支气管哮喘缓解期中医证型的代谢组学研究

Metabonomics studies on TCM syndromes of bronchial asthma in remission stage

目的:采用核磁共振波谱技术进行缓解期不同中医证型哮喘患者血浆的代谢组学研究。方法:30例肺虚组哮喘患者和30例肾虚组哮喘患者血浆经磷盐缓冲液处理后进行氢核磁共振波谱分析,收集谱图后进行预处理。处理后数据采用正交偏最小二乘判别法(OLS-DA)进行分析。采用皮尔森相关系数法和二元光谱法确定血浆中不同代谢组分。结果:OPLS-DA分析空间分布图中肺虚组与肾虚组分类良好。肾虚组血浆中异亮氨酸、亮氨酸、缬氨酸、乳酸、丙氨酸、柠檬酸、肌酸、肌酸酐等化合物显著下降,与肺虚组比较差异有统计学意义(P <0.05)。同时,丙酮、乙酰乙酸等化合物含量显著增加,与肺虚组比较差异有统计学意义(P <0.05)。结论:缓解期肺虚组与肾虚组哮喘患者血浆代谢表型比较差异有统计学意义。相较于肺虚组,肾虚组血浆中异亮氨酸、亮氨酸、缬氨酸、乳酸、丙氨酸、柠檬酸、肌酸、肌酸酐等化合物显著下降(P <0.05),丙酮、乙酰乙酸等化合物含量显著增加(P <0.05)。这种差异与哮喘的病理生理过程密切相关,如气道炎症、气道过敏和气道重塑。肾虚组哮喘能量代谢紊乱更为明显,能量消耗和免疫功能紊乱更为显著。

Objective: To observe clinical efficacy of the Mengshi Guntan decoction (礞石滚痰汤) plus pressing ear acupoints with beans on somatoform disorders of the Tanre Yujie type (痰热郁结型). Methods: 90 cases were divided into three groups. Group A was given the Mengshi Guntan decoction plus pressing ear acupoints with beans;the group B was given the Mengshi Guntan decoction simply;and group C was given duloxetine simply, for 6 weeks. Results: After treatment, the clinical effect, SCL-90 score and SF-36 score in group A were significantly different from those in group B and group C (P<0.05). Conclusion: The Mengshi Guntan decoction plus pressing ear acupoints with beans on somatoform disorders of the Tanre Yujie type show a good effect, no adverse reactions.