Discussion on Diagnosis and Treatment of Functional Constipation and Changes in Intestinal Microecology Based on Huang Yuanyu's Theory of"Cold Water,Damp Soil,and Depressive Wood"
Objective Based on Huang Yuanyu's theory of"cold water,damp soil,and depressive wood",this study explores the diagnosis and treatment of functional constipation(FC)and investigates the impact of Cistanche decoc-tion on the intestinal microecology of FC patients classified under the"cold water,damp soil,and depressive wood"type,using high-throughput sequencing technology.Methods A total of 60 chronic FC patients with the"cold water,damp soil,and depressive wood"type were selected from the Constipation Clinic of the Anorectal Department at Xiamen Hospital of Traditional Chinese Medicine between September 2020 and January 2022.They were selected as the research objects and were divided into a control group and a treatment group according to the random number table method,with 30 patients in each group.The treatment group received Cistanche decoction,while the control group received oral PEG 4000,with both treatment courses lasting for five weeks.Fecal samples(10.00±5.00 g)were collected from 20 patients in the Cistanche decoction group and 18 patients in the PEG 4000 group,both before and after treatment.These samples were immediately frozen in liquid nitrogen and stored at-80 ℃.The MagPure Soil DNA LQ Kit was used to analyze changes in intestinal microecology through high-throughput sequencing.Alpha diversity indices were analyzed using Chao,Shannon,and Simp-son indices used to calculate the abundance and diversity of the intestinal microbiota.LefSe technology was used to identify differential bacterial genera in the fecal samples before and after treatment.Results After the treatment period,there was a statistically significant difference in the quantitative scores of"cold water,damp soil,and depressive wood"symptoms be-tween the two groups.Three months after treatment,the difference in these quantitative scores remained statistically signifi-cant.The results indicated that the treatment group demonstrated superior efficacy compared to the control group.The dilu-tion curve indicated that the sequencing data were sufficient to cover all bacterial species present in the samples.After treatment,the Chao1 index of intestinal microbiota in FC patients was higher than before treatment,while the Shannon and Simpson indices were lower;however,these differences were not statistically significant(P>0.05).At the phylum level,the predominant bacterial phyla in all groups were Bacteroidota,Cyanobacteria,Campilobacterota,and Deferribacterota.At the genus level,the predominant genera included Bacteroidota,Parabacteroides,Eubacterium_eligens_group,Alistipes,and Lachnoclostridium.Conclusion Cistanche decoction can achieve mid-to-long-term efficacy in treating constipation of the"cold water,damp soil,and depressive wood"type.It can increase the population of beneficial bacteria in the intestines and improve intestinal microecology.