基于藏医宏观信息的高原红细胞增多症藏医证型分类的研究思路初探

Metabonomics Research on Syndrome Differentiation of HAPC with Tibetan

高原红细胞增多症(HAPC)是由于高原低氧引起的红细胞过度代偿性增生的慢性高原病,藏医称为"查培病"。该病严重影响到高原居住人群的健康。在前期国家自然科学基金(30973957)研究的基础上,证实藏医临床防治HAPC确有疗效,发现HAPC藏医治疗前后代谢谱有差异,但HAPC不同藏医证型的生物学基础尚不明确,文章提出"依据藏医诊断-生化检测-生物标志等多维信息的相关性分析,能揭示HAPC藏医隆型、血型的生物学基础"的假说,拟结合HAPC国际诊断标准,用藏医三诊(望、触、问)方法,收集100例青藏高原地区HAPC有效病例的头痛、头晕等临床体征,全自动生化分析红细胞数、血红蛋白、红细胞压积等指标,LC-MS等代谢组学方法分析血、尿样本,结合主成分分析等数学处理方法,发现HAPC藏医证型相关的特征性生物标志,以探索HAPC藏医隆型、血型的证型生物学的科学内涵,为其临床辨证客观化提供科学依据。

High altitude polycythemia（ HAPC） is due to the high altitude hypoxia which increases red blood cells by excessive compensatory hyperplasia,and thereby it is a chronic mountain sickness. In Tibetan medicine,it is known as Cha Pei disease.The late stage of this disease greatly harms to various systems of the body,and seriously affects the health of living at high altitude. This project is based on previous study of National Natural Science Foundation（ 30973957） and other work,the proofs from effectiveness of clinical prevention and treatment,the result of difference between pre and post metabolic spectrum of HAPC,and the unclear of that biological basis of HAPC pathogenesis. For this reason,it explores the correlations between three diagnostic information,biological markers and metabolic markers. The goal is to reveal the hypothesis of biological basis for different syndrome types of blood and wind. It is integrated with international criteria of HAPC,using Tibetan medical diagnostic method（ inspection,touching,inquring） to collect more than 100 HAPC patients with headache,dizziness and other clinical signs and count the number of red blood cell,hemoglobin and other biochemical indicators. Moreover,it analyzes the metabolism of LC-MS group in blood and urine samples,uses mathematical processing for analyzing the major chemical component and establishes the syndrome types of HAPC correlated to the features of metabolic markers of group to compare with healthy volunteers and finds out the metabolic pathway of HAPC. In addition,to explore the different types of wind and blood syndrome,finally it provides the proof for objective clinical syndrome differentiation.