基于肠道菌群探讨痰湿体质与高尿酸血症的相关机制*

作者：曹凤娇，易文明，吴梦玮，侯秀娟

单位：北京中医药大学东方医院，北京 100078

引用：引用：曹凤娇，易文明，吴梦玮，侯秀娟.基于肠道菌群探讨痰湿体质与高尿酸血症的相关机制[J].中医药导报,2026,32(3):88-93.

DOI：10.13862/j.cn43-1446/r.2026.03.015

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摘要：

目的：基于肠道菌群失调探讨痰湿体质与高尿酸血症（HUA）的关联机制，为中医“体病相关”理论提供生物学依据。方法：纳入平和体质健康组（A组）、痰湿体质非HUA组（B组）、痰湿体质HUA组（C组）各30例，采用16S rRNA测序分析肠道菌群结构，结合临床表型分析其相关性。结果：（1）代谢特征：B、C组体质量指数（BMI）、血尿酸（SUA）、总胆固醇（TG）显著高于A组（P<0.05），且C组SUA显著高于B组。（2）菌群多样性：B组Observed species指数低于A组（P<0.05），C组与B组比较，差异无统计学意义（P＞0.05）；PLS-DA显示3组菌群结构显著分离（AUC=1）。（3）关键差异菌属：与A组比较，B组柯林斯菌属的相对丰度较高（P<0.05），酸杆菌门、不动杆菌属、Candidatus_Koribacter菌属、葡萄球菌属、颤螺菌属的相对丰度较低（P<0.05）；与B组比较，C组瘤胃球菌属、埃希氏杆菌属、假单胞菌属、葡萄球菌属、棒状杆菌属（g_Corynebacterium）、寡养单胞菌属的丰度较高（P<0.05）。（4）菌群-表型相关性：SUA与布雷德菌属（r=0.37）、微球菌属（r=0.32）呈正相关，与Methanomethylovorans（r=-0.34）呈负相关（P<0.05）。结论：痰湿体质HUA患者肠道菌群失调更显著，柯林斯菌属富集、颤螺菌属减少，可能与“脾失健运”相关，可为靶向菌群干预提供新思路。

关键词：高尿酸血症；痰湿体质；肠道菌群；16S rRNA测序；体病相关

Abstract：

Objective: To investigate the association mechanism between phlegm-dampness constitution and hyperuricemia (HUA) based on gut microbiota dysbiosis, providing a biological basis for the TCM theory of "constitution-disease correlation". Methods: Thirty participants each from a balanced constitution healthy group (Group A), a phlegm-dampness constitution non-HUA group (Group B), and a phlegm-dampness constitution HUA group (Group C) were enrolled. 16S rRNA sequencing was used to analyze the structure of the gut microbiota, and its correlation with clinical phenotypes was assessed. Results: (1) Metabolic characteristics: BMI, SUA, and TG levels in Groups B and C were significantly higher than those in Group A (P<0.05), and SUA in Group C was significantly higher than in Group B. (2) Microbial diversity: The Observed species index in Group B was lower than that in Group A (P<0.05). The difference between Group C and Group B was not statistically significant (P>0.05). PLS-DA revealed a significant separation in microbial community structure among the three groups (AUC=1). (3) Key differential genera: Compared to Group A, Group B had a significantly higher relative abundance of Collinsella (P<0.05), and significantly lower relative abundances of Acidobacteria, Acinetobacter, Candidatus Koribacter, Staphylococcus, and Oscillospira (P<0.05). Compared to Group B, Group C had significantly higher abundances of Ruminococcus, Escherichia, Pseudomonas, Staphylococcus, g-Corynebacterium, and Stenotrophomonas (P<0.05). (4) Microbiota-phenotype correlation: SUA levels were positively correlated with Brevibacterium (r=0.37) and Micrococcus (r=0.32), and negatively correlated with Methanomethylovorans (r=-0.34) (P<0.05). Conclusion: Patients with phlegm-dampness constitution and HUA exhibit more significant gut microbiota dysbiosis, characterized by enrichment of Collinsella and depletion of Oscillospira, which may be related to "spleen failing in transportation". This provides new insights for targeted microbiota interventions.

Key words：hyperuricemia; phlegm-dampness constitution; gut microbiota; 16S rRNA sequencing; constitution-disease correlation

发布时间：2026-03-28

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