Features of intestinal flora and their association with traditional Chinese medicine syndrome types in elderly eczema patients with different severities

Liao Qian; Zhou Shuihan; Liu Huan; Zhang Yan; Huang Shiyan

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Features of intestinal flora and their association with traditional Chinese medicine syndrome types in elderly eczema patients with different severities

更新时间：2025-08-25

- Features of intestinal flora and their association with traditional Chinese medicine syndrome types in elderly eczema patients with different severities
- Journal of Chongqing Medical University Pages: 1-9(2025)
- 作者机构：
  
  1.四川省中西医结合医院皮肤科，成都 610041
  2.成都中医药大学附属医院皮肤科，成都 610075
- 作者简介：
- 基金信息：
- DOI：
  CLC： R758.23
- Received：31 March 2025，
  
  Published Online：25 August 2025，
- 稿件说明：
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廖倩,周水涵,刘欢等.不同病情老年湿疹患者肠道菌群特征及与中医证型的相关性分析[J].重庆医科大学学报,

Liao Qian,Zhou Shuihan,Liu Huan,et al.Features of intestinal flora and their association with traditional Chinese medicine syndrome types in elderly eczema patients with different severities[J].Journal of Chongqing Medical University,
廖倩,周水涵,刘欢等.不同病情老年湿疹患者肠道菌群特征及与中医证型的相关性分析[J].重庆医科大学学报, DOI：10.13406/j.cnki.cyxb..

Liao Qian,Zhou Shuihan,Liu Huan,et al.Features of intestinal flora and their association with traditional Chinese medicine syndrome types in elderly eczema patients with different severities[J].Journal of Chongqing Medical University, DOI：10.13406/j.cnki.cyxb..

摘要

目的

探究不同病情老年湿疹（eczema，ECZ）患者肠道菌群特征及与中医证型的相关性。

方法

选择2022年9月至2024年8月于本院治疗的老年ECZ患者（

=162）为研究对象；根据ECZ面积及严重度指数（ECZ area and severity index，EASI）评分，分为轻度组（

=60）、中度组（

=55）和重度组（

=47）；根据中医证型，分为湿热浸淫证（

=55）、血虚风燥证（

=65）、脾虚湿蕴证（

=42）。对比分析肠道菌群的Alpha和Beta多样性、细菌门属水平相对丰度，并进行主成分分析（principal component analysis，PCA）。采用LEfSe分析组间差异具有统计学意义的物种。运用PICRUSt功能预测软件对序列进行分析并推测其功能基因，再与京都基因与基因组百科全书（Kyoto encyclopedia of genes and genomes，KEGG）数据库结合，预测不同中医证型组患者肠道微生物的功能。

结果

不同病情组患者的白细胞介素-2（Interleukin-2，IL-2）、IL-4、IL-5、IL-6、IL-10、IL-17、IL-18、IL-23、IL-33、肿瘤坏死因子α（t

umor necrosis factor α，TNF-α）、干扰素-γ（interferon-γ，IFN-γ）、CD8

、CD4

水平以及Beta多样性比较均差异显著（

0.05）。与轻度组相比，重度组血虚风燥证的患者比例更高（

0.05），湿热浸淫证的患者比例更低（

0.05）。不同中医证型组患者的Beta多样性以及拟杆菌、厚壁菌、变形杆菌、放线菌相对丰度比较差异显著（

0.05）。与湿热浸淫证相比，血虚风燥证患者的丙酸杆菌属、链球菌属、拟杆菌属、埃希菌属相对丰度更低（

0.05），棒杆菌属、葡萄球菌属相对丰度更高（

0.05）；脾虚湿蕴证患者的丙酸杆菌属、拟杆菌属、埃希菌属相对丰度更低（

0.05）。PCA结果显示，不同中医证型组同组样本的肠道微生物群落组成是相似的，同时与其他组样本的细菌门组成有显著差异。血虚风燥证组优势菌种主要包括Bacteroides thetaiotaomicron、Bacteroides vulgatus、Faecalibacterium prausnitzii等；脾虚湿蕴证组优势菌种主要包括Faecalibacterium prausnitzii、Roseburia intestinalis、Escherichia coli等；湿热浸淫证组优势菌种主要包括Bacteroides fragilis、Escherichia coli、Klebsiella pneumoniae等。3组功能基因主要集中在新陈代谢、环境信息处理、遗传信息处理三方面，且功能基因主要以免疫系统、脂质代谢、氨基酸代谢、碳水化合物代谢富集为主。

结论

ECZ病情严重程度与炎症因子水平升高及肠道菌群多样性降低相关。不同中医证型ECZ患者的肠道微生物组成和功能基因存在显著差异。

Abstract

Objective

To investigate the features of intestinal flora and their association with traditional Chinese medicine（TCM） syndrome types in elderly eczema（ECZ） patients with different severities.

Methods

A total of 162 elderly ECZ patients who were treated in our hospital from September 2022 to August 2024 were enrolled as subjects； according to the Eczema Area and Severity Index （EASI） score，they were divided into mild group with 60 patients，moderate group with 55 patients，and severe group with 47 patients，and according to TCM syndrome types，they were divided into excessive damp-heat syndrome group with 55 patients，blood deficiency and wind dryness syndrome group with 65 patients，and spleen deficiency and dampness accumulation syndrome group with 42 patients. The above groups were compared in terms of the alpha and beta diversities of intestinal flora and the relative abundance of bacteria at the phylum and genus levels，and a principal component analysis（PCA） was performed. LEfSe was used to analyze the species with statistical difference between groups. PICRUSt functional prediction software was used to analyze the sequence and infer its functional genes，and then it was combined with Kyoto Encyclopedia of Genes and Genomes（KEGG） database to predict the function of intestinal flora in patients with different TCM syndrome types.

Results

There were significant differences between the patients with different severities in interleukin-2（IL-2），interleukin-4，interleukin-5，interleukin-6，interleukin-10，interleukin-17，interleukin-18，interleukin-23，interleukin-33，tumor necrosis factor α（TNF-α），interferon-γ（IFN-γ），CD8

，CD4

，and beta diversity（

0.05）. Compared with the mild group，the severe group had a significantly higher proportion of patients with blood deficiency and wind dryness syndrome（

0.05） and a significantly lower proportion of patients with excessive damp-heat syndrome（

0.05）. There were significant differences between the patients with different TCM syndrome types in beta diversity and the relative abundance of Bacteroidetes，Firmicutes，Proteobacteria，and Actinobacteria（

0.05）. Compared with the patients with excessive damp-heat syndrome，the patients with blood deficiency and wind dryness syndrome had significantly lower relative abundance of Propionibacterium，Streptococcus，Bacteroides，and Escherichia（

0.05） and significantly higher relative abundance of Corynebacterium and Staphylococcus（

0.05），and the patients with spleen deficiency and dampness accumulation syndrome had significantly lower relative abundance of Propionibacterium，Bacteroides，and Escherichia（

0.05）. The results of PCA showed a similar composition of intestinal flora in the samples within the same group and significant differences in the composition of intestinal flora at the phylum level between the g

roups with different TCM syndrome types. The dominant bacterial species in the blood deficiency and wind dryness syndrome group included

Bacteroides thetaiotaomicron，Bacteroides vulgatus

，and

Faecalibactrium prausnitzii

； the dominant bacterial species in the spleen deficiency and dampness accumulation syndrome group included

Faecalibactrium prausnitzii

，

Roseburia intestinalis

，and

Escherichia coli

； the dominant bacterial species in the excessive damp-heat syndrome group included

Bacteroides fragilis

，

Escherichia coli

，and

Klebsiella pneumoniae

. The functional genes in the three groups were mainly involved in metabolism，environmental information processing，and genetic information processing，and the functional genes were mainly enriched in immune system，lipid metabolism，amino acid metabolism，and carbohydrate metabolism.

Conclusion

The severity of ECZ is associated with the increases in the levels of inflammatory factors and the reduction in the diversity of intestinal flora. There are significant differences in the composition of intestinal flora and functional genes between ECZ patients with different TCM syndromes.

关键词

Keywords

references

Hewitt N ， Fang W ， Kolodney MS . A cross-sectional comparison of eczema and psoriasis patients with regard to cardiovascular disease and risk factors [J ] . J Eur Acad Dermatol Venereol ， 2023 ， 37 （ 7 ）： e939 - e940 ．

赵艳霞，王雅莉，李彤彤，等 . 湿疹患者中医体质、辨证分型、西医分期的年发病次数分析 [J ] . 中国实验方剂学杂志， 2019 ， 25 （ 6 ）： 101 - 107 ．

Zhao YX ， Wang YL ， Li TT ， et al . Annual frequency in traditional Chinese medicine physique，syndrome differentiation and western medicine staging of 482 eczema patients [J ] . Chin J Exp Tradit Med Formulae ， 2019 ， 25 （ 6 ）： 101 - 107 ．

Drewitz KP ， Stark KJ ， Zimmermann ME ， et al . Frequency of hand eczema in the elderly： Cross-sectional findings from the German AugUR study [J ] . Contact Dermatitis ， 2021 ， 85 （ 5 ）： 489 - 493 ．

阎瑾逸，李志军 . 肠道微生态与神经系统自身免疫性疾病 [J ] . 华中科技大学学报（医学版）， 2024 ， 53 （ 4 ）： 539 - 544 ．

Yan JY ， Li ZJ . Gut microecology and neurologic autoimmune diseases [J ] . Acta Med Univ Sci Technol Huazhong ， 2024 ， 53 （ 4 ）： 539 - 544 ．

王晓旭，吴玲珺，张广中 . 从肠道菌群紊乱探讨炎症性皮肤病的发病机制 [J ] . 中国中西医结合皮肤性病学杂志， 2021 ， 20 （ 5 ）： 522 - 525 ．

Wang XX ， Wu LJ ， Zhang GZ . From the disturbance of gut microbiome： the pathologicalmechanism of inflammatory skin disease [J ] . Chin J Dermatovenereology Integr Tradit West Med ， 2021 ， 20 （ 5 ）： 522 - 525 ．

李周阳，吴　威，李威莹，等 . 中药治疗湿疹的现代研究进展 [J ] . 沈阳药科大学学报， 2023 ， 40 （ 11 ）： 1564 - 1576 ．

Li ZY ， Wu W ， Li WY ， et al . Modern research progress on traditional Chinese medicine against treating eczema [J ] . J Shenyang Pharm Univ ， 2023 ， 40 （ 11 ）： 1564 - 1576 ．

赵　辨 . 湿疹面积及严重度指数评分法 [J ] . 中华皮肤科杂志， 2004 ， 37 （ 1 ）： 3 - 4 ．

Zhao B . Eczema area and severity index scoring method [J ] . Chin J Dermatol ， 2004 ， 37 （ 1 ）： 3 - 4 .

赵炳南，张志礼 . 简明中医皮肤病学 [M ] . 北京：中国中医药出版社， 2014 ： 753 - 755 ．

Zhao BN ， Zhang ZL . Concise TCM dermatology [M ] . Beijing ： China Press of Traditional Chinese Medicine ， 2014 ： 753 - 755 ．

赵辨 . 临床皮肤病学 [M ] . 3版 . 南京：江苏科学技术出版社， 2001 ： 604 ．

Zhao B . Clinical dermatology [M ] . 3rd ed . Nanjing ： Phoenix Science Press ， 2001 ： 604 ．

Lopez DJ ， Lodge CJ ， Bui DS ， et al . Establishing subclasses of childhood eczema，their risk factors and prognosis [J ] . Clin Exp Allergy ， 2022 ， 52 （ 9 ）： 1079 - 1090 ．

Raveendran R . Tips and tricks for controlling eczema [J ] . Immunol Allergy Clin North Am ， 2019 ， 39 （ 4 ）： 521 - 533 ．

Ta LDH ， Tay CJX ， Lay C ， et al . Household environmental microbiota influences early-life eczema development [J ] . Environ Microbiol ， 2021 ， 23 （ 12 ）： 7710 - 7722 ．

Horiuchi Y . Th1 regulatory events by infectious pathogens，herpes zoster and herpes simplex viruses： prospects for therapeutic options for atopic eczema [J ] . Postepy Dermatol Alergol ， 2022 ， 39 （ 4 ）： 662 - 667 ．

秦宗碧，李伶华，蔡　翔，等 . 血清中的免疫炎症生物标志物与慢性湿疹病人的疾病严重程度相关性研究 [J ] . 安徽医药， 2024 ， 28 （ 6 ）： 1182 - 1186 ．

Qin ZB ， Li LH ， Cai X ， et al . Study on the correlation between serum immune inflammatory biomarkers and disease severity in patients with chronic eczema [J ] . Anhui Med Pharm J ， 2024 ， 28 （ 6 ）： 1182 - 1186 ．

刘　卉，曹　俊 . 自拟消疹煎联合西药治疗慢性湿疹的临床效果及对患者血清LTB4、IL-18、ECP、INF-γ的影响 [J ] . 中国中西医结合皮肤性病学杂志， 2019 ， 18 （ 4 ）： 323 - 327 ．

Liu H ， Cao J . Clinical effects and influence of serum LTB4，IL-18，ECP and INF-γ levels for treating chronic eczema patients with self-prepared Xiaozhenjian decoction combined with western medicine [J ] . Chin J Dermatovenereology Integr Tradit West Med ， 2019 ， 18 （ 4 ）： 323 - 327 ．

Wu Y ， Wang GJ ， He HQ ， et al . Low-dose intralesional injection of 5-fluorouracil and triamcinolone reduces tissue resident memory T cells in chronic eczema [J ] . World J Clin Cases ， 2022 ， 10 （ 1 ）： 166 - 176 ．

Akagawa S ， Kaneko K . Gut microbiota and allergic diseases in children [J ] . Allergol Int ， 2022 ， 71 （ 3 ）： 301 - 309 ．

Liu Y ， Du XF ， Zhai SJ ， et al . Gut microbiota and atopic dermatitis in children： a scoping review [J ] . BMC Pediatr ， 2022 ， 22 （ 1 ）： 323 ．

Manos J . The human microbiome in disease and pathology [J ] . APMIS ， 2022 ， 130 （ 12 ）： 690 - 705 ．

孙建峰，王全林，周宪宾 . 防参止痒颗粒治疗老年湿疹的临床观察 [J ] . 老年医学与保健， 2021 ， 27 （ 3 ）： 470 - 474 ．

Sun JF ， Wang QL ， Zhou XB . Clinical observation of Fangshen Zhiyang granule in the treatment of elderly patients with eczema [J ] . Geriatr Health Care ， 2021 ， 27 （ 3 ）： 470 - 474 ．

刘　影，董　燕，孙道红，等 . 参苓白术散联合多磺酸黏多糖封包对老年慢性湿疹血虚风燥证患者炎症因子和外周血T淋巴细胞亚群的影响 [J ] . 中华中医药学刊， 2020 ， 38 （ 5 ）： 166 - 169 ．

Liu Y ， Dong Y ， Sun DH ， et al . Effect of Shenling Baizhu Powder combined with polysulfonic acid mucopolysaccharide encapsulation on inflammatory cytokines and peripheral blood T lymphocyte subsets in elderly patients with chronic eczema and blood deficiency [J ] . Chin Arch Tradit Chin Med ， 2020 ， 38 （ 5 ）： 166 - 169 ．

刚　鑫，罗雯鹏，潘　燎，等 . 复方芩柏颗粒对溃疡性结肠炎大鼠肠道菌群的调控及对肠道黏膜病理的影响 [J ] . 中医药导报， 2025 ， 31 （ 1 ）： 53 - 60 .

Gang X ， Luo WP ， Pan L ， et al . Effect of compound qinbai granules on intestinal flora regulation and intestinal mucosal pathology in rats with ulcerative colitis [J ] . Guid J Tradit Chin Med Pharm ， 2025 ， 31 （ 1 ）： 53 - 60 .

Bouabidi M ， Salamone FL ， Gadhi C ， et al . Efficacy of two Moroccan Cistus species extracts against acne vulgaris： phytochemical profile，antioxidant，anti-inflammatory and antimicrobial activities [J ] . Molecules ， 2023 ， 28 （ 6 ）： 2797 ．

姜铁民，刘　斌，刘彦品，等 . 健康成人肠道菌群对烧酸奶的反应 [J ] . 中国食品学报， 2020 ， 20 （ 12 ）： 122 - 130 ．

Jiang TM ， Liu B ， Liu YP ， et al . Response of intestinal microbiota to burned yogurt in healthy adults [J ] . J Chin Inst Food Sci Technol ， 2020 ， 20 （ 12 ）： 122 - 130 ．

青千裕，赵子苇，姜楚洋，等 . 含不同剂量酸枣仁的敷和汤对特应性皮炎模型小鼠IgE水平及肠道菌群的影响 [J ] . 中医杂志， 2024 ， 65 （ 7 ）： 728 - 736 .

Qing QY ， Zhao ZW ， Jiang CY ， et al . Study on the effect of Fuhe decoction with different doses of Suanzaoren（Ziziphus jujuba） on IgE levels and intestinal flora in atopic dermatitis model mice [J ] . J Tradit Chin Med ， 2024 ， 65 （ 7 ）： 728 - 736 .

Yi DD ， Liu X ， Wang MH ， et al . Rosmarinic acid alleviated intestinal barrier damage caused by Escherichia coli by regulating the gut microbiota and inhibiting the NF-κB signalling pathway in mice [J ] . Food Funct ， 2024 ， 15 （ 23 ）： 11740 - 11756 ．

杨媛媛，岳启安，楚海荣，等 . 棒状杆菌条件致病菌临床感染及棒状杆菌的临床应用 [J ] . 医学综述， 2007 ， 13 （ 17 ）： 1357 - 1359 ．

Yang YY ， Yue QA ， Chu HR ， et al . Clinical infection of conditional pathogenic bacteria and clinical application of Corynebacterium [J ] . Med Recapitul ， 2007 ， 13 （ 17 ）： 1357 - 1359 ．

顾建青 . 金黄色葡萄球菌与特应性皮炎 [J ] . 中华临床免疫和变态反应杂志， 2023 ， 17 （ 5 ）： 495 - 496 ．

Gu JQ . Staphylococcus aureus and atopic dermatitis [J ] . Chin J Allergy Clin Immunol ， 2023 ， 17 （ 5 ）： 495 - 496 .

张迪译，徐阳审，朱璐审 . 急性缺血性脑卒中患者的微生物菌群失调 [J ] . 中国康复， 2022 ， 37 （ 7 ）： 418 ．

Zhang DY ， Xu YS ， Zhu LS . Gut microbiota dysbiosis in acute ischemic stroke associated with three-month unfavorable outcome [J ] . Chin J Rehabil ， 2022 ， 37 （ 7 ）： 418 ．

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