Features of intestinal microbiota in hepatitis B cirrhosis patients with amassment or tympanites type of liver-kidney Yin deficiency syndrome: A comparative analysis

Objective To investigate the distribution of intestinal microbiota in hepatitis B cirrhosis patients with amassment or tympanites type of liver-kidney Yin deficiency syndrome through a comparative analysis.Methods A total of 21 hepatitis B cirrhosis patients with amassment type of liver-kidney Yin deficiency syndrome (without ascites) and 15 hepatitis B cirrhosis patients with tympanites type of liver-kidney Yin deficiency syndrome (with ascites) who were treated in Department of Liver Cirrhosis, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, from October to December, 2016 were enrolled as amassment group and tympanites group, respectively.Stool samples were collected, and DNA was extracted and sequenced by 16S rRNA sequencing technology.The Wilcoxon rank-sum test was used for comparison of categorical data;The Mann-Whitney U test was used for comparison of continuous data between groups.The ADE 4 software package of R package (v.2.15.3) was used for principal component analysis, and the abundance of operational taxonomic units (OTUs) in each sample was used to determine whether the amassment and tympanites types of liver-kidney Yin deficiency syndrome could be distinguished.Multiple hypothesis tests were used for comparison of relative abundance of each species between groups and were adjusted by Benjamini and Hochberg false discovery rate (FDR) , and Pfdr<0.05 was considered statistically significant.Results Compared with the amassment group at the phylum level, the tympanites group had a significant increase in the abundance of Proteobacteria (Pfdr=0.009) and a significant reduction in the abundance of Bacteroidetes (Pfdr=0.048) , as well as slight reductions in the abundance of Actinobacteria (Pfdr>0.05) and Firmicutes (Pfdr>0.05) .Compared with the amassment group at the genus level, the tympanites group had significant increases in the abundance of Enterobacter (Pfdr=0.035) and Escherichia-Shigella (Pfdr=0.007) of the Proteobacteria phylum, as well as significant reductions in the abundance of Bifidobacterium (Pfdr=0.009) and Actinomyces (Pfdr=0.04) of the Acfinobacteria phylum and the abundance of Lachnospira (Pfdr=0.003) , Butyrivibrio (Pfdr=0.009) , Pseudobutyrivibrio (Pfdr=0.041) , Roseburia (Pfdr=0.049) , and Faecalibacterium (Pfdr=0.021) of the Firmicutes phylum.Conclusion Compared with the hepatitis B cirrhosis patients with amassment type of liver-kidney Yin deficiency syndrome, the patients with tympanites type have significant reductions in probiotic bacteria and significant increases in conditioned pathogens in intestinal microbiota, suggesting that in hepatitis B cirrhosis patients with tympanites type of liver-kidney Yin deficiency syndrome, besides liver-kidney nourishing therapy, stomach/intestine-cleansing therapy should also be adopted to regulate the imbalance of intestinal microbiota.