中国临床药理学杂志

基于宏基因组学探讨HP阳性胃溃疡患者接受雷贝拉唑胶囊联合磷酸铝凝胶治疗后肠道菌群变化的研究

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姚嫚娇

中国临床药理学杂志 | 临床与基础桥接研究 2025,41(22): 3171-3177

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中国临床药理学杂志 |临床与基础桥接研究 2025 , 41 (22) : 3171 -3177

基于宏基因组学探讨HP阳性胃溃疡患者接受雷贝拉唑胶囊联合磷酸铝凝胶治疗后肠道菌群变化的研究

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姚嫚娇（1980-），女，副主任医师，主要从事内科学方面的研究和工作

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姚嫚娇

作者信息

大庆市中西医结合医院内科，黑龙江大庆 163515

通讯作者:

姚嫚娇 MP: 13636959013 E-mail: ymjiaoY80@163cn.email

作者简介:

姚嫚娇（1980-），女，副主任医师，主要从事内科学方面的研究和工作

A study on the changes of intestinal flora in patients with HP-positive gastric ulcer after treatment with rabeprazole capsule combined with aluminum phosphate gel based on metagenomics

Man-jiao YAO

Affiliations

Department of Internal Medicine, Daqing Hospital of Integrated Traditional Chinese and Western Medicine, Daqing 163515, Heilongjiang Province, China

出版时间: 2025-11-28 doi: 10.13699/j.cnki.1001-6821.2025.22.004

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摘要

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目的

利用宏基因组学研究幽门螺杆菌（HP）阳性胃溃疡患者接受雷贝拉唑胶囊联合磷酸铝凝胶治疗后肠道菌群的变化。

方法

选取2022年1月至2024年12月期间收治的HP阳性胃溃疡患者，随机分为联合组和对照组，对照组仅接受雷贝拉唑治疗，联合组则接受雷贝拉唑和磷酸铝凝胶联合治疗。用基于线性核的支持向量分类（SVC）模型与递归特征消除（RFE）检测区分不同治疗组患者的模型效能及关键生物标志物。用支持向量回归因子模型（SVR）检测微生物丰度与临床连续指标之间的关联。用京都基因和基因组数据库（KEGG）功能富集分析检测肠道菌群差异基因所富集的代谢与信号通路。比较2组患者的临床疗效，并评价安全性。

结果

共入组130例患者，联合组和对照组各65例。联合组的肠道微生物多样性明显高于对照组（P<0.05）。利用RFE进一步区分2组患者，曲线下面积（AUC）为0.80。联合组患者中，有10种代谢物水平升高。通过多组学整合分析2组患者的粪便样本，发现结合特定微生物群和粪便代谢物分析的AUC为0.85，准确度高于单独使用微生物群或代谢物分析，在统计学差异上有统计学意义（P<0.05）。SVC和SVR分析显示，患者的肠道炎症与特定微生物群落组成相关。基于KEGG构建了代谢反应网络图。结果表明，HP阳性胃溃疡患者中精氨酸酶、蛋白磷酸酶、酪氨酸磷酸酶水平较高。溃疡愈合率在联合组和对照组分别为95.38%（62例/65例）和83.08%（54例/65例），2组比较，在统计学上差异有统计学意义（P<0.05）。联合组和对照组的药物不良反应发生率分别为10.77%（7例/65例）和16.92%（11例/65例），2组比较在统计学上差异无统计学意义（P>0.05）。

结论

雷贝拉唑联合磷酸铝凝胶的治疗方案能够提高肠道微生物多样性，并促进微生物代谢物的分泌，有效改善肠道菌群，促进患者恢复。

关键词

雷贝拉唑胶囊 / 磷酸铝凝胶 / 宏基因组学 / HP阳性胃溃疡 / 肠道菌群

Abstract

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Objective

To investigate the changes of intestinal flora in patients with Helicobacter pylori (HP) positive gastric ulcer treated with rabeprazole capsule combined with aluminum phosphate gel based on metagenomics.

Methods

Patients with HP-positive gastric ulcers were selected who were admitted from January 2022 to December 2024. They were randomly divided into the combined group and the control group. The control group only received rabeprazole treatment, while the combined group received combined treatment with rabeprazole and aluminum phosphate gel. The model efficacy and key biomarkers for distinguishing patients in different treatment groups were detected using a linear kernel-based support vector classification (SVC) model and recursive feature elimination (RFE). The association between microbial abundance and clinical continuous indicators was detected using a support vector regression factor model (SVR). The Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analysis was used to detect the metabolic and signaling pathways enriched by the differentially expressed genes in the intestinal microbiota. The clinical efficacy of the two groups was compared, and the safety was evaluated.

Results

A total of 130 patients were enrolled in the study, with 65 patients in each of the combined group and the control group. The intestinal microbial diversity in the combined group was significantly higher than that in the control group (P<0.05). Using RFE to further distinguish between the two groups, the area under the curve (AUC) was 0.80. Among the patients in the combined group, the levels of 10 metabolites were elevated. Through multi-omics integrated analysis of the fecal samples of the two groups of patients, it was found that the AUC of combining specific microbial communities and fecal metabolites analysis was 0.85, with higher accuracy than using microbial community or metabolite analysis alone, and the statistical difference was statistically significant (P<0.05). SVC and SVR analysis showed that the intestinal inflammation of patients was related to the composition of specific microbial communities. A metabolic reaction network diagram was constructed based on KEGG. The results showed that the levels of arginase, protein phosphatase, and tyrosine phosphatase were higher in patients with positive HP gastric ulcers. The ulcer healing rates in the combined group and the control group were 95.38% (62 cases/65 cases) and 83.08% (54 cases/65 cases), respectively. There was statistically significant difference between the two groups (P<0.05). The incidence of adverse drug reactions was 10.77% (7 cases/65 cases) in the combined group and 16.92% (11 cases/65 cases) in the control group. There was no statistically significant difference between the two groups (P>0.05).

Conclusion

The treatment plan of rabeprazole combined with aluminum phosphate gel can enhance the diversity of intestinal microorganisms, promote the secretion of microbial metabolites, effectively improve the intestinal flora, and facilitate the recovery of patients.

Key words

rabeprazole capsule / aluminum phosphate gel / metagenomics / HP positive gastric ulcer / intestinal flora

引用本文

姚嫚娇. 基于宏基因组学探讨HP阳性胃溃疡患者接受雷贝拉唑胶囊联合磷酸铝凝胶治疗后肠道菌群变化的研究. 中国临床药理学杂志, 2025 , 41 (22) : 3171 -3177 . DOI: 10.13699/j.cnki.1001-6821.2025.22.004

Man-jiao YAO. A study on the changes of intestinal flora in patients with HP-positive gastric ulcer after treatment with rabeprazole capsule combined with aluminum phosphate gel based on metagenomics[J]. Chinese Journal of Clinical Pharmacology, 2025 , 41 (22) : 3171 -3177 . DOI: 10.13699/j.cnki.1001-6821.2025.22.004

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2025年第41卷第22期

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doi: 10.13699/j.cnki.1001-6821.2025.22.004

接收时间：2025-08-04
首发时间：2026-08-05
出版时间：2025-11-28

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收稿日期：2025-08-04

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大庆市中西医结合医院内科，黑龙江大庆 163515

通讯作者:

姚嫚娇 MP: 13636959013 E-mail: ymjiaoY80@163cn.email

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2025.22.004

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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