冠状动脉粥样硬化性心脏病血瘀证代谢组学的临床研究回顾与展望

Review and Prospect of Clinical Studies on Metabolomics of Blood Stasis Syndrome in Coronary Heart Disease

冠状动脉粥样硬化性心脏病(简称冠心病)归属于中医“胸痹心痛”的范畴,其中医证候学的现代生物学基础是广大学者的重点关注对象。近年来,因代谢组学“整体性”的研究特点与中医理论的“整体观念”特征相似,为满足中医证候客观化、标准化研究的迫切需要,应用代谢组学技术对中医证候本质的探索成为热点。梳理近10年来,诸多学者对冠心病血瘀证代谢组学的临床研究,通过对其试验方法、代谢物和代谢通路加以分析,发现绝大部分代谢物的变化趋势是一致的。氨酰-tRNA生物合成通路、新霉素、卡那霉素和庆大霉素的生物合成通路、精氨酸生物合成通路、D-谷氨酸和D-谷氨酰胺代谢为冠心病血瘀证特征性的代谢通路。总体而言,冠心病血瘀证代谢组学研究为阐明其物质代谢机制提供了可能,但是相关研究目前存在试验例数少、代谢物名称不规范、部分代谢变化矛盾的问题仍需解决。

Coronary heart disease belongs to the category of“chest Bi syndrome and heartache”in traditional Chinese medicine,in which the modern biological basis of medical syndrome is the focus of scholars.In resent years,because the research characteristics of“integrity”of metabonomics are similar to the characteristics of“overall concept”of traditional Chinese medicine theory,in order to meet the urgent needs of objectification and standardization of traditional Chinese medicine syndromes,the application of metabonomics technology to explore the essence of TCM syndromes has become a hot spot.This paper reviewed the clinical metabonomics researches on traditional Chinese medicine syndromes of coronary heart disease in the past 10 years.By analyzing methods,metabolites and metabolic pathways,we discovered that variation tendency of metabolites were the same.Moreover,Aminoacyl-tRNA biosynthesis,Valine leucine and isoleucine biosynthesis,Neomycin kanamycin and gentamicin biosynthesis,as well as D-Glutamine and D-glutamate metabolism are the characteristic pathway for syndrome of blood stasis of coronary heart disease.In general,the metabonomics research of coronary heart disease of blood stasis syndrome provides the possibility to clarify its material metabolism mechanism,but the related research still needs to be solved,such as the small number of test cases,the non-standard name of metabolites and the contradiction of some metabolic changes.