【摘要】 目的 探讨幽门螺杆菌（Hp）感染对慢性胃炎中医证素与肠道菌群的影响及中医证素与肠道菌群的相关性，为Hp感染患者中医辨治提供参考。方法 共收集慢性胃炎患者180例（Hp阳性组50例、Hp阴性组130例）及健康人30名（健康组）。采集四诊信息，运用证素辨证方法获取慢性胃炎患者证素分布情况；采集受试者粪便进行肠道菌群16S rRNA高通量测序。结果 证素分布情况：Hp阳性组常见病位证素依次为胃、脾和肝。Hp阴性组常见病位证素依次为胃、肝和脾。Hp阳性组常见病性证素依次为气滞、湿、热、痰、阴虚、阳虚和气虚。Hp阴性组常见病性证素依次为热、阴虚、气滞、湿、痰、气虚和阳虚。肠道菌群物种组成情况：Hp阳性组、Hp阴性组及健康组优势菌门均为拟杆菌门、厚壁菌门、变形菌门、梭杆菌门和放线菌门，Hp阳性组和Hp阴性组变形菌门丰度高于健康组（P>0.05），梭杆菌门丰度低于健康组（P>0.05）。与健康组比较，Hp阳性组巴斯德菌科未知菌属丰度明显减低（P<0.01），拟杆菌目未知菌属、厚壁菌门未知菌属和考拉杆菌属丰度减低（P<0.05）。与Hp阴性组比较，Hp阳性组经黏液真杆菌属丰度明显减低（P<0.01），毛螺菌属和萨特氏菌属丰度减低（P<0.05）。Hp阳性组毛旋螺菌科UCG-010群丰度低于Hp阴性组（P<0.05）、健康组（P<0.01）。LEfSe分析共获得39个差异标记物，Hp阳性组12个，Hp阴性组27个。肠道菌群与证素的相关性：Hp阳性组毛螺菌属与肝呈正相关，与痰呈负相关；萨特氏菌属与阴虚呈正相关。Hp阴性组萨特氏菌属与肝和气滞呈正相关，与热呈负相关。结论 Hp感染对脾的影响较大，易出现气滞、湿、热和痰等实性证素。Hp感染影响正常肠道菌群的构成，降低中性菌及有益菌的丰度。更多还原

【Abstract】 Objective To investigate the effects of Helicobacter pylori(Hp) infection on TCM syndrome elements and intestinal flora of chronic gastritis and the correlation between TCM syndrome elements and intestinal flora; To provide reference for TCM discrimination and treatment of patients with Hp infection. Methods A total of 180 patients with chronic gastritis(50 cases in Hp positive group and 130 Hp negative group) and 30 healthy subjects(healthy group) were collected. The four diagnosis information was collected, and the syndrome element distribution of chronic gastritis patients was obtained by syndrome element differentiation. Feces of the subjects were collected for intestinal flora 16S rRNA high-throughput sequencing. Results The distribution of syndrome elements: in the Hp positive group, the common syndromes were stomach, spleen and liver. In Hp negative group, the common disease syndromes were stomach, liver and spleen. The common syndromes in Hp positive group were: qi stagnation,dampness, heat, phlegm, yin deficiency, yang deficiency and qi deficiency. The common syndromes in Hp negative group were heat, yin deficiency, qi stagnation, dampness, phlegm, qi deficiency and yang deficiency. Species compositionp of intestinal flora: The dominant phyla of Hp positive group, Hp negative group, and healthy group were Bacteroidetes, Firmicutes, Proteobacteria, Fusobacteria, and Actinobacteria. In Proteobacteria, the abundance of Hp positive group and Hp negative group was higher than that of the healthy group(P>0.05), while in Fusobacteria,the abundance of Hp positive group and Hp negative group was lower than that of the healthy group(P>0.05).Compared with the healthy group, the abundance of unknown genus of Pasteurella in Hp positive group was significantly reduced(P<0.01); the abundance of unknown genera of Bacteroidete, Firmicutes and Phascolarctobacterium decreased(P<0.05). Compared with Hp negative group, the abundance of Blautia in Hp positive group significantly decreased(P<0.01), and the abundance of Lachnospira and Sutterella in Hp positive group decreased(P<0.05). In the Lachnospiraceae＿UCG-010, the abundance of Hp positive group was lower than that of Hp negative group(P<0.05) and healthy group(P<0.01). A total of 39 biomarkers were obtained by LEfSe analysis, including 12 in Hp positive group and 21 in Hp negative group. The correlation between intestinal flora and syndrome elements: Lachnospira was positively correlated with liver, but negatively correlated with phlegm in Hp positive group; Sutterella was positively correlated with yin deficiency. In Hp negative group, Sutterella was positively correlated with liver and qi stagnation, negatively correlated with heat. Conclusion Hp infection has a great influence on spleen, and is prone to qi stagnation, dampness, heat, phlegm and other excessive syndromes. Hp infection affects the composition of normal intestinal flora and reduces the abundance of neutral and beneficial bacteria.更多还原