摘要
目的:探讨结直肠癌患者术后化学治疗(简称化疗)期间舌苔变化与舌苔菌群的关系。方法:选取2023年6月至2024年4月哈尔滨医科大学附属第一医院中西医结合肿瘤科收治的结直肠癌化疗患者99例,用道生舌诊仪记录其舌象特征,按照舌苔类型分为薄白苔(BBT)、白厚苔(BHT)、白腻苔(BNT),按照化疗周期分为BBT化疗1~4周期(A1)、BBT化疗5~8周期(A2);BNT化疗1~4周期(B1)、BNT化疗5~8周期(B2);BHT化疗1~4周期(C1)、BHT化疗5~8周期(C2)。采集其中48例BBT、BHT、BNT患者舌苔样本,用高通量5R 16S rDNA测序分析菌群。结果:结直肠癌患者化疗期间舌苔以BBT、BHT、BNT为主。结直肠癌化疗患者BBT、BHT和BNT菌群结构前5位相同,丰度相近。随着化疗周期的延长,患者舌苔由腻苔占比高向薄苔占比高转变,并与舌苔菌群丰度变化相关。结直肠癌化疗患者BBT特征性菌属为卟啉单胞菌属(Porphyromonas)和副球菌属(Paracoccus);BHT特征性菌属为巨球型菌属(Megasphaera);BNT特征性菌属为口腔杆菌属(Oribacterium)、变形杆菌属(Proteus)和魏斯氏菌属(Weissella)。BBT长期化疗变形杆菌门和梭杆菌属丰度高于短期化疗(P<0.05);BHT长期化疗放线菌属丰度高于短期化疗(P<0.05);BNT长期化疗纤毛菌属丰度高于短期化疗(P<0.05)。结论:结直肠癌患者术后化疗期间舌苔菌群微生态相对稳定,舌苔以BBT、BHT、BNT为主,不同舌苔具有相似的菌群结构和不同的丰度;随着化疗周期的延长,舌苔有趋势性变化,BBT占比增加,其致病菌丰度增高。
Objective:To investigate the relationship between tongue coating changes and tongue microbiota in colorectal cancer(CRC)patients during postoperative chemotherapy.Methods:Ninety-nine CRC patients undergoing chemotherapy were recruited from the Department of Integrative Oncology,The First Affiliated Hospital of Harbin Medical University,between June 2023 and April 2024.Tongue characteristics were recorded using the DS01-B tongue diagnostic instrument.Patients were categorized into three groups based on tongue coating type:thin white coating(BBT),thick white coating(BHT),and greasy white coating(BNT).Each group was further divided according to chemotherapy cycle:BBT at cycles 1 to 4(A1)and 5 to 8(A2);BNT at cycles 1 to 4(B1)and 5 to 8(B2);BHT at cycles 1 to 4(C1)and 5 to 8(C2).Tongue coating samples were collected from 48 patients and subjected to high-throughput 5-region 16S rDNA sequencing to analyze microbial composition.Results:BBT,BHT,and BNT were the predominant tongue coatings observed during chemotherapy in CRC patients.The top five genera were consistent across the three coating types,with similar relative abundances.As chemotherapy progressed,there was a tendency for tongue coatings to shift from greasy to thin types,correlating with changes in microbial abundance.Characteristic genera were identified for each tongue coating:Porphyromonas and Paracoccus for BBT,Megasphaera for BHT,and Oribacterium,Proteus,and Weissella for BNT.In long-term chemotherapy,BBT samples showed higher abundance of Proteobacteria and Clostridium than that in short-term chemotherapy(P<0.05),BHT samples exhibited increased Actinomyces(P<0.05),and BNT samples had elevated Ciliophora(P<0.05).Conclusion:The tongue microbiota of CRC patients remains relatively stable during chemotherapy,with BBT,BHT,and BNT as the predominant coating types.While microbial community structure is similar across coating types,relative abundance differs.Tongue coating shows a changing trend with prolonged chemotherapy,accompanied by an increase in pathogenic microbial abundance,particularly in BBT.
作者
吴文萱
蒋寒冰
任少杰
徐巍
WU Wenxuan;JIANG Hanbing;REN Shaojie;XU Wei(The First Clinical Medical College of Harbin Medical University,Harbin 150081,China;The First Hospital of Harbin Medical University,Harbin 150001,China)
出处
《世界中医药》
北大核心
2025年第11期1983-1992,共10页
World Chinese Medicine
基金
中西医协同“旗舰”科室建设项目(国中医药综结合函〔2024〕221号)
国家区域中医(专科)诊疗中心(肿瘤)培育单位项目(国中医药医政函〔2018〕205号)
中医优势专科建设项目(黑中医药综涵〔2022〕36号)
黑龙江省中医药科研项目(ZHY2020-166)
哈尔滨医科大学附属第一医院科研创新基金项目(2020M25)。
关键词
结直肠癌
舌象
中医舌苔
舌苔菌群
化疗
薄白苔
白厚苔
白腻苔
Colorectal cancer
Tongue manifestation
TCM tongue coating
Tongue microbiota
Chemotherapy
Thin white coating
Thick white coating
Greasy white coating
