Based On TCM Syndromes, The Characteristic Changes Of Intestinal Flora In Patients With Nonalcoholic Steatohepatitis Were Studied

Objectives:In recent years,Nonalcoholic steatohepatitis has become an important health problem in the world,and its prevalence rate is increasing with each passing year.The treatment of Western medicine is not only the way of lifestyle intervention and drug treatment,but the effect is still not ideal,which spur medical workers to seek more diagnosis and treatment strategies.At the same time,traditional Chinese medicine has played a unique advantage in the prevention and treatment of NASH/NAFLD.Under the guiding theory of TCM syndrome differentiation and treatment,this study takes the combination of disease and syndrome as the breakthrough point.Using advanced science and technology to analyze the changes of intestinal flora structure in NASH patients with liver depression and spleen deficiency type and NASH in patients with damp heat accumulation,and to compare with the healthy subjects,so as to provide a new idea and new method for NASH treatment,and find a new evidence-based basis for clinical practice.Methods:This study collects the clinical data of 34 NASH patients and 26 healthy subjects,check the data and establish the database;Use the SPSS22.0 statistical software for statistical analysis;At the same time,the volunteers’ fecal samples were collected,based on 16S rDNA technology,extract the total DNA,sequencing on Illumina MiSeq,establish the database,and the species analysis were extracted.And then analyze the difference of bacteria group in NASH patients with different TCM syndromes.Results:1.Baseline data:①The characteristics of BMI、CAP and E values of different TCM syndromes:The values of BMI,CAP and E in NASH patients were different in different ages.On CAP and BMI indicators,the group of ganyu pixu was larger than the shire neiyun group,while the E value was larger than the ganyu pixu group.②The characteristics of ALT and AST in different TCM syndromes:there was no significant difference between the two groups on the indexes of ALT and AST;③The incidence of disease and B-ultrasound:the incidence of NASH patients is mainly moderate to severe fatty liver,and the proportion of moderate fatty liver is the highest.2.Flora result:A total of 1887515 high quality Tags were obtained in this study,with an average of 31458 samples per sample(n=60).97%similarity degree is used to cluster,and 699 OTU are produced.The abundance of OTU species between different groups ceaselessly,The OTU abundance of the gan yu pi xu group,the shi re nei yun group and the normal group had statistical significance(P=0.023<0.5).The species accumulation curve suggests that this study collects the adequacy of the sample size and its species richness.From the sobs,Chao,and ACE dilution curves,the depth of the sequencing of this study has covered all the species in the sample.From sobs,Chao,ACE index and PLS-DA analysis,it was found that there were differences in the intestinal flora between the normal group,the gan yu pi xu group and the shi re nei yun group.The specific results of different classification levels are as follows:①At the Phylum level,the relative abundance of Tenericutes in the gan yu pi xu group and shi re nei yun group was significantly lower than that in the normal group(P<0.05),but there was no statistical significance in the gan yu pi xu group and shi re nei yun group(P>0.05).The bacteria abundance of Acidobacteria in gan yu pi xu group is slightly higher than in normal group,and the normal group is higher than the group ofshi re nei yun,the two was not statistically significant(P>0.05);However,the gan yu qi zhi group is more obviously than the shi re nei yun group,there was significant difference(P<0.05).The abundance of Bacteroidetes in the gan yu pi xu group and shi re nei yun group was significantly lower than that in the normal group(P<0.05),but there was no significant difference between the gan yu pi xu group and shi re nei yun group(P>0.05).②At the Class level,the flora abundance of Acidobacteriia in gan yu pi xu group and shi rre nei yun group increased more significantly than the normal flora,and the ratio of gan yu pi xu group is slightly higher than the shi re nei yun group,there were statistically significant(P<0.05);the abandunce of Saprospirae in the gan yu pi xu group increased more significantly than the normal group and the gan yu pi xu group bacteria,there were statistically significant(P<0.05).③At the Order level,Saprospirales,Acidobacteriales in the gan yu pi xu group is significantly higher than the normal group and the shi re nei yun group,the difference between them was statistically significant(P<0.05);Rhodospirillales in the shi re nei yun group were significantly higher than the normol and the gan yu pi xu group,the difference was statistically significant(P<0.05).④At the Familygroup,Chitinophagaceae,Staphylococcaceae and Rhodospirillaceae in the gan yu pi xu group were higher than those in the shi re nei yun group and the normal group,the difference was statistically significant(P<0.05).⑤At the Genus level,only Staphylococcus in the gan yu pi xu group was higher than that in the shi re nei yun group and the normal group.The difference was statistically significant(P<0.05).Conclusion:1.The BMI、CAP and E values of NASH patients were different under different TCM syndromes.2.Compared with the normal subjects,the intestinal flora of NASH patients changed,and there is the uniqueness in different TCM syndromes.3.In the development of NASH/NAFLD,the change of intestinal micro flora may play an important role.