骨髓增生异常综合征中医证型与代谢组学的相关性研究  

Relativity Research on TCM Types and Metabonomics of Myelodysplastic Syndrome(MDS)

作　　者：扈冰[1] 周永明[1] 朱文伟[1] 任荣政[1] 胡明辉[1] 孙伟玲[1] 陆嘉惠[1] 王婕[1] 胡令彦[1] 陈海琳[1] 陈闽军[2] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海交通大学药学院

出　　处：《浙江中医药大学学报》2012年第11期1173-1176,共4页Journal of Zhejiang Chinese Medical University

基　　金：国家自然基金(30873342);国家自然基金(81072959);上海市中医药事业三年行动计划首批重大研究项目(ZYSNXD-CC-ZDYJ020)~~

摘　　要：[目的]研究骨髓增生异常综合征(MDS)患者不同中医证型血清中小分子代谢物质的表达差异,以探索代谢组学在MDS中医证候学研究中的应用。[方法]根据有关中医辨证标准对60例MDS患者进行中医辨证,分为脾肾阴虚蕴毒型和脾肾阳虚蕴毒型两组,采用代谢组学及智能计算等新型研究方法,对两组不同证型患者生化代谢物质的色谱-质谱图进行判别分析,构建MDS中医证型的生化代谢指纹谱。[结果]MDS患者的色谱峰表达低于正常人,对正常对照组与MDS组的色谱峰表达进行两样本均数比较,共得到20个色谱峰表达有统计学意义(P<0.05,P<0.01),应用代谢组学构建的MDS判别方程在与正常人进行判别时的自身验证总体准确率达到92%,交互验证总体准确率达到90%;脾肾阳虚蕴毒型组的色谱峰表达明显低于脾肾阴虚蕴毒型组,对两组的色谱峰表达进行两样本均数比较,共得到18个色谱峰表达,有统计学意义(P<0.05,P<0.01),运用代谢组学构建的中医证型判别方程在自身判别和交互判别中的总体准确率均为93.33%。[结论]MDS患者的中小分子代谢物质的表达明显低于正常人,脾肾阳虚蕴毒型组的代谢物质的表达明显低于脾肾阴虚蕴毒型组,通过代谢组学分析建立的判别方程具有优异的判别MDS、正常人的能力;揭示了MDS两组中医证型的代谢差异。[Objective] To study expression difference of serum small molecule metabolites in different MDS patients,to explore the application of metabo nomics in MDS TCM syndrome research.[Method] Under concerned TCM differentiation standard,60 MDS cases were divided into types of Yin defi ciency and Yang deficiency of spleen and kidney with containing toxin.Take new research measures of metabonomics and wisdom calculation to make judgment and analysis on color-spectrum-mass spectrogram of different types of patients＇metabolites,to construct MDS TCM types biochemistry metabolism dactylogram.[Result] The patients＇ color spectrum summit expression was lower than normal persons;comparing 2 samples means of color spectrum summit expression of both groups,there＇re 20 summits with statistical meaning;self-checking total correct rate reached 92% judged with MDS discriminant equation from normal persons,the mutual-checking correct rate was 90%;the color spectrum summit expression of Yang deficiency was markedly lower than Yin deficiency type;the comparison of sample mean got 18 summit expression with statistical meaning;and the total correct rate was 93.33% judged with TCM syndrome discriminant equation.[Conclusion] MDS patients＇ small and medium molecule metabolites expression was obviously lower than normal persons,the expression of metabolites of Yang deficiency group was much less than Yin deficiency of spleen and kidney containing tox in;the discriminant equation constructed from metabonomics analysis had excellent ability of distinguishing MDS from normal persons,exposing the metabolism difference between 2 TCM types of MDS.

关 键 词：骨髓增生异常综合征 生化代谢 代谢组学 气相色谱-质谱联用技术 辨证分型 

分 类 号：R221[医药卫生—中医基础理论]