16s rRNA测序分析针灸治疗对腹泻型肠易激综合征(肝郁脾虚证)患者肠道菌群的影响  

16s rRNA Sequencing to Analyze the Changes of Intestinal Flora in Patients with Diarrheal Irritable Bowel Syndrome(Liver-Depression and Spleen-Deficiency)Regulated by Acupuncture

作　　者：黄发樟 姚志芳[1] HUANG Fazhang;YAO Zhifang(Department of Acupuncture and Moxibustion,Affiliated People's Hospital of Fujian University of Chinese Medicine,Fujian Fuzhou 350004,China)

机构地区：[1]福建中医药大学附属人民医院针灸科,福建福州350004

出　　处：《中国医药导刊》2024年第4期407-411,共5页Chinese Journal of Medicinal Guide

基　　金：福建省卫生健康科研人才培养项目-青年科研课题(2019-1-71);福建省第四批老中医药专家学术经验继承人项目(闽卫中医函[2022]554号)。

摘　　要：目的:从肠道菌群角度入手,探究针灸调节腹泻型肠易激综合征(IBS)的临床疗效及作用机理。方法:选取我院针灸科收治的肠易激综合征患者40例,按照3∶1比例随机分为针灸治疗组(30例),对照组(10例)。根据《中医消化病诊疗指南》评价临床疗效,应用16s rRNA测序检测治疗前后肠道菌群α多样性以及肠道菌群组成。结果:针灸治疗组患者治疗有效率高于对照组(93.33%vs 60%,P<0.05),对针灸治疗组中有效的28例患者的肠道菌群α多样性和组成差异进行分析:治疗后,反应物种丰富度的Chao指数、反应多样小的Shannon指数均优于治疗前(P<0.05)。在属水平上,与治疗前相比,治疗后双歧杆菌属、乳杆菌属、直肠真杆菌属、肠球菌属、粪杆菌属、拟杆菌属、毛螺菌属、罗氏菌属成为优势菌属(P<0.05)。结论:针灸治疗对腹泻型肠易激综合征(肝郁脾虚证)患者疗效显著。患者治疗前后肠道菌群的变化,提示针灸治疗可能可以通过调节肠道菌群,对腹泻型IBS发挥临床疗效。Objective:From the perspective of intestinal flora,explore the clinical efficacy and mechanism of action of acupuncture in regulating diarrhea-predominant irritable bowel syndrome(IBS).Methods:40 patients with irritable bowel syndrome were randomly divided into the acupuncture treatment group(30 cases)and the control group(10 cases)according to a 3∶1 ratio.Evaluate clinical effi-cacy according to the"Guidelines for the Diagnosis and Treatment of Digestive Diseases in Traditional Chinese Medicine",and use 16s rRNA sequencing to detect theαdiversity of intestinal flora and the composition of intestinal flora before and after treatment.Results:The effective rate of the acupuncture treatment group was significantly higher than that of the control group(93.33%vs 60%,P<0.05).Analysis of theαdiversity and composition of the intestinal flora in the 28 effective cases in the acupuncture treatment group revealed that after treatment,both the Chao index,which reflects species richness,and the Shannon index,which reflects diversity,were significantly improved compared to before treatment(P<0.05).At the genus level,compared to before treatment,after treatment,Bifidobacterium,Lactobacillus,Rectal Eubacterium,Enterococcus,Faecalibacterium,Bacteroides,Lachnospira,and Roseburia became dominant gen-era(P<0.05).Conclusion:Acupuncture treatment has a significant effect on diarrhea-predominant irritable bowel syndrome(liver depression and spleen deficiency).The changes in intestinal flora before and after treatment in patients suggest that acupuncture treat-ment may exert clinical efficacy on diarrhea-predominant IBS by regulating the intestinal flora.

关 键 词：16s RRNA 针灸 肠易激综合征 肠道菌群 

分 类 号：R574.4[医药卫生—消化系统]