补中益气汤对便秘型肠易激综合征脾胃虚弱证肠道菌群的影响OA

Objective To investigate the clinical efficacy of Buzhong Yiqi Decoction in treating constipation-predominant irritable bowel syndrome(IBS-C)with spleen-stomach deficiency pattern,and its effects on gut microbiota.Methods A total of 120 patients with IBS-C were randomly assigned,using a random number table,to a treatment group and a control A group,with 60 patients in each group.In addition,60 age-and sex-matched healthy individuals undergoing physical examination during the same period were selected as control B group.The control A group received conventional Western medical treatment,while the treatment group received Buzhong Yiqi Decoction.The two patient groups were compared in terms of traditional Chinese medicine syndrome score(TCMSS),Cleveland Clinic Constipation Score(CCS),Irritable Bowel Syndrome-Quality of Life questionnaire(IBS-QOL)score,levels of somatostatin(SS),neuropeptide Y(NPY),substance P(SP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-8,anorectal dynamic parameters during simulated defecation,including maximal anal squeeze pressure(MSP),net anal sphincter decompression,rectal volume at sensory threshold(RVST),defecation threshold,and rectal compliance(RC),gut microbiota counts,clinical efficacy,adverse reactions,and recurrence.High-throughput sequencing was performed using the Hiseq2000 system to analyze the relative abundance of the microbiota.Alpha diversity indices were used to assess the diversity of the gut microbiota,followed by principal component analysis.Results After treatment,compared with the control A group,the treatment group showed lower TCMSS,CCS,net anal sphincter decompression,RVST,defecation threshold,RC,SS,NPY,TNF-α,IL-6,and IL-8 levels,as well as lower counts of Enterobacter,Enterococcus,and Bacteroides(P<0.05).The treatment group showed higher IBS-QOL scores,MSP,SP levels,and counts of Bifidobacterium and Lactobacillus(P<0.05).The total effective rate was 93.33%(56/60)in the treatment group and 80.00%(48/60)in the control group,with a significantly higher total effective rate in the treatment group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Compared with the control A group,the recurrence rate was lower in the treatment group(P<0.05).The relative abundance and diversity of the gut microbiota in the treatment group were significantly better than those in the control A group.After treatment,compared with the control A group,the positions of the treatment group and control B group were closer in the two-dimensional coordinate system.Conclusion Buzhong Yiqi Decoction can significantly improve clinical symptoms in patients with IBS-C and markedly improve the relative abundance and diversity of the gut microbiota,bringing them closer to those of healthy individuals undergoing physical examination.