基于代谢组学技术的慢性胃炎脾胃湿热证病机转化规律研究  

Study on Mechanism Transformation of Spleen and Stomach Dampness and Heat Syndrome in Chronic Gastritis Based on Metabonomics Technique

作　　者：徐晓惠 孙易娜 杨琼 周姝含 万莹[2] 高清华 吕文亮 Xu Xiaohui;Sun Yina;Yang Qiong;Zhou Shuhan;Wan Ying;Gao Qinghua;Lyu Wenliang(Clinical College of Chinese Medicine,Hubei University of Chinese Medicine,Wuhan 430061,China;Wuhan First Hospital,Wuhan 430022,China;School of Basic Medicine,Hubei University of Chinese Medicine,Wuhan 430061,China)

机构地区：[1]湖北中医药大学中医临床学院,武汉430061 [2]武汉市第一医院,武汉430022 [3]湖北中医药大学基础医学院,武汉430061

出　　处：《世界科学技术-中医药现代化》2021年第8期2607-2615,共9页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：湖北省卫生计生委2016-2017湖北省中医药中西医结合科研课题一般项目(鄂卫生计生通[2017]20-9):脾胃湿热型浅表性胃炎、萎缩性胃炎的代谢组学研究,负责人:吕文亮;湖北中医药大学2021“青苗计划”资助项目(中医校【2021】61号):2021ZZX021轻度免疫缺陷小鼠脾胃湿热证病证结合模型构建机制研究,负责人:周姝含

摘　　要：目的观察脾胃湿热型慢性非萎缩性胃炎、萎缩性胃炎、胃癌患者尿液代谢组学变化,探讨异病同证背景下脾胃湿热证的病机转化与代谢产物的关联性,为中医预防或截断"炎癌转化"途径提供生物学依据。方法搜集脾胃湿热型慢性萎缩性胃炎34例、慢性萎缩性胃炎其他证型46例患者的尿液进行核磁共振氢谱(^(1)H-NMR)检测,采用多变量统计学方法中主成分分析(PCA)、最小二乘判别分析(PLS-DA)及单变量统计分析方法测定相关代谢标志物的含量。结果PLS-DA显示,(1)胃癌组与慢性萎缩性胃炎伴肠上皮化生组比较,筛选得到差异性代谢产物14种,与胃癌组相比,后者柠檬酸、赖氨酸等7种物质含量上升;甘油、岩藻糖等7种物质含量下降。(2)胃癌脾胃湿热证组与慢性萎缩性胃炎胃络瘀血证组比较发现,与前者相比,后者柠檬酸、甘氨酸等7种物质含量上升;N-苯乙酰甘氨酸、甘油等7种物质含量下降。(3)与对照组相比,脾胃湿热型慢性萎缩性胃炎组:卡尼丁等3种物质含量上升,甘油、葫芦巴碱等5种物质含量下降。结论"慢性萎缩性胃炎脾胃湿热证——胃络瘀血证——胃癌"与"慢性萎缩性胃炎不伴肠上皮化生——伴肠上皮化生——胃癌"的代谢组学变化相似,说明湿热兼瘀是"炎-癌"转变的关键病机,此类证型具有代谢生物标志物的共性特征,对于进一步运用代谢组学技术探讨脾胃湿热证病机转化规律,优化防治方案具有重大意义。Objective To observe the changes of urine metabolomics in patients with chronic non-atrophic gastritis,atrophic gastritis and gastric cancer with dampness heat of spleen and stomach,and to explore the correlation between pathogenesis transformation and metabolites of dampness heat of spleen and stomach under the background of different diseases and the same syndrome,so as to provide biological basis for TCM prevention or blocking the way of"inflammation cancer transformation".Methods The urine of 34 cases of chronic atrophic gastritis of spleen and stomach syndrome,and 46 patients with chronic atrophic gastritis was collected for nuclear magnetic resonance hydrogen spectrum(1 h-nmr).The multivariate statistical methods of PCA and PLS-DA and univariate statistical analysis method were used for determining the content of related metabolic markers.Results PLS-DA showed that(1)the gastric cancer group was compared with the chronic atrophic gastritis with intestinal metaplasia group,and 14 different metabolites were screened.Compared with the gastric cancer group,the content of 7 substances including citric acid and lysine increased in the latter;The content of 7 substances including glycerin and fucose decreased.(2)Comparing the gastric cancer spleen and stomach damp-heat syndrome group with the chronic atrophic gastritis gastric collateral blood stasis syndrome group,it was found that compared with the former,the content of 7 substances including citric acid and glycine in the latter increased;the contents of 7 substances including N-phenylacetylglycine and glycerine decreased.(3)Compared with the control group,the spleen and stomach damp-heat chronic atrophic gastritis group:the content of 3 substances including carnitine increased,and the contents of 5 substances including glycerin and trigonelline decreased.Conclusion The metabonomic changes of"chronic atrophic gastritis with spleen and stomach damp-heat syndromestomach collateral blood stasis syndrome-gastric cancer"and"chronic atrophic gastritis without intesti

关 键 词：脾胃湿热证 非萎缩性胃炎 萎缩性胃炎 胃癌前病变 胃癌 代谢组学技术 炎癌转化 

分 类 号：R259[医药卫生—中西医结合]