Study On The Characteristics Of TCM Tongue Diagnosis And Tongue Coating Microecology In Patients With Colorectal Tubular Adenom

Background Colorectal tubular adenoma is a common disease of the digestive system.Clinically,patients may have no obvious symptoms in the early stage.Some patients have gastrointestinal symptoms such as abdominal pain and abdominal distension,and there is a risk of cancer.Colonoscopy is the gold standard for diagnosing colorectal tubular adenoma.However,due to the invasive examination,some patients do not accept the examination due to psychological factors or cannot tolerate the examination due to disease risk,resulting in missed diagnosis and further development of cancer.Therefore,a simple method to indicate the possible presence of colon polyps has become an important research direction of this disease.It is the basic principle of TCM diagnostics to "carry out the affairs outside the body and carry out the affairs inside the body".In particular,tongue diagnosis can effectively understand the basic information of the human internal environment,which is helpful for the diagnosis and monitoring of diseases.In recent years,with the development of science and technology,TCM tongue diagnosis has stepped into the microscopic level,and researches on the correlation between various diseases and tongue diagnosis and tongue coating microecology have been gradually carried out.However,there are few researches on the relationship between colorectal adenoma,tongue coating microecology and TCM tongue diagnosis.In this study,16SrRNA high-throughput sequencing technology and bioinformatics analysis method were used to study the microecology of tongue coating in patients with colorectal tubular adenoma.Objective In order to get the distribution of tongue diagnosis in the population of colorectal tubular adenoma.At the same time,to find the difference in the composition of tongue coating bacteria between the population and the normal population,so as to provide a new idea for the early warning of colorectal tubular adenoma.Methods Patients who underwent colonoscopy at the Digestive Endoscopy Center of Oriental Hospital of Beijing University of Chinese Medicine from May 2022 to March 2023 were selected.According to the order of treatment,80 patients who met the inclusion and exclusion criteria were selected.The tongue quality and tongue coating were observed,and the characteristics of spirit,color,shape and state were recorded.The patients diagnosed with colorectal adenoma by colonoscopy and pathological examination were divided into colorectal tubular adenoma group,a total of 50 cases.Normal colonoscopy population was the control group,a total of 30 cases.At the same time,the tongue coating of two groups of people was scraped for high-throughput sequencing.All patients met the inclusion criteria and signed informed consent.Results The age of patients with colorectal adenoma was significantly higher than that of normal group,p<0.05.The proportions of red tongue,thick moss and yellow moss in colorectal tubular adenoma group were significantly higher than those in normal group,p<0.05.Compared with the normal group,there were significant differences in tongue coating microbial groups in the large intestine tubular adenoma group as follows:① At the phylum level,Actinobacteria;② On the class level:Actinobacteria and Coriolobacteriia;③ At the order level:Actinomycetales and Coriobacteriales;④ At the level of science:Actinomycetaceae,Micrococcaceae,Coriobacteriaceae,Corynebacteriaceae,Rikenellaceae,Burkh olderiaceae;⑤ On the genus level:Actinomyces,Rothia,Atopobium,Corynebacterium,Lautropia,Blvii28;There were 15 distinct microbial groups（LDA>2）.At the phylum level,the population group of the large Proteobacteria intestinal adenoma group was significantly increased;at the class level,the population group of the large Epsilonproteobacteria intestinal adenoma group was significantly increased;at the order level,Enterobacteriales and Campylobacterales increased significantly in the large intestinal adenoma groups.At the family level:Enterobacteriaceae,Veillonellaceae,Peptostreptococcaceae and Campylobacteraceae increased significantly in the population groups of large intestinal tubular adenoma.At the genus leve:SMB53,Paraprevotella,Citrobacter,Veillonella,Peptostreptococcus,Oribacterium,Campylobacter large intestinal tubular adenoma group significantly increased in population group.Compared with the normal group,the relatively high content of tongue coating in the large intestinal tube adenoma group was as follows:① Phylum level:Actinobacteria,p<0.05;Class level:Actinobacteria and Coriolobacteriia,p<0.05;③Order level:Actinomycetales and Coriobacteriales,p<0.05;④ Family level:Micrococcaceae,Actinomycetaceae,p<0.05;⑤genus level:Rothia,Actinomyces and Atopobium p<0.05.The low relative abundance of bacteria in the large intestine tubular adenoma group was as follows:at the phylum level:TM7（TM7）and Proteobacteria,p<0.05;At class level:TM7₃,p<0.05;At Order level:none;At the family level:Veillonellaceae,p<0.05;On genus level:Oribacterium,Veillonella p<0.05.Conclusion①There was a great difference between the tongue coating flora of patients with colorectal tubuloadenoma and that of healthy people,among which Rothia,Actinomyces and Atopobium were significantly increased.The bacteria that decreased significantly were Oribacterium and Veillonella.② Patients with colorectal tubular adenoma are older.（3）Tongue diagnosis in patients with colorectal tubular adenoma was more red tongue,thick coating and yellow coating;...