内镜联合康复新液治疗对肝硬化食管胃底静脉曲张患者口腔和肠道菌群的影响

Effects of endoscopy combined with Kangfuxin liquid on oral and intestinal flora of patients with liver cirrhosis and esophageal and gastric varices

目的探讨内镜联合康复新液治疗对肝硬化食管胃底静脉曲张患者口腔和肠道菌群的影响。方法收集2021年6月-2022年9月在河北工程大学附属医院和邯郸市传染病医院治疗的17例肝硬化食管胃底静脉曲张患者内镜联合康复新液治疗前、治疗3 d后、治疗7 d后的唾液和粪便样本,提取样本的细菌DNA进行16S rDNA文库制备,结果进行OTU聚类、物种分析、差异性分析和多样性分析。结果3个时间点口腔和肠道菌群具有137个相同的OTU,且每类标本都具有不同的OTU,治疗前后菌群的Alpha多样性指数具有上升的趋势,3个时间点粪便样本被聚类为三类肠型,每个时间点聚集的肠型可能与不同时期肠道的功能有关。口腔和肠道菌群门水平主要包括拟杆菌门、厚壁菌门和变形菌门,属水平口腔优势菌属为普氏菌属、韦荣球菌属等,肠道菌群丰度依次是拟杆菌属、粪杆菌属、埃希杆菌属等。口腔菌群中颗粒链菌属、巨球形菌属在内镜联合康复新治疗后丰度处于下降趋势,肠道菌群中的普氏菌属在内镜联合康复新液治疗前后丰度具有差异且治疗后巨球形菌属下降而布劳特菌属上升。结论肝硬化食管胃底静脉曲张患者经内镜联合康复新液治疗后口腔和肠道菌群中的致病菌丰度下降,肠道微生物屏障具有恢复的趋势,研究内镜联合康复新液治疗不同阶段的肠型可能有助于预测菌群的功能。

Objective It is to investigate the effect of endoscopy combined with Kangfuxin liquid on oral and intestinal flora of patients with liver cirrhosis and esophagogastric fundus varices.Methods Seventeen patients with liver cirrhosis and esophagogastric fundus varices treated at the Affiliated Hospital of Hebei University of Engineering and Handan Infectious Disease Hospital from June 2021 to September 2022 were selected,and their saliva and fecal samples were collected before treatment,and after 3,7 days of treatment with endoscopy combined with Kangfuxin liquid,the bacterial DNA of the samples was extracted for 16S rDNA library preparation,and the results were subjected to OTU clustering,species analysis,analysis of variance,and diversity analysis.Results The oral and intestinal flora at the three time points had 137 identical OTUs,and each type of specimen had different OTUs,the Alpha diversity index of the flora before and after the treatment had an increasing trend,the fecal samples at the three time points were clustered into three types of intestinal phenotypes,and the clustered intestinal phenotypes at each time point may be related to the intestinal tract function in different periods.The oral and intestinal flora phylums mainly included Bacteroidetes,Firmicutes and Proteobacteria,and the dominant oral genera genuses were Prevotella and Weilonella.etc,and the abundance of intestinal flora was in the order of Bacteroides,Faecalibacterium and Escherichia.etc.The abundances of Granulicatella and Megasphaera in the oral flora were in a decreasing trend after treatment with endoscopy combined with Kangfuxin liquid,the difference in the abundance of Prevotella in the intestinal flora before and after treatment with endoscopy combined with Kangfuxin liquid was significant,and the abundance of Megasphaera was decreased while Blautia was increased after the treatment.Conclusion The abundance of pathogenic bacteria in the oral and intestinal flora of patients with liver cirrhosis and esophagogastric fundus varices decreased after treatment with endoscopy combined with Kangfuxin liquid,the gut microbial barrier has a tendency to recover,and the study on the treatment of intestinal phenotypes at different stages with endoscopy combined with Kangfuxin liquid may be useful for predicting the function of flora.