| Objective: 1.Based on the means of bibliometry,this paper analyzed the current status of research focusing on intestinal flora in the field of traditional Chinese medicine and explored the research trends and hot spots in this field.2.To explore the characteristics of intestinal flora in patients with Qi Deficiency Syndrome and summarize the correlation between intestinal flora and Qi Deficiency Syndrome,and to explore the clinical efficacy of modified Renshen Yangrong Decoction and the possible mechanism of its clinical effect of Tonifying Qi.Method: 1.This paper combed the literature of traditional Chinese medicine related to intestinal flora in the core data set of Web of Science by using VOSviewer and Citespace and carried out the visualization analysis of knowledge map with countries(regions),institutions,authors and keywords as the research objects.2.From March 2018 to March 2019,20 subjects diagnosed with Qi Deficiency Syndrome were recruited in the outpatient clinic of Hubei Provincial Hospital of Traditional Chinese Medicine.10 healthy volunteers were recruited at the same time.Among them,subjects diagnosed with Qi Deficiency Syndrome were given Modified Renshen Yangrong Decoction for 8 weeks,while healthy subjects were not given any interventions.The general demographic information of the subjects in each group was collected respectively,and then the clinical scales were used to evaluate the clinical effectiveness of modified Renshen Yangrong Decoction in the treatment of Qi Deficiency Syndrome.Meanwhile,fecal specimens of subjects were collected,and high-throughput sequencing technology was used to analyze and compare the differences of intestinal flora composition between subjects with Qi Deficiency Syndrome and healthy volunteers,as well as between subjects with Qi Deficiency Syndrome before and after intervention.Result: 1.A total of 273 qualified pieces of literature were retrieved.The number of literature increased year by year from 1998 to 2019,and the growth rate of the number of pieces of literature has accelerated significantly since 2017.The participating countries(regions),institutions and authors are mainly domestic,and the overall cooperation network is sparse.Researchers mainly focused on the digestive system and endocrine system diseases,spleen deficiency syndrome was the main traditional Chinese medicine syndromes concerned,and single herbs and its extracts were the main medications concerned.2.There were no significant differences in gender,age,and BMI between subjects with Qi Deficiency Syndrome and healthy volunteers(P > 0.05).After treatment with modified Renshen Yangrong decoction,the effective rates of Traditional Chinese Medicine Syndromes at the 2nd,4th,6th,and 8th weeks are 40%,75%,70%,and 80%,respectively.The results of the Cochran's and Mantel-Haenszel statistics showed that the clinical effective rate increase with the course of treatment on the whole(P < 0.01).The results of the one-way repeated measures ANOVA indicated that the scores of Qi S,FS-14,FSAS,and MFI-20 scales show a downward trend with the increase of course of treatment on the whole(P < 0.001).3.A total of 3056257 Tags were detected in this study,with an average of 61125 per sample.Clean Tags were clustered into 551 OTUs at 97% similarity degree.The species accumulation curve indicated that this study collected the adequacy of the sample size and its species richness.Combining with the dilution curve,most species in the samples have been detected in this study.There was no significant difference in the alpha diversity among HG,QD.W0,and QD.W8(P > 0.05).In Beta diversity analysis,the author found that the three groups of samples are significantly discriminated at the OTU,genus,and species level,while no significant difference was found at the phylum level.Compared with HG,the relative abundance ratio of p-Firmicutes to p-Bacteroidetes increase in QD.W0 and decrease after drug intervention.Compared with HG,p-Cyanobacteria,c-Chloroplast,o-Streptophyta,g-Odoribacter,and s-Clostridium_methylpentosum are significantly enriched in QD.W0(P < 0.01).Compared with QD.W0,the abundance of p_Proteobacteria is significantly increased in QD.W8(P < 0.01).4.The abundance of g-Bacteroides is positively correlated with the Qi S.The abundance of p-Cyanobacteria is positively correlated with the FSAS and MFI-20.The abundance of g-Lactobacillus is negatively correlated with the Qi S.The abundance of g-Enterococcus is negatively correlated with the FS-14,FSAS,and MFI-20.The abundance of both g-Gemmiger and g-Dialister is negatively correlated with the FSAS.The abundance of both g-Eubacterium and g-Prevotella is negatively correlated with the MFI-20.Conclusion: 1.At present,intestinal flora has been paid more and more attention from researchers of traditional Chinese medicine.In future research,researchers need to further strengthen the diversified cooperation across regions,agencies,and teams.2.Clinical research suggested that modified Renshen Yangrong decoction is safe and effective in treating Qi Deficiency Syndrome.The composition of intestinal flora in patients with Qi Deficiency Syndrome is different from that of healthy people,and modified Renshen Yangrong decoction can regulate the structure of human intestinal flora to a certain extent,which may also be a potential mechanism for its effect of "tonifying Qi". |
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