脾肾阳虚型腺瘤性结肠息肉患者肠道中致病性大肠杆菌分布变化分析

发布时间：2018-04-21 15:59

本文选题：腺瘤性结肠息肉 + 脾肾阳虚　；参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:通过对腺瘤性结肠息肉患者的临床表现进行中医临床分型、肠镜检查、病理诊断及宏基因组测序统计中医辨证分型为脾肾阳虚型腺瘤性结肠息肉患者肠道内致病性大肠杆菌的分布情况,探索脾肾阳虚型腺瘤性结肠息肉与致病性大肠杆菌感染的相关性,丰富中西医辨证治疗的内容,以更好的指导临床治疗用药。材料与方法:符合纳入标准的受试者进行肠镜检查及病理诊断,根据肠镜下所见,将所有受试者分为腺瘤组和非腺瘤组。根据粪便样本肠道菌群宏基因组测序结果,统计腺瘤组及非腺瘤组两组内致病性大肠杆菌感染数量,分析统计脾肾阳虚型腺瘤性结肠息肉与致病性大肠杆菌感染的相关性。根据受试者的临床表现由高年资中医师辨证为脾肾阳虚型且结肠镜检查后病理分型为腺瘤性结肠息肉患者分为腺瘤组,存在腹泻症状经肠镜检查确诊无结肠息肉的受试者分为非腺瘤组。1.利用lefse确定菌种类别间的差异特征;2.运用metastats分析非腺瘤组与腺瘤组间肠道内致病性大肠杆菌分布的显著性差异。证明脾肾阳虚型腺瘤性结肠息肉和致病性大肠杆菌感染有相关性。结果:1.腺瘤组与非腺瘤组相比肠道内致病性大肠杆菌数量存在明显差异(P0.05)。2.腺瘤组致病性大肠杆菌数量明显高于非腺瘤组。结论:整体观测脾肾阳虚型腺瘤性结肠息肉患者肠道内致病性大肠杆菌的感染情况,发现中医辨证为脾肾阳虚型腺瘤性结肠息肉的患者肠道内致病性大肠杆菌数量较非腺瘤组明显增多(P0.05)。与所发现的结肠息肉患者中医辨证分型与体质学说相互结合,说明通过调整肠道菌群结构是潜在的可应用于治疗腺瘤样结肠息肉患者临床治疗的新方法。
[Abstract]:Objective: to study the clinical manifestations of adenomatous colonic polyps by traditional Chinese medicine (TCM) and endoscopy. Pathological diagnosis and macro genome sequencing were used to analyze the distribution of pathogenic Escherichia coli in the intestine of patients with adenomatous colonic polyps of spleen and kidney yang deficiency type. To explore the correlation between adenomatous colonic polyps and pathogenic Escherichia coli infection of spleen and kidney yang deficiency type, enrich the content of TCM and western medicine differentiation treatment, and guide the clinical treatment better. Materials and methods: all subjects were divided into adenoma group and non-adenoma group. According to the results of microflora macro genome sequencing in fecal samples, the number of pathogenic Escherichia coli infection in adenoma group and non-adenoma group was counted, and the correlation between adenomatous colonic polyp of spleen and kidney yang deficiency type and pathogenic Escherichia coli infection was analyzed. Patients with adenomatous colonic polyps were classified as adenomatous colonic polyps after colonoscopy according to the clinical manifestations of the subjects, who were diagnosed as deficiency of spleen and kidney yang according to their clinical manifestations, and were divided into adenoma group. Patients with diarrhea diagnosed by colonoscopy were divided into non-adenoma group. 1. Lefse was used to determine the characteristics of the difference between species. The distribution of pathogenic Escherichia coli in intestinal tract between nonadenoma group and adenoma group was analyzed by metastats. It was proved that adenomatous colonic polyps and pathogenic Escherichia coli infection were associated with deficiency of spleen and kidney yang. The result is 1: 1. There was significant difference in the number of pathogenic Escherichia coli between adenoma group and non-adenoma group. The number of pathogenic Escherichia coli in adenoma group was significantly higher than that in non-adenoma group. Conclusion: the infection of intestinal pathogenic Escherichia coli in patients with adenomatous colonic polyps with deficiency of spleen and kidney yang was observed. It was found that the number of pathogenic Escherichia coli in the intestinal tract of the patients with adenomatous colonic polyps of spleen and kidney yang deficiency syndrome differentiation was significantly higher than that of non-adenoma patients (P 0.05). The combination of TCM syndrome differentiation and physique theory of colonic polyps showed that adjusting intestinal flora structure was a potential new method for the treatment of adenomatous colonic polyps.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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