血瘀证基础研究的若干思考

On Basic Research of Blood-Stasis Syndrome

通过对目前证候相关基因研究中主要研究思路的归纳和梳理,预测和展望血瘀证基础研究的未来发展。证相关基因研究的思路主要有:1.不同证候状态下基因表达的比较研究;2.中医证型与基因多态性的相关研究;3.基因突变型与中医证型的相关性研究;4.以方测证,结合药物干预反证证本质。近50年来,血瘀证基础研究的内容涉及到血流动力学、微循环、血小板功能、凝血功能、血管内皮细胞损伤、组织氧供、炎症与结缔组织代谢研究等方面,取得了较大进展,但也存在两大困惑和误区:1.无证不血瘀、无病不血瘀的错误倾向;2.实验室指标与临床辨证相关性差。为此,血瘀证基础研究的发展在于:开展同病异证、异病同证血瘀证的比较学研究,进一步优化完善血瘀证诊断标准及建立可靠的动物模型,开展血瘀证体质、证候、疾病与基因多态性的相关研究,开展血瘀证基因组学及蛋白质组学研究。

This article aimed at predicting the development in basic research on blood-stasis syndrome by analyzing main pathways in investigating syndrome-associated gene. Research on syndrome-associated gene involved Ⅰ）detection and identification of differentially expressed gene between various syndromes in genomie level or single-gene level, Ⅱ） correlation analysis between syndrome-typing and gene polymorphism, Ⅲ） correlation analysis between syndrome-typing and gene mutation, Ⅳ） disproofing the entity of TCM syndrome by elucidating the pharmacological mechanism of Chinese formula and herbs. In the past fifty years, great progress has been made in basic research on blood-stasis syndrome which mainly involves many fields such as hemodynamics, microcirculation, function of thrombocyte, blood coagulation, injury of vascular endothelial cell, oxygen supply of tissue, inflammation and metabolism of connective tissue. However, there also exist two predicaments. One is the “false image”which seems no disease is not correlated with blood stasis,the other is the dis-coincidence between laboratory parameters and clinical syndrome-differentiation. To better interpret the entity of blood-stasis syndrome, we propose to carry out the following research work： Ⅰ） to compare the difference between patients with blood-stasis syndrome who are same in disease diagnosis while differ in syndrome differentiation, or vice versa, Ⅱ） to further optimize the diagnosis standard and to create reliable animal model of blood-stasis syndrome Ⅲ） to perform research on correlation analysis among body constitution of blood-stasis, blood-stasis syndrome, blood-stasis associated disease and gene polymorphism Ⅳ） to perform the genomic and proteomic research on blood-stasis syndrome.