肾虚血瘀型不明原因复发性流产肠道菌群特征观察及证型相关分析

Characteristics of Intestinal Flora in URSA Patients with Kidney Deficiency and Blood Stasis and Its Correlation with Clinical Symptoms

目的观察肾虚血瘀型不明原因复发性流产(unexplained recurrent spontaneous abortion,URSA)患者未孕状态下肠道微生态特点及与正常女性粪便中肠道菌群的差异;探讨URSA肾虚血瘀型与肠道菌群是否存在一定的相关性。方法收集2020年9月—2021年1月就诊于黑龙江中医药大学附属第一医院妇科门诊和住院部的患者作为研究对象:试验组(30例)为URSA肾虚血瘀型未孕患者、对照组(40例)为正常未孕女性。收集基本信息、中医证候等资料,采集粪便标本,通过高通量测序方法检测肠道菌群,并对其进行定性、定量分析。结果URSA肾虚血瘀型患者与正常女性肠道菌群的物种组成、丰度,Alpha、Beta多样性存在差异。URSA患者年龄与粪球菌、梭状杆菌、厌氧菌、双歧杆菌成正相关;流产次数与罗氏菌属、丹毒丝菌科正相关,与真杆菌属负相关;中医证候积分与粪球菌属呈正相关,与巨球型菌属、卡氏伯克霍氏菌、毛螺菌属呈负相关;变形杆菌门在URSA肾虚细化证型中存在显著差异。结论URSA肾虚血瘀型患者与正常女性肠道优势菌群的丰度比例存在差异,造成差异的主要贡献菌群不同。

Objective To observe the characteristics of intestinal microecology of unexplained recurrent spontaneous abortion(URSA)patients with kidney deficiency and blood stasis in non pregnant state and the difference of intestinal flora between URSA patients with kidney deficiency and blood stasis and normal women.To explore whether there is a certain correlation between URSA kidney deficiency and blood stasis syndrome and intestinal flora.Method The patients who visited the gynecology clinic and inpatient department of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from September 2020 to January 2021 were collected as the research objects.The experimental group(30 cases)were non pregnant patients with URSA kidney deficiency and blood stasis type and the control group(40 cases)were normal non pregnant women.The basic information of subjects,TCM syndromes and other data were collected.The fecal samples were collected.The intestinal flora was detected by high-throughput sequencing and the qualitative and quantitative analysis was conducted.Results There were differences in species composition,abundance,alpha and beta diversity between URSA patients with kidney deficiency and blood stasis and normal women.The age of URSA patients was positively correlated with Fecococcus,Clostridium,Anaerobic Bacteria and Bifidobacterium.The number of abortions was positively correlated with Roseburia and Erysipelothrichaceae,and negatively correlated with Eubacterium.TCM syndrome score was positively correlated with Fecococcus,and negatively correlated with Macroglobulus,Burkholderia karenii and Spirillum.The difference of Proteus in URSA kidney deficiency syndrome was statistically significant.Conclusion There is a difference in the abundance ratio of dominant gut microbiota between URSA patients with kidney deficiency and blood stasis type and normal women,and the main contributing bacteria to the difference are different.