Study On The Relationship Between Changes Of TCM Syndromes And Intestinal Flora In Patients With Colorectal Cancer After The Treatment Of Warming Yang And Strengthening The Spleen

ObjectiveIIuman gut microbiota have a critical role in the progression of colorectal cancer(CRC).CRC surgical operation will further destroy the intestinal microecology of patients,which may lead to postoperative infection,diarrhea and other complications.Severe postoperative complications can affect the living quality and the survival of patients.Therefore,it is of great significance to intervene the intestinal microecology of patients after surgery.Wenyang Jianpi method has good clinical efficacy in the treatment of patients with CRC.It can reduce the postoperative clinical symptoms and improve the living quality and the prognosis of patients.It is found that traditional Chinese medicine(TCM)preparations can promote the proliferation of gut microbiota,like prebiotic,and can regulate the gut microbiota bidirectionally.This study intends to prove that Wenyang Jianpi method can reduce postoperative symptoms by regulatingthe intestinal microecology of patients,through comparing the changes of TCM syndromes in patients with spleen and kidney yang deficiency after the treatment of Wenyang Jianpi method,and analyzing the changes of the intestinal microbial structure in patients before and after the treatment compared with that of healthy people by the second generation high-throughput sequencing technology.This study hopes to provide reference for relevant research on the anti-tumor effects of TCM.MethodsThis study conducted a self-controlled trial.A total of 7 patients with spleen and kidney yang deficiency after surgery were enrolled and treated with Wenyang Jianpi Decoction for 2 weeks.TCM symptoms scores of the spleen and kidney yang deficiency were evaluated before and after the treatment.The fecal samples of the patients before and after treatment and 10 healthy subj ects(as the baseline of the study)were collected to characterize intestinal microbial information with 16S rDNA sequencing technique.Then,Alpha diversity analysis,Beta diversity analysis.gut microbiota composition analysis and multivariate statistical analysis were adopted to compare the changes of the composition of gut microbiota before and after the treatment with those of healthy people and to reveal the interaction between the changes of TCM symptoms and gut microbiota.Results1.For postoperative patients,the efficiency of Wenyang Jianpi method in alleviating the spleen and kidney yang deficiency-related symptoms was 100%.The TCM symptoms scores before the treatment,after 1 week of treatment,and after 2 weeks of treatment were 13.9±1.4,9.4±0.8,and 5.6±1.0,and there were significant differences in paired comparisons(P<0.01).2.The results of Alpha diversity analysis indicate that the richness and diversity of gut microbiota in postoperative patients were decreased compared with healthy people,but increase was observed after the treatment of Wenyang Jianpi method.3.The results of Beta diversity analysis demonstrate that postoperative patients were characterized by a degree of gut microbial dysbiosis.The composition of gut microbiota for postoperative patients was different from those of healthy people and changed after the treatment of Wenyang Jianpi method.4.There were no differences among dominant microbiome of three groups at the three levels of phylum,class and order.But at the level of family,Prevotellaceae was absent from the group of CRC patients compared with the healthy group.5.The composition of gut microbiota both changed before and after the treatment,specifically,an increase in the abundance of Bifidobacteriaceae and a decrease in Bacteroidaceae.6.There were statistically significant differences in the composition of gut microbiota between postoperative patients and healthy people(P<0.01)whether before or after the treatment,m ainly in the abundance of Enterobacteriaceae.The structure of gut microbiota for postoperative patients changed after the treatment of Wenyang Jianpi method but no statistically significant differences were detected.ConclusionThis study confirmed the statistically significant differences in the gut microbiota composition between CRC patients after surgery and healthy people.Wenyang Jianpi method can alleviate TCM symptoms of spleen and kidney yang deficiency,improve the living quality.modulate the intestinal microecology,specifically,increasing the richness and diversity of gut microbiota,enriching the probiotic Bifidobacteriaceae,and decreasing the opportunistic pathogen Bacteroidaceae,which helps the gut microbiota structure return to normal.Therefore,the mechanism of Wenyang Jianpi method to alleviate the clinical symptoms of patients with spleen and kidney yang deficiency after surgery may be correlated with modulating the intestinal microecological environment of patients.