兼夹病性证素为:热、气滞、痰、湿、食积、气虚、血虚、阳虚。两组间各病位证素分布无明显差异;兼夹病性证素在积分的比较中,痰证素(P<0.05)具有统计学意义。(2)物种组成情况:属水平上,与健康组相比,CAG阴虚组在卟啉单胞菌属和经黏液真杆菌属上的丰度明显增加(P<0.01);在嗜胨菌属和Eubacterium_hallii_group菌属上的丰度增加(P<0.05);CNAG阴虚组在卟啉单胞菌属和嗜胨菌属上的丰度明显增加(P<0.01),在放线菌属上的丰度增加(P<0.05),在Lachnospiraceae_UCG010、UCG003菌属和丁酸球菌属的丰度上减少(P<0.05)。相比CAG阴虚组,CNAG阴虚组在经黏液真杆菌属的丰度上明显减少(P<0.01);而CAG阴虚组在厌氧菌属、粪球菌属和丁酸球菌属的丰度上相较于CNAG阴虚组出现明显富集(P<0.05)。LEfse分析共获得17个生物标记物,CAG阴虚组4个,CNAG阴虚组11个,健康组2个。结论 CAG与CNAG阴虚组的证素分布存在差异,其肠道菌群的多样性及特定菌群丰度存在差异,肠道菌群失调与慢性胃炎Objective To explore the distribution of syndrome elements and differences in gut microbiota in patients with chronic gastritis with yin deficiency syndrome,and provide reference for clinical diagnosis of chronic gastritis patients.Methods A total of 52 patients with chronic gastritis with yin deficiency syndrome were collected,including 35 patients with chronic atrophic gastritis(CAG) with yin deficiency syndrome,17 patients with chronic non atrophic gastritis(CNAG)with yin deficiency syndrome,and 31 healthy individuals.Using the method of syndrome differentiation to analyze the differences in the distribution of syndrome elements between CAG and CNAG with yin deficiency syndrome,and using the16S rRNA high-throughput sequencing method to detect gut microbiota,identify differential bacterial communities,and analyze the relationship between the distribution of syndrome elements in CAG and CNAG with yin deficiency syndrome and the differences in gut microbiota.Results(1) Distribution of syndrome elements:The common disease locations and syndrome elements of CAG Yin deficiency syndrome are stomach,liver,and spleen;The common and miscellaneous syndrome elements include heat,qi stagnation,phlegm,dampness,food accumulation,qi deficiency,yang deficiency,and yang hyperactivity.The common locations and elements of CNAG Yin deficiency syndrome are stomach,liver,and spleen;The common and miscellaneous syndrome elements include heat,qi stagnation,phlegm,dampness,food accumulation,qi deficiency,blood deficiency,and yang deficiency.There was no significant difference in the distribution of syndrome elements at different locations between the two groups;In the comparison of points,the phlegm syndrome element(P<0.05)has statistical significance in the analysis of concurrent and miscellaneous disease syndrome elements.(2) Species composition:At the genus level,compared with the healthy group,the abundance of CAG Yin deficiency group in the genera Porphyromonas and Actinobacteria increased significantly(P <0.01);In the genus Pepto

关 键 词：慢性萎缩性胃炎 慢性非萎缩性胃炎 阴虚证 证素 肠道菌群 

分 类 号：R259[医药卫生—中西医结合]