Analysis Of The Regulatory Effect Of Compound Huangqi Decoction On Intestinal Flora In Patients With Spleen And Kidney Deficiency Type Ⅰ And Ⅱ M

Purpose: To observe the structure and distribution of intestinal flora in patients with myasthenia gravis(MG)of spleen-kidney deficiency type Ⅰ and Ⅱ and the effect of Fufang Huangqi decoction on intestinal flora in these patients,and to explore the correlation between intestinal flora and MG and the regulatory effect of Fufang Huangqi decoction on intestinal flora in patients with MG of spleen-kidney deficiency type Ⅰ and Ⅱ.Material and method:In this study,80 fresh stool samples were collected from patients with spleen-kidney deficiency type Ⅰ and type Ⅱ myasthenia gravis admitted to the outpatient department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from March 2021 to December 2022,including 40 stool samples from the Fufang Huangqi decoction group and 40 stool samples from the MG group.In the Fufang Huangqi decoction group,31 cases took Fufang Huangqi decoction,9 cases took bromopyristine and Fufang Huangqi decoction;In the MG group,14 cases did not take medicine,and 26 cases took brompyristine.Among the tested MG patients,41 were male and 39 were female,with a sex ratio of 1:0.95,aged 21-72 years,and the course of disease was 3-94 months.In addition,15 healthy subjects were recruited as blank control(healthy group),including 4 males and 11 females,with a sex ratio of 1:2.75,aged from 24 to 67 years.The fresh feces of the subjects were sequenced by 16 s RNA to analyze the community diversity composition spectrum of intestinal microbes,and the abundance level(phylum,family,genus),diversity,species difference and difference markers of intestinal flora in the healthy group,MG group and Fufang Huangqi decoction group were detected.SPSS26.0,QIIME2(2019.4)and R language analysis software were used for statistical analysis.Results:1.At phylum level,compared with MG group,the abundance of Firmicutes and actinomyces in Fufang Huangqi decoction group was significantly increased,while the abundance of Bacteroidetes(p < 0.05)was significantly decreased;Compared with the healthy group,the abundances of Firmicutes(p < 0.05)and actinomyces were significantly decreased in MG group,while the abundances of Bacteroidetes(p < 0.05)were significantly increased.There were no significant differences in the abundance of Firmicutes,Bacteroidetes and actinomyces between Fufang Huangqi decoction group and healthy group(P > 0.05).2.At the family level,compared with MG group,the abundance of Veronella(p < 0.05)and Prevotella(p < 0.05)in Fufang Huangqi decoction group was significantly decreased,while the abundance of Spirillum and Bifidobacteriaceae were significantly increased;Compared with the healthy group,the abundance of Spirillaceae(p < 0.05)and Bifidobacteriaceae in MG group was significantly decreased,while the abundance of Bacteroideaceae,Veronella(p< 0.05)and Prevotella(p < 0.05)was significantly increased.There were no significant differences in the abundance of Spirillaceae,Veronella,bifidobacteriaceae and Prevotella between Fufang Huangqi decoction group and healthy group(P > 0.05).3.At the genus level,compared with MG group,the abundances of Coprobacillus(p < 0.05),Rothella(p < 0.05),Macroomonas(p < 0.05)and Prevotella(p < 0.05)in Fufang Huangqi decoction group were significantly decreased,while the abundances of bifidobacterium and Blautia(p < 0.05)were significantly increased;Compared with the healthy group,the abundance of Bacteroides,Rossella,Macroomonas and Prevotella were significantly increased(p < 0.05),while the abundance of Blautia and Bifidobacterium were significantly decreased(p < 0.05).There were no significant differences in the abundance of Rothella,Bifidobacterium,macroomonas and Prevotella between Fufang Huangqi decoction group and healthy group(P > 0.05).4.Compared with Fufang Huangqi decoction group and healthy group,the community richness of MG group was decreased,with statistical significance(P < 0.05).There was no significant difference in community diversity between Fufang Huangqi decoction group and healthy group(P > 0.05).5.The intestinal communities of MG group were significantly different from those of compound Huangqi decoction group and healthy group(P < 0.05),but there was no significant difference between Fufang Huangqi decoction group and healthy group(P > 0.05).6.At the genus level,there are significant differences among intestinal microbial communities,and the species markers influencing the differences between groups are Megamonas,Prevotella,Bifidobacterium and Lactobacillus.Conclusion:1.The intestinal flora of patients with myasthenia gravis of spleen-kidney deficiency type Ⅰand type Ⅱ have obvious intestinal microbial metabolic disorder;2.Fufang Huangqi decoction can improve the clinical symptoms of myasthenia gravis patients with spleen-kidney deficiency type I and Ⅱ,and regulate the intestinal community within and between habitats when the patients reach the standard of MMS or better after taking medicine for more than 2 years,and can make the abundance of intestinal microorganisms become healthy flora;3.Fufang Huangqi decoction can reduce the abundance of Macromonas and Prevotella and increase the abundance of Lactobacillus and Bifidobacterium in MG patients with spleen-kidney deficiency type Ⅰ and Ⅱ.