温针灸法治疗脾胃虚弱证便秘型肠易激综合征后肠道菌群宏基因组学研究  

Metagenomic study of intestinal flora after warm acupuncture treatment of constipated irritable bowel syndrome with spleen and stomach weakness

作　　者：吴美英 宋希暖 王晓娟 徐春晓 WU Meiying;SONG Xinuan;WANG Xiaojuan;XU Chunxiao(Department of Gastroenterology,Jiaozhou Central Hospital of Qingdao,Jiaozhou,Shandong,266300,China)

机构地区：[1]青岛市胶州中心医院消化内科,山东胶州266300

出　　处：《中国中西医结合消化杂志》2025年第2期149-155,162,共8页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：青岛市2023年度医药卫生科研指导项目(No:2023-WJZD144);2022-2024年青岛市市级临床重点专科胃肠道肿瘤综合治疗专科(No:青卫政字[2022]6号)。

摘　　要：目的:基于宏基因组学探讨疏肝解郁温针灸法治疗脾胃虚弱证便秘型肠易激综合征后肠道菌群的变化。方法:共纳入研究对象120例,随机将其分为西医治疗组(60例)和联合治疗组(60例)。西医治疗组使用奥替溴铵片,联合治疗组在西医药物治疗的基础上,增加温针灸治疗。收集2组患者的一般临床资料,采集血清,收集实验室指标及肠道粪便标本,进行宏基因组检测,分析肠道微生物代谢产物,进行生物信息学分析。结果:联合治疗组的肠道微生物多样性明显高于西医治疗组,使用RFE进一步对2组患者进行区分,AUC为79.5%,联合治疗组患者中梭菌科和瘤胃杆菌科等10种代谢物的水平升高。利用多组学整合对2组患者的粪便进行特定微生物群和粪便代谢物分析,AUC为83.6%,与仅使用微生物群或代谢物相比,两者的结合分析提供了更好的准确度,且差异有统计学意义(P<0.05)。利用支持向量机分类器和支持向量回归因子模型分析发现,肠易激综合征患者中肠道炎症与特定的微生物群落组成有关。基于KEGG数据库深入探索肠易激综合征患者肠道微生物群与相应代谢物之间的联系,以此为基础构建代谢反应网络图,结果表明在肠易激综合征患者中游离丙酸、天冬氨酸酰化酶、丙氨酸的水平较高,这可能与肠道微生物群的特定代谢活动有关。结论:本研究通过宏基因组学分析,证实了结合温针灸法的治疗方案对便秘型肠易激综合征患者肠道菌群的积极影响。Objective To investigate the changes in the gut microbiome of patients with constipation-type irritable bowel syndrome(IBS-C)with spleen-deficiency syndrome after treatment with warm acupuncture based on metagenomics.Methods A total of 120 patients were included in this study and randomly divided into two groups:the Western medicine treatment group(60 cases)and the combined treatment group(60 cases).The western medicine treatment group received otinium bromide tablets,and the combined treatment group added warm acupuncture and moxibustion treatment on the basis of Western medicine treatment.Clinical data were collected for both groups,including serum samples and laboratory indicators.Fecal samples were collected for metagenomic analysis to study the gut microbiota and its metabolic products.Bioinformatics analysis was then performed to assess the microbial changes.Results The diversity of gut microbiota in the combined treatment group was significantly higher than that in the Western medicine treatment group.Further differentiation using recursive feature elimination yielded an area under the curve(AUC)of 79.5%.In patients of the combined treatment group,the levels of 10 metabolites,including those from Clostridiaceae and Ruminococcaceae families,were elevated.Multi-omics integration was employed to analyze specific microbial communities and fecal metabolites from both groups,achieving an AUC of 83.6%.Compared to analyses using only microbiota or metabolites,the combined analysis provided better accuracy,and the difference was statistically significant(P<0.05).Using support vector machine classifiers and support vector regression factor models,it was analyzed that intestinal inflammation in IBS patients was related to specific microbial community composition.Based on the KEGG database,a deeper exploration was conducted into the relationship between the gut microbiota and corresponding metabolites in IBS patients.A metabolic reaction network was constructed,which revealed that levels of free propionate,aspartate a

关 键 词：宏基因组学 便秘型肠易激综合征 温针灸 肠道菌群 

分 类 号：R574.4[医药卫生—消化系统]