糖尿病肾脏病湿热证患者肠道菌群临床特征的研究

Study on the clinical characteristics of intestinal flora in diabetic nephropathy patients with damp-heat syndrome

目的探究糖尿病肾脏病湿热证患者肠道菌群的结构特征。方法将2018年10月—2019年11月就诊于北京中医药大学东直门医院的20例糖尿病肾脏病湿热证患者作为糖尿病肾病湿热组,20例健康体检者作为健康组,20例单纯2型糖尿病患者作为糖尿病组,20例糖尿病肾脏病非湿热证患者作为糖尿病肾病非湿热组。收集各组受检者粪便样本进行基因DNA提取,获取粪便样本的生物学信息,通过生物学分析方法比较各组肠道菌群的多样性、菌落组成、物种丰度。结果糖尿病肾病湿热组肠道菌群物种的丰富度和均匀度较健康组、糖尿病组、糖尿病肾病非湿热组升高,4组间菌落组成未发现明显差异。与健康组比较,糖尿病肾病湿热组厚壁菌门(主要是布劳特氏菌属、毛螺旋菌属、梭菌属_sensu_stricto_1、罗斯氏菌、韦荣球菌属含量降低)、拟杆菌门、梭杆菌门、变形菌门丰度降低,放线菌门(主要是双歧杆菌属)丰度升高。与糖尿病组比较,糖尿病肾病湿热组梭杆菌门、厚壁菌门(主要是布劳特氏菌属)丰度降低,放线菌门(主要是双歧杆菌属)丰度升高;与糖尿病肾病非湿热组比较,糖尿病肾病湿热组变形菌门(主要是肠杆菌属、克雷伯菌属、变形菌属)、拟杆菌门丰度降低,厚壁菌门(主要是粪芽孢菌属)、放线菌门丰度升高。结论糖尿病肾脏病湿热证患者肠道中有不同程度的致病菌、有益菌增加,但肠道内微生态系统复杂多变,研究结果有待验证。

Objective It is to explore the structural characteristics of intestinal flora in patients with diabetic nephropathy with damp-heat syndrome.Methods Twenty patients with diabetic nephropathy and damp-heat syndrome treated in Dongzhimen Hospital of Beijing University of Chinese Medicine were selected as the observation group,20 healthy subjects were selected as the healthy group,20 patients with simple type 2 diabetes were selected as the diabetes group,and 20 patients with diabetic nephropathy and non-damp-heat syndrome were selected as the diabetic nephropathy non-damp-heat group.The fecal samples of the subjects in each group were collected for gene DNA extraction,and the biological information of the fecal samples was obtained,and the diversity,colony composition and species abundance of the intestinal flora in each group were compared by biological analysis methods.Results Compared with the healthy group,the abundance of Firmicutes(mainly the contents of Blautella,Lachnospira,Clostridium_sensu_stricto_1,Rosetella,Veillonella decreased),Bacteroides,Fusobacterium and Proteobacteria was decreased,and the abundance of Actinobacteria(mainly Bifidobacterium)was increased.Compared with the diabetes group,the abundance of Fusobacterium and Firmicutes(mainly Blautella)in the diabetic nephropathy damp-heat group was decreased,and the abundance of Actinobacteria(mainly Bifidobacterium)was increased;compared with the nephropathy non-damp-heat group,the abundance of Proteobacteria(mainly Enterobacter,Klebsiella,and Proteobacteria)and Bacteroidetes in the diabetic nephropathy damp-heat group was decreased,and the abundance of Firmicutes(mainly Faecalibacterium),Actinomycetes was increased.Conclusion Diabetic nephropathy patients with damp-heat syndrome have different levels of pathogenic bacteria and beneficial bacteria increased in the intestinal tract,but the intestinal micro-ecosystem is complex and changeable,and the research results need to be verified.