Research On The Correlation Between TCM Syndromes Of Functional Constipation And Intestinal Flora

ObjectiveFunctional constipation is a common clinical functional bowel disease.It has a long treatment period,many causes of morbidity,poor clinical efficacy,and symptoms often recur.It is difficult to cure and consume a lot of medical resources.Based on syndrome differentiation and treatment,TCM has individualized treatment for the same disease with different treatments,and the effect is remarkable.Therefore,it is of great significance to study the syndromes,syndrome distribution and epidemiology of functional constipation and find out the syndrome characteristics of this disease.On this basis,high-throughput sequencing 16SrDNA technology was used to detect and analyze the flora of patients with functional constipation and the main syndrome types,to explore the characteristics of the flora of functional constipation and the characteristics of the main syndrome types,and to carry out functional constipation for traditional Chinese medicine The treatment characteristics of the same disease but different treatment provide an objective basis for the flora.MethodsThis thesis consists of two parts:literature review and clinical research.?1?The literature review consists of three parts.The first part is "cognition of traditional Chinese medicine for functional constipation",which mainly discusses the disease name,pathogenesis,and syndrome differentiation of functional constipation.The second part is "progress of modern research on functional constipation",which discusses the epidemiology,etiology,pathogenesis,diagnosis and treatment of functional constipation.The third part is "Research progress of functional constipation based on intestinal flora",which mainly introduces the research progress of functional constipation intestinal flora and the research of syndromes based on intestinal flora.?2?The clinical research part is divided into two parts.The first part is based on a unified TCM syndrome scale,which collects 112 cases.The collected general information and four diagnosis data are imported into Excel.Based on SPSS 23.0 statistical software,cluster analysis and factors The method of analysis is to obtain the distribution characteristics of TCM syndromes,diseases and syndromes common in functional constipation.The second part is the use of 16SrDN A technology to test the flora of patients with functional constipation and patients with functional constipation according to the first two major TCM syndromes.By comparing the flora of functional constipation patients and healthy control groups,the functional constipation patients are obtained.Bacterial characteristics;By comparing the two types of bacterial flora,the bacterial characteristics of specific syndromes were obtained.Result?1?A total of 112 patients with functional constipation were collected in this project,including 31 males?27.7%of the total?and 81 females?72.3%of the total?.The male to female ratio was 0.38:1.The youngest was 22 years old.The oldest is 78 years old and the average age is 52.27 ± 16.80 years old,there is a significant difference in the distribution of different genders between different age groups?P<0.05?;retirees are more frequent?41.1%?,and the proportion of workers is the least?2.7%?The number of patients with high school and below is the largest,accounting for 63.4%.The first is undergraduate?23.2%?,master and above?13.4%?.Dietary preferences are mostly sweets?20.5%?,oily?17.9%?,and spicy?1 7.0%?;Most patients drink less than 1500 ml?70.5%?of water per day,and there is insufficient water intake.?2?In this study,there are mainly five types of syndromes of functional constipation:Qi stagnation,heat secretion,yang deficiency,qi deficiency,yin deficiency,and yin deficiency.The disease location was in the large intestine,liver,spleen,stomach,kindney,and lungs.Among the disease syndromes,qi stagnation and heat were the main evidence,and deficiency syndromes were mainly yang deficiency,qi deficiency and yin deficiency.Qi stagnation distribution is most common,accounting for 42.85%,followed by heat secrets 41.07%,yang deficiency secrets 8.04%,qi deficiency secrets 4.46%,and yin deficiency secrets at least 3.57%.Qi stagnation and heat constipation are the two main symptoms of patients with functional constipation.?3?In terms of intestinal flora comparison between patients with functional constipation and healthy controls,? diversity analysis showed that there was a significant difference between the flora of functional constipation group and healthy control group;in terms of analysis of a diversity,observed patients with functional constipation FC group,simpson index,chaol index and shannon index were higher than healthy control group.Significant differences in the bacterial flora at the phylum level are that the abundance of the Firmicutes,Actinobacteria,and Fusobacteria of patients with functional constipation is higher than that of healthy people,and the abundance of Bacteroidetes and Cyanobacteria is greater in healthy people is reduced.In addition,functional constipation intestinal flora TM7 increased in other phyla than healthy people.In comparison of the main species at the level of the class group,the functionalconstipation group had more intestinal flora Clostridia,Actinobacteria,Erysipelotrichi,and Deltaproteobacteria compared with healthy people;Bacteroidia decreased.Among other levels of flora,Coriobacteriia and TM7-3 in the functional constipation group increased significantly,while Chloroplast decreased.Compared with the main species at the level of the order,the functional constipation group increased in Clostridiales,Bifidobacteriales,Fusobacteriales,Erysipelotrichales,and Desulfovibrionales compared with healthy people,and the Bacteroidales decreased.Among the other flora levels,the functional constipation group showed a significant increase in Coriobacteriales,Turicibacterales,and Actinomycetales,and Streptophyta decreased significantly.The main differences between the two groups in terms of family level were:functional constipation group Lachnospiraceae,Ruminococcaceae,Bifidobacteriaceae,Rikenellaceae increased compared with the normal group,Veillonellaceae?3.4%?decreased.The main differences in the genus levels between the two groups are:functional constipation group,faecalibacterium,bifidobacterium,ruminococcus₁,Coprococcus,which is more abundant than healthy people,Phascolarctobacterium,Blautia,and prevotella Genus abundance is lower than healthy people?4?In terms of comparison of main symptoms of functional constipation,there is no significant difference in ? diversity analysis between Qi stagnation group and heat constipation group;in terms of ? diversity analysis,the two groups are observed,simpson index,chaol index,and Shannon index.No significant difference was seen in this respect.In the comparison of the bacteria groups at different levels,it can be concluded that the bacteria group with a significant difference in family level is Leuconostocaceae,and the abundance of the heat secret group is significantly higher than that of the Qi stagnation secret group.According to LefSe analysis,the specific dominant flora of Qi stagnation group was Butyricimonas,and the specific dominant flora of heat stagnation group was Leuconostocaceae.Conclusion?1?Using cluster analysis and factor analysis,there are five types of syndromes of functional constipation:Qi stagnation syndrome,heat syndrome,yang deficiency syndrome,qi deficiency syndrome,and yin deficiency syndrome.Objectively reflect the distribution of TCM syndromes and characteristics of functional constipation.Qi stagnation and heat stagnation are the two main symptoms.?2?The functional diversity of patients with functional constipation is higher than that of healthy people,and the structure of bacteria at all levels has changed significantly.Butyric acid-producing bacteria in the intestinal microflora of functional constipation patients and those involved in bile acid metabolism have significantly increased It is related to the intestinal mucosal inflammation and immune response.In addition,the flora characteristics can reflect the diet structure of patients with constipation to a certain extent.There was no significant difference in the flora diversity between patients with Qi stagnation and heat secretion,and there was a significant difference in the department level of Leuconostocaceae.The specific predominant flora of Qi stagnation is Butyricimonas,and the specific predominant flora of heat secret is Leuconostocaceae.There are significant differences in the flora of the main syndrome types of functional constipation,which provides an objective scientific basis for the same treatment of functional constipation.