Study On Intestinal Microflora Of Graves’ Disease Patients With Liver Stagnation

Objective:In this study,the type and quantity of intestinal microbial communities in stool specimens of patients with toxic diffuse goiter(Graves disease,referred to as GD)were detected,and compared with healthy people,as well as newly diagnosed liver-stagnation type GD patients(liver stagnation of qi Syndrome,liver depression and spleen deficiency syndrome)of the intestinal flora characteristics.Methods: Collection of newly diagnosed GD patients who visited the thyroid diagnosis and treatment center of Hubei Academy of traditional Chinese medicine(TCM)between August 2020 and December 2020,we enrolled 15 GD patients to form a GD test group according to the diagnostic criteria,and recruited 15 healthy volunteers to establish a healthy control(control)group.The fecal samples of these 30 cases were collected and stained with 16 S ribosomal DNA(16S ribosome DNA,16 S r DNA)high-throughput sequencing techniques were used to quantify and qualitatively analyze the gut microbial communities in the collected 30 fecal samples,analyze the differences in the richness,diversity and structural composition of their gut microbial communities,and explore the correlation between the gut microbiota and related clinical indicators.Result: 1.There were no statistically significant differences in gender,age,and BMI between patients with GD and normal controls.There were no statistically significant differences in gender,age,and BMI between patients with GD and different syndrome types(liver stagnation syndrome group,liver stagnation spleen deficiency syndrome group),and there were differences in TCM syndrome between the two groups.2.The community richness of GD patients was lower than that of the Control group(P<0.05),and the community coverage of GD patients was higher than that of the control group,and there was no significant difference in the community evenness and diversity between the two groups(P>0.05).3.Compared with the Control group,the number of Fusobacterium Phylum、Fusobacterium Class 、 Fusobacterium Order 、 Fusobacterium Famliy 、Fusobacterium Genus 、 corynebacerials(actinomycetes)was significantly increased in GD group,while the thickness of the bacteria,pseudobacteria and actinomycetes were significantly decreased(P<0.05).4.Compared with the liver stagnation and qi stagnation group,the abundance of Romboutsia 、 Bacteroidetes Phylum 、 Bacteroidetes Class 、 Bacteroidetes Genus,and Gastrostreptococcus in the syndrome group of liver stagnation an qi stagnation group increased.Abundance of Clostridium,Spirulina,Veillonellales Selenomonadales,Ruminococcus,Lachnoclostridium,Coprobacter Erysipelas,Firmicutes,and Lactobacillus decreased.There were significant differences in Bacteroidetes,Firmicutes,Ruminococcus and Coprobacillus between the two groups.5.Analysis of relevant clinical indicators in GD group:the genus Roseburia was positively correlated with TGAb,the genera monoglobuslachnospira were negatively correlated with TPOAb,the genus parabacteria was negatively correlated with TRAb,the genus faecalibacterium was positively correlated with BMI,and the genus ucg-003 in the family rosacea was negatively correlated with BMI.Faecalibacterium,Bifidobacterium,butyricicoccus,lachnospiraceae＿The ucg-004 genus,lachnospiraceae＿ND3007＿Group genera were all positively associated with TSH.Conclusion: This study shows that the intestinal microflora of newly diagnosed GD patients with liver depression is similar to that of healthy people,the intestinal flora showed the disorder of flora abundance which regulated immune balance in GD group.And the symptoms of weight loss and depression in GD patients may be related to the intestinal flora involved in energy metabolism.The relationship between thyroid function and thyroid autoimmune antibody level and the flora regulating Th17/Treg balance,Th1/Th2 balance and related inflammatory factors suggests that intestinal flora may be involved in the pathogenesis of GD and the specific mechanism remains to be verified.It is possible to prevent and treat GD by improving or regulating the structure of intestinal flora.It may have a certain guiding significance for the subsequent Shugan Jianpi method to improve the intestinal flora of GD patients with liver depression,but it needs further verification.