帕金森病肠道菌群与中医证候的相关性研究
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摘要
目的:探讨帕金森病(PD)患者肠道菌群与中医证候的相关性。方法:随机纳入门诊PD患者(18例),分别采用PD证候要素量表(PD-PES-13)进行中医证候辨别,16S rDNA高通量测序分析患者粪便菌群类别结构,Pearson相关性分析及Spearman相关性分析进行组间相关性分析。结果:PD患者内热证(8例)与拟杆菌门呈正相关(r=-0.534,P=0.022),与厚壁菌门呈负相关(r=-0.480,P=0.044),痰浊证(6例)与厚壁菌门呈负相关(r=-0.470,P=0.049),阴虚证(6例)与软壁菌门呈负相关(r=-0.572,P=0.013)。结论:PD具有多种肠道菌群寄生,拟杆菌门与中医内热证相关,而非特异的厚壁菌门分别与内热证和痰浊证负相关,其对中医药选择治疗具有潜在指导价值。
Objective: To explore the correlation between intestinal flora and TCM syndromes in patients with Parkinson's disease. Methods: Patients with Parkinson's disease(18 cases) were randomly enrolled in the outpatient clinic. TCM syndrome elements were distinguished by the Parkinson's disease pattern element scale of PD(PD-PES-13). The fecal flora structure of the subjects was analyzed by high-throughput 16 S rDNA sequencing, Pearson correlation analysis and Spearman correlation analysis were used to analyze the inter-group correlation. Results: There was a positive correlation between Parkinson's internal heat syndrome and Bacteroides(r=-0.534, P=0.022), a negative correlation between internal heat syndrome and sclerenchyma(r=-0.480, P=0.044), and a negative correlation between phlegm turbidity syndrome and sclerenchyma(r=-0.470,P=0.049). There was a negative correlation between yin deficiency syndrome and teneribacteria(r=-0.572, P=0.013). Conclusion:Parkinson's disease has a variety of intestinal flora parasitism. Bacteroides are related to TCM internal heat syndrome, while nonspecific thick-walled bacteria are negatively related to internal heat syndrome and phlegm turbidity syndrome respectively. They have potential guiding value for Chinese medicine treatment.
Objective: To explore the correlation between intestinal flora and TCM syndromes in patients with Parkinson's disease. Methods: Patients with Parkinson's disease(18 cases) were randomly enrolled in the outpatient clinic. TCM syndrome elements were distinguished by the Parkinson's disease pattern element scale of PD(PD-PES-13). The fecal flora structure of the subjects was analyzed by high-throughput 16 S rDNA sequencing, Pearson correlation analysis and Spearman correlation analysis were used to analyze the inter-group correlation. Results: There was a positive correlation between Parkinson's internal heat syndrome and Bacteroides(r=-0.534, P=0.022), a negative correlation between internal heat syndrome and sclerenchyma(r=-0.480, P=0.044), and a negative correlation between phlegm turbidity syndrome and sclerenchyma(r=-0.470,P=0.049). There was a negative correlation between yin deficiency syndrome and teneribacteria(r=-0.572, P=0.013). Conclusion:Parkinson's disease has a variety of intestinal flora parasitism. Bacteroides are related to TCM internal heat syndrome, while nonspecific thick-walled bacteria are negatively related to internal heat syndrome and phlegm turbidity syndrome respectively. They have potential guiding value for Chinese medicine treatment.
引文
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[24]李婷,田金洲,秦斌,等.帕金森病中医证候与运动症状的相关性研究.云南中医学院学报,2016,39(5):65-68
[25]水冰洁,温成平,范永升,等.解毒祛瘀滋阴方对系统性红斑狼疮小鼠肠道菌群的调节作用.中华中医药杂志,2015,30(7):2464-2469
[26]Xie W D,Gu D Y,Li J N,et al.Effects and action mechanisms of berberine and rhizoma coptidis on gut microbes and obesity in high-fat diet-fed C57BL/6J mice.PLoS One,2011,6(9):e24520
[27]王彩娟.帕金森病认知功能障碍患者中医证型分布规律.长春中医药大学学报,2016,32(4):770-772
[2]Zhang Z X,Roman G C,Hong Z,et al.Parkinson’s disease in China:Prevalence in Beijing, Xian, and Shanghai.Lancet,2005,365(9495):595-597
[3]Dickson D W,Braak H,Duda J E,et al.Neuropathological assessment of Parkinson’s disease:Refining the diagnostic criteria.Lancet Neurol,2009,8:1150-1157
[4]Braak H,Del Tredici K,Rub U,et al.Staging of brain pathology related to sporadic Parkinson’s disease.Neurobiol Aging,2003,24:197-211
[5]Lin A,Zheng W,He Y,et al.Gut microbiota in patients with Parkinson’s disease in southern China.Parkinsonism&Related Disorders,2018,53:82-88
[6]Scheperjans F,Aho V,Pereira P A,et al.Gut microbiota are related to Parkinson’s disease and clinical phenotype.Mov Disord,2015,30(3):350-358
[7]Lees A J,Hard J,Revesz T.Parkinson’s disease.Lancet,2009,373(9680):2055-2066
[8]靳昭辉.帕金森病中医证候分型诊断量表及中医证候特征研究.北京:北京中医药大学,2015
[9]王永炎,李明富,戴锡盟,等.中医内科学.6版.上海:上海科学技术出版社,1994:369-370
[10]杨宁,过伟峰,刘卫国,等.350例帕金森病患者中医证候特点分析.长春中医药大学学报,2018,34(2):285-287
[11]陈婉珉.帕金森病中医证候要素及证型分布规律的研究.广州:广州中医药大学,2009
[12]霍青,刘萍,黄银龙.帕金森病证候规律的临床研究.世界中西医结合杂志,2017,12(11):1486-1489
[13]Qin J,Li R,Raes J,et al.A human gut microbial gene catalogue established by metagenomic sequencing.Nature,2010,464(7285):59-65
[14]刘慧,孙涛.肠道菌群失调的研究进展.医学综述,2014,20(3):468-471
[15]甄建华,于河,谷晓红.肠道微生态医学研究进展概述.中华中医药杂志,2017,32(7):3069-3075
[16]Braak H,Del Tredici K,Rub U,et al.Staging of brain pathology related to sporadic Parkinson’s disease.Neurobiol Aging,2003,24:197-211
[17]Hawkes C H, Del Tredici K,Braak H.Parkinson’s disease:A dualhit hypothesis.Neuropathol Appl Neurobiol,2007,33:599
[18]Holmqvist S,Chutna O,Bousset L,et al.Direct evidence of Parkinson pathology spread from the gastrointestinal tract to the brain in rats.Acta Neuropathol,2014,128:805-820
[19]Klingelhoefer L,Reichmann H.The gut and nonmotor symptoms in Parkinson’s disease.Int Rev Neurobiol,2017,134:787-809
[20]Lebouvier T,Neunlist M,Bruleydes Varannes S,et al.Colonic biopsies to assess the neuropathology of Parkinson’s disease and its relationship with symptoms.PLoS One,2010,5:e12728
[21]Minato T,Maeda T,Fujisawa Y,et al.Progression of Parkinson’s disease is associated with gut dysbiosis:Two-year follow-up study.PLo S One,2017,12(11):e0187307
[22]Scheperjans F,Aho V,Pereira P A,et al.Gut microbiota are related to Parkinson’s disease and clinical phenotype.Mov Disord,2015,30(3):350-358
[23]李雨濛,时晶,李婷,等.帕金森病抑郁的中医证候要素特征研究.环球中医药,2018,11(1):44-47
[24]李婷,田金洲,秦斌,等.帕金森病中医证候与运动症状的相关性研究.云南中医学院学报,2016,39(5):65-68
[25]水冰洁,温成平,范永升,等.解毒祛瘀滋阴方对系统性红斑狼疮小鼠肠道菌群的调节作用.中华中医药杂志,2015,30(7):2464-2469
[26]Xie W D,Gu D Y,Li J N,et al.Effects and action mechanisms of berberine and rhizoma coptidis on gut microbes and obesity in high-fat diet-fed C57BL/6J mice.PLoS One,2011,6(9):e24520
[27]王彩娟.帕金森病认知功能障碍患者中医证型分布规律.长春中医药大学学报,2016,32(4):770-772