非创伤性股骨头坏死中医体质类型与亚甲基四氢叶酸还原酶C677T位点多态性的相关性研究  

Relation study between TCM constitution types of nontraumatic osteonecrosis of femoral head and polymorphism of methylene tetrahydrofolate reductase C677T site

作　　者：李盛华[1] 周明旺[1] 郭铁峰[2] 王晓萍[1] 孙凤岐[2] 穆欢喜[2] 

机构地区：[1]甘肃省中医院,兰州730050 [2]甘肃中医学院,兰州730020

出　　处：《中华中医药杂志》2015年第6期2194-2198,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81072821)~~

摘　　要：目的:研究非创伤性股骨头坏死(NONFH)高发中医体质类型与亚甲基四氢叶酸还原酶(MTHFR)677位点多态性的关系。方法:根据前期研究,笔者发现血瘀质、痰湿质、气虚质是NONFH的高发体质类型,根据纳入与排除标准选择2011年1月-2013年8月在甘肃省中医院门诊、住院部对NONFH患者及非血缘关系健康志愿者进行问卷调查,将调查病例所得数据资料建立数据库。从数据库中筛选出气虚质、痰湿质、血瘀质3种高发体质患者,采集血液标本共93例NONFH患者(其中血瘀质32例、痰湿质31例、气虚质30例)及83名正常健康非血缘关系志愿者。对每位受检者取血样3m L,提取DNA进行PCR扩增,对PCR产物进行DNA测序,检测MTHFR677位点多态性,并对结果进行统计学分析。结果:1MTHFRC677T位点病例组与对照组比较,病例组TT基因型的发病风险是CC基因型的2.340倍(95%CI[1.050-5.217],P=0.038),T等位基因的发病风险是C等位基因的1.667倍(95%CI[1.092-2.545],P=0.018),且具有显著差异(P<0.05)。2血瘀质病例组TT基因型的发病风险是CC基因型的3.840倍(95%CI[1.196-12.328],P=0.024),T等位基因的发病风险是C等位基因的2.255倍(95%CI[1.232-4.126],P=0.008),且具有显著差异(P<0.05)。结论:MTHFRC677T位点的突变使NONFH的发病风险增高,MTHFRC677T位点可能与NONFH发病相关。MTHFRC677T位点的突变使血瘀质NONFH的发病风险增高,MTHFRC677T位点基因多态性可能是痰湿质高发NONFH的分子生物学机制之一。Objective： To study the relation between the high-risk TCM constitution types of nontraumatic osteonecrosis of femoral head （NONFH） and the polymorphism of methylene tetrahydrofolate reductase （MTHFR） 677T site. Methods： According the preliminary study, it was suggested that types of blood-stasis, phlegm-dampness and qi-deficiency constitution were high occurred in NONFH. By the inclusion and exclusion criteria, the NONFH patients and unrelated healthy volunteers from out-patient and in-patient departments of Gansu Provincial Hospital of TCM, from January 2011 to August 2013 were included for questionnaire survey, and the data were collected and established a database. Patients of the 3 high-risk constitution types were screened from the database. The 3mL of blood sample was collected from each of 93 NONFH patients （32 blood- stasis constitution, 31 phlegm-dampness constitution and 30 qi-deficiency constitution） and 83 unrelated healthy volunteers, and the DNA was extracted for PCR amplification to sequence DNA and detect the polymorphism of MTHFR 677T site, then the results were statistically analyzed. Results： （1） About MTHFRC677T site, compared with the control group, the incidence rate of TT genotype was 2.340 times of that of CC genotype in the patients group （95%CI[1.050-5.217], P=0.038）, T allele was 1.667 times of that of C allele （95%CI [1.092-2.545], P=0.018）, which had significant difference （P〈0.05）. （2） The incidence rate of TT genotype was 3.840 times of that of CC genotype in the blood-stasis constitution group （95%CI [1.196-12.328], P=0.024）, T allele was 2.255 times of that of C allele （95%CI [1.232-4.126], P=0.008）, which had significant difference （P〈0.05）. Conclusion： （3） The mutation of MTHFRC677T site highs the risk of NONFH, which might be related with the incidence of NONFH. （4） The mutation of MTHFRC677T site highs the risk of blood-stasis constitution type, the polymorphism of which might be one of the mechanisms of high ris

关 键 词：非创伤性股骨头坏死 亚甲基四氢叶酸还原酶 中医体质 血瘀质 痰湿质 

分 类 号：R274.9[医药卫生—中西医结合]