反复上呼吸道感染肺卫气虚证的血浆代谢组学特征及玉屏风颗粒干预的临床疗效  

Plasma Metabonomics Characteristics of Lung and Defensive Qi Deficiency Syndrome in Repeated Upper Respiratory Infection Patients and Clinical Effects of Yupingfeng Particles(玉屏风颗粒) Intervention

作　　者：林燕[1] 王亚利[1] 王鑫国[2] 张明泉[2] 王文智[2] 耿立梅[3] 孙玉凤[4] 曹文利[2] 师旭亮[2] 

机构地区：[1]河北医科大学研究生学院,河北省石家庄市050017 [2]河北中医学院 [3]河北省中医院 [4]河北医科大学附属第二医院

出　　处：《中医杂志》2015年第15期1302-1306,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81150030)

摘　　要：目的运用代谢组学方法研究反复上呼吸道感染肺卫气虚证潜在的证候标记物,同时观察玉屏风颗粒干预的临床疗效及可能作用机制。方法选择反复上呼吸道感染肺卫气虚证患者15例(疾病组),给予玉屏风颗粒治疗,每次5 g,每日3次,共治疗60天。同时收集健康体检者18例设为健康组。采集健康组及疾病组治疗前后血液,采用高效液相色谱-质谱联用仪(HPLC-MS)检测血浆代谢物,利用主成分分析(PCA)和偏最小二乘法(PLS)对数据进行统计分析,比较健康组和疾病组治疗前后的血浆代谢组学原始谱图和数据。结果治疗后疾病组患者易感性、畏寒、自汗等临床症状较治疗前有明显改善(P<0.01)。疾病组中医证候疗效临床痊愈4例,显效7例,有效3例,总有效率为93.34%。疾病组在治疗前的代谢谱和健康组存在明显不同,经玉屏风颗粒干预后其代谢谱有显著改变,向健康组回归;半胱氨酸、L-蛋氨酸、苏氨酸、焦谷氨酸4种物质为反复上呼吸道感染肺卫气虚证的潜在证候标志物。结论反复上呼吸道感染肺卫气虚证患者存在氨基酸代谢紊乱,纠正氨基酸代谢紊乱可能是玉屏风颗粒治疗肺卫气虚证的作用机制之一。Objective To use metabonomics method to study the potential syndromes markers about lung and defensive Qi deficiency syndrome of repeated upper respiratory infection （URI） and observe clinical effects and possible mechanism of action of Yupingfeng Particles. Methods Fifteen patients with lung and defensive Qi deficiency syndrome of repeated URI （disease group） were given Yupingfeng Particles, 5 g each time, three times a day for a total of 60 days. Eighteen healthy subjects were collected as health group at the same time. Blood samples from the healthy and the disease group were collected before and after treatment. High performance liquid chromatography mass spectrometry instrument （HPLC-MS） was used to detect plasma metabolites, and principal component analysis （PCA） and partial least squares （PLS） was used to make statistical analysis to the data for comparing plasma metabo- nomics original spectra and data of the healthy group and the disease group before and after treatment. Results After treatment, clinical symptoms such as susceptibility, chills, spontaneous perspiration of patients in the disease group improved significantly （P 〈 0. 01 ）. Curative effect of traditional Chinese medicine syndrome in the disease group showed that clinical recovery were 4 cases, 7 cases were markedly effective, 3 cases were effective and the total effective rate was 93.34%. Metabolic spectrum of the disease group was significantly different from the health groups before the treatment. The disease group＇s metabolic spectrum has significant changes after Yupingfeng Particles inter- vention, regressed to the health group. Four kinds of material including Cysteine, L-methionine, threonine, pyroglu- tamic acid were potential syndrome markers of lung and defensive Qi deficiency syndrome of repeated URI. Conclu- sion Patients with lung and defensive Qi deficiency syndrome of repeated URI had disorder of amino acid metabo- lism. Correcting disorder of amino acid metabolism may be one of the mechanisms of a

关 键 词：反复上呼吸道感染 肺卫气虚证 玉屏风颗粒 代谢组学 

分 类 号：R259[医药卫生—中西医结合]