Study On The Difference Of Intestinal Flora In Patients With Ulcerative Colitis With Damp-heat Syndrome Of The Large Intestine And Spleen-kidney-yang Deficiency

BACKGROUND:Ulcerative colitis(UC)is a type of inflammatory bowel disease(IBD).Clinically,it is characterized by recurrent abdominal pain,diarrhea,mucus pus and blood.Physical and mental health affects patients' daily activities.With the gradual improvement of the living standards of Chinese residents and the popularization of inspection methods,the clinical incidence has also increased.At present,the medical treatment has not yet reached the goal of cure,and the disease may have a lifetime recurrence.Since the medical community began to understand UC,its etiology and mechanism have not yet been clarified.Existing research shows that genetic,immune,environmental and infection factors are closely related to the pathogenesis of UC.There are a large number of microorganisms in the human intestine,most of which are in the colon,and the lesions of UC are confined to the colon,and people have to doubt the correlation between the two.Traditional Chinese medicine has a clear clinical effect and unique advantages in the treatment of UC.Syndrome differentiation is one of the two major characteristics of traditional Chinese medicine.The large intestine dampness and heat syndrome and the spleen-kidney yang deficiency syndrome are two clinical syndromes of one deficiency and one deficiency.type.A large number of related clinical and basic researches have been carried out at home and abroad,but the research on the intestinal flora of patients with ulcerative colitis with different specific types is still lacking.OBJECTIVE:To explore the differences between the intestinal flora of UC patients and normal people to clarify the relationship between the incidence of UC and intestinal flora,and the differential manifestations of intestinal flora with the two types of syndromes of large intestine damp-heat syndrome and spleen-kidney yang deficiency syndrome.METHOD:A total of 40 UC patients were included in this clinical trial,of which 20 were of the type of damp-heat of the large intestine and 20 were of the spleen-kidney-yang deficiency type.A total of 40 healthy volunteers were recruited.The 16S rDNA method was used to detect the differences in the intestinal flora of the healthy control group and all UC patient groups,as well as the differences between the above two different types of UC patients Mechanism,and the relationship between different UC syndromes and intestinal flora.RESULTS:By comparing the test results of the healthy control group and the UC patient group,it was found that the two groups of bacteria were structurally different:8 categories such as Thick-walled Bacteroides,Bacteroides,Actinomycetes,etc.were different species at the door level(p<0.05);12 classes including Clostridia,Bacteroides,Bacillus,Actinomycetes,etc.are the level difference species(p<0.05);Clostridia,Bacteroides,Lactobacillus,Bifidobacteria,12 orders including nematodes are significantly different species at the order of the order(p<0.05);Trichospiraceae,Bacteroides,Bifidobacteriaceae,Peptostreptococcaceae,Verrucobacteriaceae,Streptococcusceae,Clostridiaceae,Actinobacteriaceae,Enterococci,etc.22 families are significantly different species at the family level(p<0.05);Bacteroides,Lactobacillus,Bifidobacterium,Brautella,Streptococcus,27 genera such as Actinomyces,Enterococcus,Enterobacter,Salmonella,etc.are the level-different species(p<0.05).The Alpha diversity analysis of intestinal microbes in the healthy control group and the UC patient group showed that the two groups had significant differences in the richness and uniformity of the flora,and they were statistically significant by rank sum test(p<0.05);Beta diversity analysis showed The composition of the flora of the two groups is significantly different.LefSe analysis showed that the different species with LDA score>4 in the UC patient group were:Pachycephalospora,Clostridium,Clostridia,Trichosporidae,which is the most influential bacterial group among the UC patients with significant differences.The different species with LDA score>4 in the healthy group are:Prevotidae,Bacteroidetes,Bacteroides,and Bacteroides.By comparing the test results of the large intestine damp-heat type UC group and the spleen-kidney-yang deficiency type UC group,it was found that the differences in the bacterial group structure between the two groups of patients:Bacteroides phylum is a different species at the phylum level(p<0.05);Clostridium and Bacteroides Classes are class-level differential species(p<0.05);Clostridia and Bacteroides are class-level species with significant differences(p<0.05);Trichosporaceae,Veillonellaceae and Christensenaceae It is a significantly different species at the family level(p<0.05);Macromonas,Trichospira and Serratia are the level-differential species(p<0.05).Alpha diversity analysis showed that the two groups had a significant difference in the comparison of flora richness(p<0.05),while there was no significant difference in the comparison of flora diversity(p>0.05).Beta diversity analysis showed that there were significant differences in the flora composition between the large intestine damp-heat type UC group and the spleen-kidney-yang deficiency type UC group.LefSe analysis showed that the different species with LDA score>4 in the large intestine damp-heat type UC group were:Bacteroidetes,Bacteroides,and Bacteroides,which were the most influential bacterial groups among the significantly different species in large intestine damp-heat type UC patients.The different species with LDA score>4 in the UC group with spleen and kidney yang deficiency are:Trichosporaceae,Clostridia,ClostridiumCONCLUSIONS:1.By comparing the intestinal flora of healthy people and UC patients,the significantly different species are Actinomycota,TM7,Actinomycetes,TM7-3,Bifidobacterium,Zurich Order,Rhodobacteriaceae,Rhizoctonia,Bifidobacteriaceae,Zurichae,Rhodobacteraceae,Actinomyceteaceae,Enterococcus,Veillonellaceae,Bifidobacterium,Zurichium,Cloth Lauterella,Erwinia,etc.Among them,Pachybacteria,Clostridia,Clostriales,Trichospiraceae are the most influential flora among UC patients with significant differences,indicating that this part The imbalance of intestinal flora may be involved in the pathogenesis of UC.2.By comparing the differences in intestinal flora between patients with UC with large intestine damp-heat and those with spleen-kidney-yang deficiency,the two significantly different species are Bifidobacterium,Actinomycetes,Bifidobacteria,Bifidobacteriaceae,etc.This indicates that the difference in intestinal flora in this part may be the cause of the clinical manifestations of UC patients with two different syndromes,and may also be the difference between the intestinal flora in the UC active phase and the remission phase.