Research On The Essence Of "spleen Deficiency" In HBV-related Chronic Liver Disease Based On The Characteristics Of Intestinal Flora

Objective: To explore the essence of "Spleen Deficiency" in HBV related chronic liver disease from the characteristics of intestina l flora,and to guide clinical diagnosis and treatment.Methods: From June 2020 to December 2020,patients with chronic hepatitis B,HBV related cirrhosis(compensated and decompensated),HBV related liver failure and HBV related liver cancer diagnosed as spleen deficiency syndrome by western medicine were hospitalized in the liver disease center of the First Affiliated Hospital of Hunan University of traditional Chinese medicine;And 99 healthy college students and graduate students from Hunan University o f traditional Chinese medicine as healthy control group.They were divided into six groups.Fresh feces of patients in each group were collected for 16 S r DNA high-throughput pyrosequencing detection.Results: There were differences in the species compositi on of human intestinal flora between the control group and the experimental group.Even though the dominant species did not change,their proportion changed.The Shannon index,observed OTU,Chao1 index and faith's index of the intestinal flora in the expe rimental group decreased significantly,indicating that the abundance and diversity of the intestinal flora in the healthy control group were significantly different from those in the disease group.There were significant differences between the control gr oup(f)and the disease groups(P = 0.002,0.001,0.001,0.001,0.001,respectively).With the progress of the disease,the intestinal microecology in the early stage of end-stage liver disease was also changed compared with that of chronic liver disease.There were differences between group D and groups A and B(P = 0.010,0.022,respectively),and there were also some differences between group D and group E(P = 0.066),There was no significant difference between the other groups.Conclusion: The imbalance of intestinal microecology in patients with HBV related chronic liver disease of "Spleen Deficiency" type is mainly manifested in the significant changes of species diversity,abundance,structural composition and quantity of intestinal flora.With the p rogress of the disease,the imbalance of intestinal microecology is more obvious.It is shown that chronic hepatitis B cirrhosis,liver cirrhosis,or liver failure are progressing progressively.It shows that the intestinal flora of patients with end-stage liver disease is more obvious than that of the early stage of liver disease.