【摘要】 目的：探讨慢性萎缩性胃炎（CAG）不同萎缩范围中医证素分布差异及与肠道菌群的相关性。方法：应用Kimura-Takemoto分类法将120例CAG患者进行镜下萎缩范围分级，运用证素辨证方法分析CAG不同萎缩范围的证素分布差异，并运用16S rRNA测序方法进行肠道菌群检测，寻找差异菌群，分析CAG病证演变特点及生物学基础。结果：证素分布情况：CAG患者常见病位证素为胃、脾、肝、心神，常见病性证素为气滞、热、阴虚、湿、痰、气虚、阳虚、阳亢、血虚、血瘀。当CAG萎缩范围从C-1发展至C-3阶段，病位证素心神的占比逐渐升高，病性证素中实性证素占比呈下降趋势，虚性证素占比呈上升趋势，呈现由实转虚、虚实夹杂的病机转化规律。CAG不同萎缩范围肠道菌群分布差异：LEfSe分析共获得4个生物标记物。物种组成情况，在属水平上，普雷沃菌属（Prevotella）在C-3组丰富度较C-1组显著富集（P<0.05），双歧杆菌属（Bifidobacterium）在C-3组丰富度较C-1组显著减少（P<0.05）。结论：CAG不同萎缩范围患者证素分布存在差异，其肠道菌群的多样性及特定菌群丰度存在差异，肠道菌群失调与CAG的发生和发展密切相关。更多还原

【Abstract】 Objective: To explore the correlation between the distribution of traditional Chinese medicine(TCM)syndrome elements and intestinal flora in different atrophy degrees of chronic atrophic gastritis(CAG). Methods: A total of 120CAG patients were classified by Kimura-Takemoto classification under microscope, and syndrome differentiation method was used to analyze the distribution difference of syndrome elements in different atrophic degrees of CAG. In addition, 16S rRNA sequencing method was used to detect intestinal flora, find the difference of flora, and analyze the evolution characteristics and biological basis of CAG. Results: The distribution of syndrome elements: The common disease-position syndrome elements from high to low of CAG are: stomach, liver, spleen, and mind. Common disease location syndrome elements, the syndrome elements are: qi stagnation, heat, yin deficiency, dampness, phlegm, qi deficiency, food accumulation, yang deficiency, yang hyperactivity,blood deficiency and blood stasis. When CAG atrophy ranges from C-1 to C-3, The proportion of disease location syndrome and mind gradually increased. The proportion of solid syndrome element was decreasing and that of deficiency syndrome element was increasing. The pathogenesis of the disease was changed from real to virtual and mixed with virtual and real. The difference of intestinal flora distribution in different atrophic degrees of CAG: a total of 4 biomarkers were obtained by LEfse analyse. In terms of species composition, at the genus level, Prevotella was more abundant in group C-3 than in group C-1(P<0.05). The abundance of Bifidobacterium in C-3 group was significantly lower than that in C-1 group(P<0.05). Conclusion: The diversity of intestinal flora and the abundance of specific flora were different in patients with different atrophy degrees of CAG, dysregulation of intestinal flora is closely related to the occurrence and development of CAG.更多还原