胃溃疡患者三联疗法治疗前后舌苔菌群的变化

The changes of tongue coating flora in patients with gastric ulcer before and after triple therapy

目的观察并分析胃溃疡患者三联疗法治疗前后舌苔菌群的变化,为后续研究提供参考。方法选择2018年1月至2018年12月我院收治的20例GU活动期患者为研究对象,分为GU治疗前组(20例,GU1组,均为黄腻苔)和GU治疗后组(20例,GU2组,均为薄白苔)。选择同期我院体检无异常的健康者20例为正常组(NGT组,均为薄白苔)。运用16S rDNA高通量测序技术对比分析3组对象舌苔菌群结构及菌属差异。结果与GU1组相比,GU2组与正常组的舌苔相似菌群更多。与GU2组相比,GU1组和正常组舌苔菌群在属水平的各物种丰度较多,同时GU1组与正常组在属水平的各物种群落构成更为相似。BetaNMDS差异分析显示与GU2组相比,GU1组舌苔菌群与正常组的群落构成差异更小,GU1组的各物种群落构成更接近于正常组。在属水平中,与GU2组和正常组相比,GU1组Gammaproteobacteria的丰度明显偏低,而Prevotellaceae、Prevotella-7、Fretibacterium丰度明显偏高(均P<0.05)。结论 GU患者经过三联疗法治疗后舌苔菌群构成更接近健康人,但各物种丰富度明显降低,个别菌属生长受到抑制,其可能为不利于GU患者恢复的菌群,但Gammaproteobacteria的生长受到促进,其可能为有利于GU患者恢复的有益菌群。

Objective To analyze the changes of tongue coating flora in patients with gastric ulcer(UC) before and after triple therapy and provide a reference for the following study. Methods A total of 20 UC patients treated in our hospital from Jan. 2018 to Dec. 2018 were enrolled and divided into the pre-treatment group(20 cases with yellow putty coating, GU1 group) or post-treatment group(20 cases with thin white coating, GU2 group), with twenty healthy individuals accepting physical exam in the same period as normal controls(NGT group, thin white coating). 16 S rDNA high-throughput sequencing technology was used to analyze the community structure and flora differences among the three groups. Results Compared with GU1 group, GU2 group and NGT group had more similar flora in tongue coating. Compared with the GU2 group, the species richness in GU1 group and normal control group were higher, while the species community composition were more similar at genus level. BetaNMDS analysis showed that compared with GU2 group, the difference in community composition between GU1 group and normal control group was smaller, and the species community composition in GU1 group was closer to that in normal control group. At genus level, compared with GU2 group and normal control group, Gammaproteobacteria in GU1 group was significantly lower, while Prevotellae, Prevotella-7 and Fretibacterium in GU1 group were significantly higher(all P<0.05). Conclusion The micro-flora in tongue coating of GU patients after triple therapy is close to the healthy people, but the richness of some species are significantly reduced, which may be the bacteria that is not conducive to the recovery of GU. The growth of Gammaproteobacteria is promoted, which may be beneficial to the recovery of GU.