慢性再生障碍性贫血中医证型与肠道菌群的相关性研究  

Correlation between traditional Chinese medicine syndrome types and gut microbiota in chronic aplastic anemia

作　　者：陆婉琪 谢菁菁 王恒[1] 李峻[1] LU Wanqi;XIE Jingjing;WANG Heng;LI Jun(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;Jiangyin Hospital of Chinese Medicine,Wuxi 214400,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029 [2]江阴市中医院,江苏江阴214400

出　　处：《现代中西医结合杂志》2025年第1期37-46,共10页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江苏省卫健委科研课题(Z2018004);江苏省中医药管理局课题(YB201812,MS2023016);第五批全国中医临床优秀人才研修项目(国中医药人教函2022-1号);江苏省中医院科研课题(Y22063)。

摘　　要：目的探讨不同中医证型慢性再生障碍性贫血患者的肠道菌群差异。方法纳入2018年7月—2021年6月就诊于南京中医药大学附属医院血液科门诊和病房的21例慢性再生障碍性贫血患者,根据中医辨证分型分为肾阴虚组12例、肾阳虚组4例和肾阴阳两虚组5例,使用16S rRNA基因扩增测序法测定3组患者肠道菌群的多样性和丰富度,并分析组间物种差异。结果不同证型患者肠道菌群存在差异,其中肾阴阳两虚组菌群丰富度明显低于肾阴虚组(P<0.05)。红杆菌目(Rhodobacterales)相对丰度肾阳虚组>肾阴虚组>肾阴阳两虚组,普雷沃菌属UCG-001(Prevotellaceae_UCG-001)相对丰度肾阳虚组>肾阴虚组>肾阴阳两虚组,高氏瘤胃球菌属([Ruminococcus]_gauvreauii_group)相对丰度肾阳虚组>肾阴阳两虚组>肾阴虚组,差异均有统计学意义(P均<0.05)。肠道菌群Alpha多样性分析显示,肾阴阳两虚组observed_species指数明显低于肾阴虚组(P<0.05)。LEfSe分析显示,肾阴阳两虚组相对丰度较高的肠道菌群为光岗菌属(Mitsuokella),肾阴虚组为霍尔德曼菌属(Holdemania),肾阳虚组为红杆菌目、红杆菌科(Rhodobacteraceae)、高氏瘤胃球菌属、普雷沃菌属UCG-001。结论不同中医证型慢性再生障碍性贫血患者肠道菌群构成特征差异明显,其差异可能有助于区分临床中医证型。Objective It is to explore the differences in gut microbiota among chronic aplastic anemia patients with different traditional Chinese medicine syndromes.Methods Twenty-one patients with chronic aplastic anemia treated in the outpatient clinics and wards of the Department of Hematology of the Affiliated Hospital of Nanjing University of Chinese Medicine from July 2018 to June 2021 were included,and were divided into kidney Yin deficiency group(n=12),kidney Yang deficiency group(n=4),and kidney Yin Yang deficiency group(n=5)according to traditional Chinese medicine syndrome differentiation,and the diversity and abundance of the intestinal flora of patients in the three groups were detected by 16S rRNA gene amplification sequencing,and species differences among the groups were analyzed.Results There were differences in gut microbiota among chronic aplastic anemia patients with different traditional Chinese medicine syndrome types,the abundance of microbiota in the kidney Yin and Yang deficiency group was significantly lower than that in the kidney Yin deficiency group(P<0.05).The relative abundance of Rhodobacterales:kidney Yang deficiency group>kidney Yin deficiency group>kidney Yin and Yang deficiency group;the relative abundance of Prevotellaceae_UCG-001:kidney Yang deficiency group>kidney Yin deficiency group>kidney Yin and Yang deficiency group;the relative abundance of[Ruminococcus]gauvreauii_group:kidney Yang deficiency group>kidney Yin and Yang deficiency group>kidney Yin deficiency group,all the differences were statistically significant(all P<0.05).LEfSe analysis showed that the intestinal flora with higher relative abundance in the kidney Yin and Yang deficiency group was Mitsuokella,in the kidney Yin deficiency group was Holdemania,and in the kidney Yang deficiency group was Rhodobacteriales,Rhodobacteraceae,[Ruminococcus]_gauvreauii_group,and Prevotellaceae_UCG-001.Conclusion There are significant differences in the composition characteristics of gut microbiota among chronic aplastic anemia patients wi

关 键 词：慢性再生障碍性贫血 肠道菌群 辨证分型 

分 类 号：R556.5[医药卫生—血液循环系统疾病]