肠道菌群与痤疮发生的相关性分析：110例肠道菌群样本的回顾性研究(1)
[摘要]目的：探讨肠道菌群是否参与痤疮的发病。方法：回顾性调查分析树兰(杭州)医院曾进行肠道菌群检测的110例患者。根据皮肤状态将其分为痤疮组和非痤疮组，并设计LND评分表对痤疮严重程度进行量化评估，运用R统计软件(t检验，皮尔逊相关性检验)进行两组间肠道6种优势细菌菌群差异分析。结果：两组肠道菌群多样性未发现显著差异，但痤疮组的乳酸菌、双歧杆菌数量均少于非痤疮组，且痤疮组的双歧杆菌与肠杆菌比值(B/E值)低于非痤疮组，差异均有统计学意义(P<0.05)。痤疮严重程度与B/E值之间并无统计意义的相关性。结论：痤疮患者肠道内益生菌数量的丢失可能参与痤疮的发病机制，但痤疮严重程度与益生菌的丢失量之间并无线性相关。
[关键词]痤疮；肠道微生态；聚合酶链式反应；回顾性
[中图分类号]R758.73+3 [文献标志码]A [文章编号]1008-6455(2018)09-0009-04
Correlation Analysis of Intestinal Microflora and Acne： A Retrospective Study
, 百拇医药
on 110 Patients
WANG Cui1，ZHANG Liu-ying2，HUANG Wei-xin2
[1.Department of Plastic Surgery，Shulan (Hangzhou) Hospital，Hangzhou 310000，Zhejiang，China；2.Zhejiang Tongchuang Yuecheng Health Technology Co.，Ltd， Shaoxing 312000，Zhejiang，China]
Abstract： Objective In this study， we retrospective investigate changes in intestinal microflora in patients with acne， and their role in this dermatological disorder. Methods 110 patients whose fecal flora were analyzed within a year were retrospective studied. They were classified into acne group and non-acne group. LND tool was used to assess the acne. The numbers of intestinal microflora between the two groups were statistical analyzed. Results The number of fecal lactobacillus， as well as bifidobacterium were significantly deceased in patients with acne compared with the non-acne group， and B/E (Bifidobacterium/Enterobacter) was significantly deceased in patients with acne compared with the non-acne group， the differences were statistically significant(P<0.05). There was no statistically significant correlation between acne severity and B/E value. Conclusion Intestinal flora in patients with acne was severely disturbed and gut microbiological colonization resistance was impaired. Suggest that the alterations to the microbial flora， specially decreased probiotics， may involve in acne pathogenesis.
, 百拇医药
Key words： acne； intestinal microflora； polymerase chain reaction(PCR)； retrospective
1930年，皮膚科医生Stokes和Pillsbury首次提出肠-脑-皮肤轴(gut-brain-skin)理论，80多年后的今天，这个理论再度成为热点。根据该理论，皮肤疾病与肠道微生态密切相关。为进一步验证肠道菌群是否参与寻常痤疮的发生，本次收集2017年1月-2017年12月在树兰(杭州)医院进行“人体肠道内6种优势细菌菌群的定量检测”的110例患者的临床资料，进行回顾性分析。通过随访调查将110例患者分为痤疮组和非痤疮组。分析比较痤疮患者与非痤疮人群肠道菌群的种类、数量差异与相对数量比值，寻找肠道菌群与痤疮发生的相关性。
1 资料和方法
1.1 临床资料：选取2017年1月-2017年12月在树兰(杭州)医院进行过“人体肠道内6种优势细菌菌群的定量检测”的517例患者，对其中小于60岁的病例采用电话和书面方式进行随访填表，共收到有效回访表格110份。
, 百拇医药
1.2 痤疮诊断与评分：参考《中国痤疮治疗指南(2014修订版)》对110例中的痤疮患者进行诊断，面部皮损表现符合痤疮诊断者划分为痤疮组。结合痤疮分级诊疗指南及临床治疗经验，设计LND评分表对痤疮进行量化评估，见表1。皮损类型(L， lesion)：L=1轻度(I级)，仅有粉刺；L=2指中度(Ⅱ级)，炎性丘疹；L=3中度(Ⅲ级)，脓疱；L=4重度(IV级)：结节、囊肿。痤疮数量(N， numerous)：N=1代表全身痤疮皮损少于等于5个；N=2代表全身痤疮皮损6～10个(包括6和10)；N=3代表全身痤疮皮损11～19个(包括6和10)；N=4代表全身痤疮皮损大于等于20个。痤疮病程(D， duration)：D=1指病程初发，不超过半年；D=2指病程反复，超过半年，不足2年；D=3指病程反复2年以上；D=4指病程反复2年以上，且临床治疗无法控制。痤疮评估分值(A，acne)=L+N+D。分值越大表明痤疮症状越明显、治疗难度愈大。110例中不符合痤疮诊断的患者，痤疮评分A=1。, 百拇医药(王萃 张柳萦 黄卫新)
[关键词]痤疮；肠道微生态；聚合酶链式反应；回顾性
[中图分类号]R758.73+3 [文献标志码]A [文章编号]1008-6455(2018)09-0009-04
Correlation Analysis of Intestinal Microflora and Acne： A Retrospective Study
, 百拇医药
on 110 Patients
WANG Cui1，ZHANG Liu-ying2，HUANG Wei-xin2
[1.Department of Plastic Surgery，Shulan (Hangzhou) Hospital，Hangzhou 310000，Zhejiang，China；2.Zhejiang Tongchuang Yuecheng Health Technology Co.，Ltd， Shaoxing 312000，Zhejiang，China]
Abstract： Objective In this study， we retrospective investigate changes in intestinal microflora in patients with acne， and their role in this dermatological disorder. Methods 110 patients whose fecal flora were analyzed within a year were retrospective studied. They were classified into acne group and non-acne group. LND tool was used to assess the acne. The numbers of intestinal microflora between the two groups were statistical analyzed. Results The number of fecal lactobacillus， as well as bifidobacterium were significantly deceased in patients with acne compared with the non-acne group， and B/E (Bifidobacterium/Enterobacter) was significantly deceased in patients with acne compared with the non-acne group， the differences were statistically significant(P<0.05). There was no statistically significant correlation between acne severity and B/E value. Conclusion Intestinal flora in patients with acne was severely disturbed and gut microbiological colonization resistance was impaired. Suggest that the alterations to the microbial flora， specially decreased probiotics， may involve in acne pathogenesis.
, 百拇医药
Key words： acne； intestinal microflora； polymerase chain reaction(PCR)； retrospective
1930年，皮膚科医生Stokes和Pillsbury首次提出肠-脑-皮肤轴(gut-brain-skin)理论，80多年后的今天，这个理论再度成为热点。根据该理论，皮肤疾病与肠道微生态密切相关。为进一步验证肠道菌群是否参与寻常痤疮的发生，本次收集2017年1月-2017年12月在树兰(杭州)医院进行“人体肠道内6种优势细菌菌群的定量检测”的110例患者的临床资料，进行回顾性分析。通过随访调查将110例患者分为痤疮组和非痤疮组。分析比较痤疮患者与非痤疮人群肠道菌群的种类、数量差异与相对数量比值，寻找肠道菌群与痤疮发生的相关性。
1 资料和方法
1.1 临床资料：选取2017年1月-2017年12月在树兰(杭州)医院进行过“人体肠道内6种优势细菌菌群的定量检测”的517例患者，对其中小于60岁的病例采用电话和书面方式进行随访填表，共收到有效回访表格110份。
, 百拇医药
1.2 痤疮诊断与评分：参考《中国痤疮治疗指南(2014修订版)》对110例中的痤疮患者进行诊断，面部皮损表现符合痤疮诊断者划分为痤疮组。结合痤疮分级诊疗指南及临床治疗经验，设计LND评分表对痤疮进行量化评估，见表1。皮损类型(L， lesion)：L=1轻度(I级)，仅有粉刺；L=2指中度(Ⅱ级)，炎性丘疹；L=3中度(Ⅲ级)，脓疱；L=4重度(IV级)：结节、囊肿。痤疮数量(N， numerous)：N=1代表全身痤疮皮损少于等于5个；N=2代表全身痤疮皮损6～10个(包括6和10)；N=3代表全身痤疮皮损11～19个(包括6和10)；N=4代表全身痤疮皮损大于等于20个。痤疮病程(D， duration)：D=1指病程初发，不超过半年；D=2指病程反复，超过半年，不足2年；D=3指病程反复2年以上；D=4指病程反复2年以上，且临床治疗无法控制。痤疮评估分值(A，acne)=L+N+D。分值越大表明痤疮症状越明显、治疗难度愈大。110例中不符合痤疮诊断的患者，痤疮评分A=1。, 百拇医药(王萃 张柳萦 黄卫新)
参见：首页 > 医疗版 > 疾病专题 > 皮肤科 > 皮肤附属器官疾病 > 痤疮(青春痘)