类风湿关节炎患者寒热证候与肠道菌群相关性研究

Study on the correlation between cold-heat syndrome ofrheumatoid arthritis and intestinal flora

目的对比寒湿痹阻证、湿热痹阻证类风湿关节炎(rheumatoid arthritis,RA)患者与健康人肠道菌群构成及多样性特征的差异,探讨两种中医证型RA患者的肠道菌群特征。方法对2020年1月至2020年11月于内蒙古自治区中医医院风湿免疫科住院的RA患者进行调查,根据纳入标准及排除标准筛选患者。从寒热两组证型患者中各抽取6例初诊未经治疗患者,共12例,分为寒湿痹阻证(A组)、湿热痹阻证(B组)两组,并另外采集10例健康人作为对照组(C组),收集粪便进行16S rDNA测序。通过Alpha及Beta多样性分析等方法,对比总结寒热两组差异。结果B组患者肠道菌群丰富度较C组下降,A组变化不显著,且三组菌群结构存在差异。在菌群不同分类水平,菌群构成存在差异,在门分类水平,酸杆菌门B组较C组丰度降低(P<0.05),Myxococcota门B组较C组丰度升高(P<0.05),Desulfobacterota门、芽单胞菌门A组较B、C组呈降低趋势(P<0.05)。在属分类水平,不动杆菌属、瘤胃球菌属A组较B、C组明显升高(P<0.05),Lachnoclostridium属A组较C组呈下降趋势(P<0.05),普氏菌属A组较C组显著升高(P<0.05)。在种分类水平,瘤胃球菌属_sp_N15.MGS-57种、Blautia_obeum种、Alistipes_inops种、乳酸乳球菌种A组较B、C组明显升高(P<0.05),普氏菌种A和B组较C组明显升高(P<0.05)。结论寒湿痹阻证与湿热痹阻证RA患者的肠道菌群存在失调的情况,且寒湿痹阻证与湿热痹阻证RA患者菌群结构存在一定差异。

Objective The differences in the composition and diversity of intestinal flora between rheumatoid arthritis(RA)patients with cold-dampness blockage type,dampness-heat blockage type and healthy people were compared.And the characteristics of intestinal flora of RA patients with two TCM syndromes were discussed.Methods The RA patients who were hospitalized in the Department of Rheumatology and Immunology in the Traditional Chinese Medicine Hospital of Inner Mongolia Autonomous Region from January 2020 to November 2020 were investigated,and the patients were screened according to the inclusion and exclusion criteria.Six newly diagnosed untreated patients were selected from the two groups of cold-heat syndrome RA patients,a total of 12 patients were divided into groups A and group B,and another 10 healthy human feces were collected as the control group(group C).The feces were collected for 16S rDNA high-throughput sequencing.Then through Alpha and Beta diversity analysis,the differences among the groups were compared and summarized.Results The abundance of intestinal flora in the group B was lower than that in the group C,and the change in the group A was not significant,and there were differences in the structure among the three groups of flora.In the different classification levels of the flora,the composition of the flora is different.At the level of phylum classification,compared with the group C,the abundance of Acidobacteriota in the group B was decreased(P<0.05),the abundance of Myxococcota in the group B was increased(P<0.05).The Desulfobacterota and Gemmatimonadetes in the group A showed a down-regulation trend compared with the group B and the group C(P<0.05).At the level of genus classification,Agathobacte r and Ruminococcus in the group A were significantly higher than those in the group B and the group C(P<0.05),Lachnoclostridium in the group A showed a down-regulation trend compared with that in the group C(P<0.05),and the Prevotella in the group A was significantly higher than that in the group C(P<0.05).At the level of species classification,Ruminococcus_sp_N15.MGS-57,Blautia_Obeum,Alistipes_inops and Lactococcus_lactis in the group A were significantly higher than those in the group B and the group C(P<0.05),and Preprevella_copri in the group A and the group B were significantly higher than those in the group C(P<0.05).Conclusion The intestinal flora of RA patients with cold-dampness blockage type and dampness-heat blockage type are imbalanced,and there is a certain difference in the flora structure of RA patients with cold-dampness blockage type and dampness-heat blockage type.