肾阳虚骨关节炎个案与13个免疫基因的初步研究——辨证论治的个体化医学及分子疗效评定方法探试

Preliminary study on osteoarthritis which is accompanied by the cold Zheng and the thirteen immune genes

目的 :观察温针治疗肾阳虚骨关节炎典型病例的疗效 ,通过基因芯片前沿方法研究该疗效的差异表达基因。从而探索辨证论治的个体化医学治疗效果及分子疗效评定的新方法。方法 :对 10例典型肾阳虚关节炎患者 ,辨证评分 ,然后施以温针灸治疗后精选疗效最好者。对其治疗前、后分别采血 ,提取mRNA ,经标记、杂交、清洗、芯片扫描、图象采集与数据分析等过程获得差异基因表达谱。结果 :在 10例肾阳虚关节炎治疗有显著性的背景上 ,所选 1例患者的肾阳虚证、疼痛分分别减少 2 6分、12分 ,基因芯片检测该患者治疗前、后血液获得有表达差异的基因 5 7条 ,其中已知功能的基因有 3 3条 ,与免疫相关有 13条 ,约占整个已知功能基因的 3 6 4%。结论 :温针治疗肾阳虚证有效病例的基因表达涉及广泛 ,其分子机理包括免疫、能量、疾病、肿瘤等多个方面 ,但以免疫方面最为突出。同时也可由肾阳虚证的分子生物学基础 。

Objective:To study the genes different expression by the cDNA microarray responsing to the heat puncture of osteoarthritis which is accompanied by the cold Zheng.In order to explore the curative effect of individuality medicine and methods of evaluation.Methods:Selected patients who have the deficiency syndrome of kidney yang by clinical observation and harvested their blood to extract mRNA,then rewersly transcripted them to cDNA,which were labeled by cy-3-dUTP.After the patients taking the treatment of heat puncture for half a month,their blood was harvested again and this time the cDNA were labeled by cy5-dUTP.These probes were hybridized with the cDNA microarrays,scanned and analyzed.Results:The curative effect mark of cold Zheng is 28.The result demonstrates that there are 57 differentia genes,including up regulated and down regulated.In the 57 differentia genes,there are 33 recognized genes.13 of the recoginzed genes are related to immunity.Conclusion:By using cDNA microarrays,we found the osteoarthritis with Han Zheng genes involve extensive expression especially the genes on immunity and we have studied the whole mechanism of Han Zheng,explore the curative effect of individuality medicine and methods of evaluation.