利用16SrDNA分析清胆泄热法治疗慢性鼻—鼻窦炎患者的鼻腔菌群结构变化

发布时间：2018-05-01 20:58

本文选题：慢性鼻-鼻窦炎 + 鼻渊舒口服液　；参考：《成都中医药大学》2016年硕士论文

【摘要】：研究目的本课题旨在利用16SrDNA分析鼻腔菌群结构,探讨鼻渊舒口服液作为清胆泄热法的代表方在治疗胆腑郁热证慢性鼻-鼻窦炎方面的作用机制。研究方法将符合标准的12例胆腑郁热型慢性鼻-鼻窦炎患者及9例健康正常人纳入组取其中鼻道分泌物,并予以慢性鼻-鼻窦炎病人组华神集团生产的鼻渊舒口服液,每日3次,每次1支,2周治疗结束后再次取同侧中鼻道分泌物。利用16SrDNA克隆文库测序分析法检测各组鼻腔细菌菌群结构表达情况。最后经统计学分析,得出结论。研究结果慢性鼻-鼻窦炎病人组中样品最大shannon指数为1.406,Simpson指数最小为0.213,服用鼻渊舒口服液后的鼻窦炎患者组中最大shannon指数为0.453,simpson指数最小为0.103,健康正常人的shannon指数最大为0.952,Simpson指数最小为0.15。慢性鼻-鼻窦炎患者组的鼻腔菌群多样性较健康正常人高,服用鼻渊舒口服液治疗后的慢性鼻-鼻窦炎患者鼻腔菌群多样性有所降低,较健康正常人低。鼻窦炎病人组的菌群结构为Staphylococcaceae占67.53%, Enterobacteriaceae占22.34%,Streptococcaceae占5.87%,Pseudomonadaceae占0.91%,Oxalobacteraceae占0.28%,Xanthomonadaceae占0.21%。服用鼻渊舒治疗后的鼻窦炎病人组菌群比例为Enterobacteriaceae占95.28%,Staphylococcaceae占3.24%、Streptococcaceae占0.93%,其余细菌均未达到0.1%。健康正常人组菌群比例为Staphylococcaceae占96.12%,Enterobacteriaceae 占 0.85%, Streptococcaceae占0.51%,其余细菌均未达到0.1%。结论①慢性鼻-鼻窦炎患者较正常健康人鼻腔菌群多样性高,二者菌群比例有所不同,但优势菌都为Staphylococcaceae,推测慢性鼻-鼻窦炎发病是条件致病菌引起的。②服用鼻渊舒口服液治疗后的慢性鼻-鼻窦炎患者的菌群多样性减少,优势菌群的科属发生改变,推测鼻渊舒口服液治疗慢性鼻-鼻窦炎的作用机制在于改变鼻腔内环境,调整鼻腔菌群结构,抑制条件致病菌生长。
[Abstract]:Objective to investigate the mechanism of Biyuanshu oral liquid in treating chronic rhinosinusitis with chronic rhinosinusitis by 16SrDNA. Methods 12 patients with chronic rhinosinusitis and 9 healthy controls were included in the study group. The nasal secretions were collected from the patients with chronic rhinosinusitis and were treated with Biyuanshu oral liquid produced by Huaxin Group, a group of patients with chronic rhinosinusitis. After 2 weeks of treatment, the secretion of middle nasal canal was collected again 3 times a day. The expression of bacterial flora in nasal cavity was detected by sequencing analysis of 16SrDNA clone library. Finally, by statistical analysis, draw a conclusion. Results the maximum shannon index of samples in patients with chronic rhinosinusitis was 1.406 and the minimum was 0.213. The maximum shannon index of sinusitis patients after taking Biyuanshu oral liquid was 0.453 and the minimum was 0.103. The shannon index of healthy people was the highest. Dawei 0.952 Simpson index minimum 0.15. The diversity of nasal microflora in patients with chronic rhinosinusitis was higher than that in healthy subjects, and the diversity of nasal flora in patients with chronic rhinosinusitis was lower than that in healthy subjects after treatment with Biyuanshu oral liquid. In sinusitis group, the microflora structure was Staphylococcaceae (67.53), Enterobacteriaceae (22.34) and Streptococcaceae (5.87). Pseudomonadaceae was 0.91% and Oxalobacteraceae was 0.280.28%, Xanthomonadaceae was 0.21%. The proportion of bacteria in patients with sinusitis treated with Biyuanshu was 95.2828. Staphylococcaceae was 3.24 and Streptococcaceae was 0.93.The other bacteria did not reach 0.1. In healthy people, the proportion of bacteria in Staphylococcaceae was 96.12, 0.85 in Enterobacteriaceae, 0.51in Streptococcaceae, none of the other bacteria had reached 0.1. Conclusion (1) the diversity of nasal flora in patients with chronic rhinosinusitis is higher than that in normal controls. But the dominant bacteria were Staphylococcaceae. it was speculated that the incidence of chronic rhinosinusitis was caused by opportunistic bacteria. 2. The diversity of bacteria in patients with chronic rhinosinusitis treated with Biyuanshu oral solution was decreased, and the family and genus of dominant bacteria were changed. It is inferred that the mechanism of Biyuanshu oral liquid in treating chronic rhinosinusitis lies in changing the intranasal environment, adjusting the structure of nasal flora and inhibiting the growth of conditioned pathogens.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R276.1

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