| Objective:Chronic atrophic gastritis(CAG)is a precancerous disease of gastric cancer,with a cancer rate of 2.55%?7.46%.Spleen-stomach damp-heat syndrome is a common clinical demonstration.Shanghai is located in a humid region south of the Yangtze river,with a high prevalence of spleen-stomach damp-heat syndrome,providing a good regional environment for the research of spleen-stomach damp-heat syndrome.Intestinal flora constitutes an important functional organ of the human body,which is most closely related to the spleen and stomach of TCM.Therefore,we conducted a correlation study between the spleen-stomach damp-heat syndrome of CAG and intestinal flora,looking for the characteristics of the different flora of spleen-stomach damp-heat syndrome,which can provide a reference for the microscopic diagnosis of spleen-stomach damp-heat syndrome,and provide a basis for the early and non-invasive objective diagnosis and treatment of spleen-stomach damp-heat syndrome.Methods: Fecal samples of spleen-stomach damp-heat syndrome of CAG and deficiency cold of spleen and stomach syndrome,spleen-stomach damp-heat syndrome of CNAG and healthy people were sequenced based on 16 S r DNA high-throughput sequencing technology.Through the PCo A,LEf Se analysis,LDA biological information analysis techniques and NMDS to analyze the different intestinal flora of patients with spleen-stomach dampness-heat syndrome of CAG compared with other groups.Results:(1)Comparison between spleen-stomach damp-heat syndrome of CAG group(S)and deficiency cold of spleen and stomach syndrome group(H): chao index,ace index and shannon index of group S were significantly lower than that of group H,while Simpson index was significantly higher,indicating that the richness and diversity of intestinal flora of patients with spleen-stomach damp-heat syndrome of CAG were lower than those with deficiency cold of spleen and stomach syndrome.Further analysis of the different flora showed that the abundance of tenericutes,verrumicrobia in group S was significantly lower than that in group H.Specific to the genus level,the abundance of eubacillus rectum,eggerthella,rumen coccus,norank?f??Ruminococcaceae in group S was significantly higher than that in group H,while eubacterium,christensen?R?7?group,veronococcus?UCG?003,peptococcus,prevoteua?9,rumen coccus?1,ruminococcaceae,lachnoclostridium,norank?o??Mollicutes?RF9 was significantly lower than that of group H.(2)Spleen-stomach damp-heat syndrome of CAG group(S)were compared with healthy people group(Z):Chao index,ace index and shannon index were significantly lower than that of group Z,while Simpson index was higher than that of group Z,indicating that the richness and diversity of intestinal flora in patients with spleen-stomach damp-heat syndrome of CAG were lower than that of healthy people.Further analysis of the different flora showed that the abundance of clostridium,proteobacteria in the S group was significantly higher than that in the Z group,and the abundance of lentisphaerae,tenericutes,synergistetes was significantly lower than that in the Z group.At the generic level,the abundance of nesterenkonia,clostridium,rumen coccus,bacteroides,escherichia,coli,norank?f?Ruminococcaceae in the S group was significantly higher than that in the Z group,while the abundance of eubacterium,christensen?R?7?group,veronococcus?UCG?003,coprococcus,lachnoclostridium,norank?o??Mollicutes?RF9,prevoteua?9,ruminococcaceae,rumen coccus?1 was significantly lower than that of the Z group.(3)Comparison between spleen-stomach damp-heat syndrome of CAG group(S)and spleen-stomach damp-heat syndrome of CNAG group(F): chao index,ace index and shannon index of group S were significantly lower than that of group F,while Simpson index was significantly higher,which fully demonstrated that the richness and diversity of intestinal flora in patients with spleen-stomach damp-heat syndrome of CAG were lower than those with spleen-stomach damp-heat syndrome of CNAG.Further analysis of the difference in the flora showed that the abundance of proteobacteria in group S was significantly higher than that in group F,while the abundance of tenericutes was significantly lower than that in group F.At the level of genus,the abundance of genera like Parasutterella?group,escherichia coli,rumen coccus,gnavus?group,eubacillus rectum in group S was significantly higher than that in group F.However the abundance of bacterial genera,such as eubacterium,barnes,christensen?R?7?group,veronococcus?UCG?003,megamonas,prevotella?nk3b31?group,lachnoclostridium,rumen coccus,norank?o??Mollicutes?RF9 was significantly lower than that of group F.(4)Correlation analysis of environmental factors: Eleven environmental factors,including BMI,sweet food(TS),Fried food(YZSW),western food(XC),preserved food(YZSP)and midnight snack(XY)were selected and retained for further analysis.Redundancy analysis(RDA)showed that both BMI and dietary habits were related to intestinal flora,and TS in dietary habits had the greatest impact on intestinal flora of CAG patients with spleen-stomach damp-heat syndrome.Conclusion: This study shows that the structure and characteristics of intestinal flora of patients with spleen-stomach damp-heat syndrome of chronic atrophic gastritis are consistent with the theory of TCM.And consistent with other research results;In addition,the characteristics of intestinal flora abundance and diversity in patients with spleen-stomach damp-heat syndrome of chronic atrophic gastritis can reflect the characteristics of "dampness" and "heat" in the pathogenic elements of spleen-stomach damp-heat syndrome to a certain extent.The abundance and diversity of intestinal flora in CAG patients with spleen-stomach damp-heat syndrome were lower than that in patients with deficiency cold of spleen and stomach syndrome.Compared with subjects in other groups,the increase of 4 bacterialabundance and the decrease of 12 bacterial abundance in patients with CAG syndrome of dampness and heat of spleen and stomach were related to the formation of CAG syndrome of dampness and heat of spleen and stomach.In addition,through the analysis of environmental factors,the influence of sweet food on the changes of intestinal flora in CAG patients with spleen-stomach damp-heat syndrome was also concluded,Eating more sweet food may have a certain correlation with the formation of spleen-stomach damp-heat syndrome of CAG patients by reducing the bacterial abundance of the chaetospiraceae?NK4A136?group in the human body.The results of this study are consistent with the theories of TCM and with those of other scholars.This study expands the direction for further research on the internal material basis of the occurrence of spleen-stomach damp-heat syndrome,and lays a foundation for the study on the role of intestinal microorganisms in the occurrence of CAG. |
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