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试探

Preliminary Study on Osteoarthritis of Kidney-Yang Deficiency and Thirteen Immune Genes

目的通过用基因芯片方法研究肾阳虚骨关节炎温针治疗典型病例的差异表达基因,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例典型肾阳虚骨关节炎患者辨证评分,然后施以温针灸治疗,选出1例疗效最好者,对其治疗前、后差异基因表达谱进行分析。结果所选患者肾阳虚证、疼痛评分分别减少26分和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57条,其中已知功能的基因有33条,与免疫相关者13条,约占整个已知功能基因的39·39%。结论温针治疗肾阳虚证有效病例的基因表达涉及面广,其分子机理包括免疫、能量、疾病、肿瘤等多个方面,但以免疫最为突出。这提示可以以肾阳虚证的分子生物学为基础,来探讨辨证论治的个体化医学疗效及其评价方法。

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, to explore the curative effect of individuality medicine and medthods of evaluation. Methods Selected patients who have the deficiency syndrome of kidney yang by clinical observation and harvested their blood to extract mRNA,then reversely transcripted them to cDNA, which were labeled by cy-3-dUTP. After the patients took 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 was 28;the result demonstrated that there were 57 different genes, including up-regulated and down-regulated ones. In the 57 different genes, there were 33 recognized genes. 13 of the recognized genes are related to immunity. Conclusion By using cDNA microarrays, we find 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 medthods of evaluation.