Gut microbiota contributes to the distinction between two traditional Chinese medicine syndromes of ulcerative colitis

BACKGROUND Ulcerative colitis(UC)is considered to be closely associated with alteration of intestinal microorganisms.According to the traditional Chinese medicine(TCM)theory,UC can be divided into two disease syndromes called Pi-Xu-Shi-Yun(PXSY)and Da-Chang-Shi-Re(DCSR).The relationships among gut microbiota,TCM syndromes,and UC pathogenesis have not been well investigated.AIM To investigate the role of gut microbiota in UC and the distinction of microbiota dysbiosis between PXSY and DCSR syndromes.METHODS From May 2015 to February 2016,UC patients presenting to LongHua Hospital who met the established inclusion and exclusion criteria were enrolled in this retrospective study.Fresh stool specimens of UC patients with PXSY or DCSR were collected.The feces of the control group came from the health examination population of Longhua Hospital.The composition of gut bacterial communities in stool samples was determined by the pyrosequencing of 16S ribosomal RNA.The high-throughput sequencing reads were processed with QIIME,and biological functions were predicted using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States.RESULTS The composition of gut bacterial communities in 93 stool samples(30 healthy controls,32 patients with PXSY syndrome,and 31 patients with DCSR syndrome)was determined by the pyrosequencing of 16S ribosomal RNA.Beta diversity showed that the composition of the microbiota was different among the three groups.At the family level,Porphyromonadaceae,Rikeneliaceae,and Lachnospiraceae significantly decreased while Enterococcus,Streptococcus,and other potential pathogens significantly increased in UC patients compared to healthy subjects.At the genus level,Parabacteroides,Dorea,and Ruminococcus decreased while Faeca-libacterium showed increased abundance in UC compared to healthy controls.Five differential taxa were identified between PXSY and DCSR syndromes.At the genus level,a significantly increased abundance of Streptococcus was observed in DCSR patients,while Lachnoclostridium increased in PXSY patients.The differential functional pathways of the gut microbiome between the PXSY and DCSR groups mainly included lipid metabolism,immunity,and the metabolism of polypeptides.CONCLUSION Our study suggests that the gut microbiota contributes to the distinction between the two TCM syndromes of UC.

运用五心养肾法治疗慢性肾脏病Ⅲ~Ⅳ期脾虚湿蕴证临床疗效评价

目的:观察五心养肾法治疗慢性肾脏病(CKD)Ⅲ~Ⅳ期脾虚湿蕴证的临床疗效。方法:2017年11月-2019年3月收治CKDⅢ~Ⅳ期脾虚湿蕴证患者80例,随机分为两组,各40例。两组均给予基础治疗;对照组给予脐敷治疗;试验组给予五心养肾法治疗。比较两组治疗效果。结果:试验组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。试验组治疗后中医症候积分低于对照组,差异有统计学意义(P<0.05)。试验组治疗后血肌酐(SCr)、肾小球滤过率(GFR)及24 h尿蛋白定量等指标水平均优于对照组,差异有统计学意义(P<0.05)。结论:五心养肾法能有效改善CKDⅢ~Ⅳ期脾虚湿蕴证患者SCr及24 h尿蛋白水平,提升GRF水平,改善临床症状,延缓病情进展。