OBJECTIVE  To explore the syndrome material basis of spleen yang deficiency syndrome in children with diarrhea from the perspective of fecal metabolism.

  METHODS  20 children with persistent diarrhea of spleen yang deficiency syndrome were selected as the observation group, and 20 healthy children were selected as the normal control group. After collecting the fecal samples of each group, the samples were analyzed by gas chromatography-mass spectrometry, and the differences in metabolites between the two groups were compared.

  RESULTS  There were 25 potential biomarkers related to persistent diarrhea with spleen yang deficiency syndrome, among which 9 were down-regulated, namely L-glutamine, L-Glutamic acid, 4-hydroxybenzaldehyde, L-cysteine, ornithine, L-isoleucine, succinic acid, β-alanine, fumaric acid, in persistent diarrhea with spleen yang deficiency syndrome. There were 16 kinds of upregulation in the stool of children, including serine, ribonic acid, α-linolenic acid, benzoic acid, fructose, L-alanine, pyroglutamic acid, pyruvate, hypoxanthine, capric acid, L-aspartic acid, and other metabolites. There were 7 related pathways involved, including the metabolism of alanine, aspartic acid and glutamate, the metabolism of D-glutamine and D-glutamate, the metabolism of pyruvate, the metabolism of arginine and proline, arginine biosynthesis, glycolysis/gluconeogenesis, citric acid cycle (TCA cycle).

  CONCLUSION  Compared with healthy children, children with persistent diarrhea with spleen yang deficiency syndrome may experience disturbances in neural regulation metabolism, abnormal energy metabolism, and enhanced anaerobic fermentation in the body. The discovery of related differential metabolites may lay a certain material foundation for the pathogenesis, diagnosis, and treatment of persistent diarrhea with spleen yang deficiency syndrome in children.