高血压患者粪便菌群变化及中医病体证状态分析

An Analysis of Fecal Bacterial Flora in Patients with Hypertension and Integration of Disease Symptoms,Syndrome and Body Constitution

目的:探讨高血压患者粪便菌群变化及其中医病症、证候、体质(病体证)特点。方法:采用横断面调查方法,纳入符合标准的患者220例,其中高血压组122例,非高血压组98例,均动态监测血压并检测粪便菌群,判定中医体质与证候类型。结果:高血压组及非高血压组革兰阳性球菌分别为(31.5±19.19)%、(23.4±14.29)%,差异有统计学意义(P<0.05)。高血压组球杆比为0.962±2.594,非高血压组为0.380±0.419,差异有统计学意义(P<0.05)。粪便菌群分型高血压组正常型40例,中间型32例,异常型50例;非高血压组正常型55例,中间型15例,异常型28例,两组分型比较差异有统计学意义(P<0.05)。革兰阴性杆菌高血压组异常型88例,非高血压组异常型82例,差异有统计学意义(P<0.05)。分别对正常型、革兰阴性杆菌异常型行Logistic回归分析,差异均有统计学意义(P<0.05)。两组体质类型、证候类型比较差异均有统计学意义(P<0.05)。结论:高血压患者粪便菌群存在显著异常,革兰阳性球菌占比升高、球杆比值异常以及异常型增多;血压波动是导致粪便菌群异常的关键,高血压患者体质与证候特点主要表现在痰、湿、瘀、热、郁等方面,建议强化高血压患者中西医整合的血压管理措施。

Objective:To explore the changes of fecal bacterial flora in hypertension patients and its characteristics of TCM disease symptoms,syndrome and body constitutions.Methods:Using cross-sectional survey method,220 patients who met the criteria were included,among them,there were 122 patients in hypertension group and 98 patients in non-hypertension group,they accepted dynamic monitoring of blood pressure and the detection of fecal flora,to judge TCM body constitutions and the types of syndromes.Results:The percentages of Gram positive cocci of hypertension group and non-hypertension group were(31.5±19.19)%and(23.4±14.29)%respectively,and the difference was statistically significant(P<0.05).The proportion of cocci and bacilli in hypertension group was 0.962±2.594;the proportion in non-hypertension group 0.380±0.419,and the difference showed statistical meaning(P<0.05).In hypertension group,40 cases were of normal type fecal flora,32 cases of intermediate type and 50 cases of abnormal type;in non-hypertension group,55 cases of normal type,15 cases of intermediate type and 28 cases of abnormal type,and the difference was statistically significant(P<0.05).There were 88 abnormal cases of Gram negative bacilli in hypertension group,82 abnormal cases in non-hypertension group,and the difference had statistical meaning(P<0.05).The difference showed statistical meaning after performing the analysis on normal and abnormal type Gram negative bacilli respectively(P<0.05).The difference showed statistical meaning in the types of body constitutions and syndromes between both groups(P<0.05).Conclusion:Fecal bacterial flora in patients with hypertension are significantly abnormal,increasing proportion of Gram positive cocci,abnormal proportion of cocci and bacilli and abnormal type increase;blood pressure fluctuation is the key of abnormal fecal bacterial flora,the characteristics of body constitutions and syndrome of the patients with hypertension mainly show in the aspects of phlegm,dampness,stagnation,heat,depression and others,the patients with hypertension are suggested to enhance blood pressure management measures of integrative medicine.