代谢综合征痰证病性兼杂及理化指标与PPARγ基因的相关性研究  

Study on the Correlation Between the Pathogenicity and Miscellaneous and Physicochemical Indexes of Phlegm Syndrome of Metabolic Syndrome and PPARγ Gene

作　　者：张萍 李缘缘 邵岩飞 李丹 许超强 房盛懿 陈淑娇[4] 俞洁[1,2,5] 高碧珍 ZHANG Ping;LI Yuan-yuan;SHAO Yan-fei;LI Dan;XU Chao-qiang;FANG Sheng-yi;CHEN Shu-jiao;YU Jie;GAO Bi-zhen(College of Traditional Chinese Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou 350122;Fujian 2011 Chinese Medicine Health Management Collaborative Innovation Center,Fuzhou 350122;Department of Gastrointestinal Surgery,Ruijin Hospital affiliated to Shanghai Jiao Tong University Medical College,Shanghai 200025;The Third affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350122;Key Laboratory of TCM Health Differentiation in Fujian Province,Fujian University of Traditional Chinese Medicine,Fuzhou 350122;School of Integrated Chinese and Western Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou 350122)

机构地区：[1]福建中医药大学中医学院,福州350122 [2]福建省2011中医健康管理协同创新中心,福州350122 [3]上海交通大学医学院附属瑞金医院胃肠外科,上海200025 [4]福建中医药大学附属第三人民院内分泌科,福州350122 [5]福建省中医健康状态辨识重点实验室,福州350122 [6]福建中医药大学中西医结合学院,福州350122

出　　处：《中国中西医结合杂志》2021年第1期29-34,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81873234,No.81273666);福建省自然科学基金面上项目(No.2018J01875);福建省2011中医健康管理协同创新中心资助项目(No.JG2017004-协同)。

摘　　要：目的通过分析代谢综合征(MS)痰证兼杂及理化指标与过氧化物酶体增殖物激活受体γ(PPARγ)基因的相关性,探讨其可能的生物学基础。方法收集MS患者,运用证素辨证法从中筛选MS痰证单纯兼杂患者,即MS痰兼湿证组、痰兼热证组、痰兼阴虚证组,各30例,并以30名健康人作为健康组。理化检测指标包括:BMI、SBP、DBP、TG、TC、HDL-C、LDL-C、ALT、AST、ALT/AST、GGT、BUN、SCr、UA以及FPG,实时荧光定量PCR法(q-PCR)及酶联免疫吸附法(ELISA)检测PPARγmRNA及蛋白表达。结果MS痰证兼杂病性证素频次由高至低依次为:湿、阴虚、热、气滞、气虚、阳虚、血瘀、血虚;MS痰证病位证素频次由高至低依次为:肝、肺、肾、脾、心、胆、胃;与健康组比较,痰兼湿、痰兼热、痰兼阴虚组BMI、SBP、DBP、FPG均显著升高(P<0.01,P<0.05),痰兼湿、痰兼阴虚组FPG显著升高(P<0.01,P<0.05);痰兼阴虚组FPG高于痰兼热证组、痰兼湿证组(P<0.01);痰兼热证组SCr高于健康组、痰兼阴虚组、痰兼湿证组(P<0.01)。痰兼热证组、痰兼阴虚组BUN高于痰兼湿证组(P<0.05)。与健康组比较,痰兼阴虚组、痰兼热证组、痰兼湿证组PPARγmRNA表达量均升高,而蛋白表达降低(P<0.01,P<0.05);痰兼阴虚组及痰兼湿证组PPARγ蛋白表达高于痰兼热证组(P<0.01);痰兼湿证组PPARγmRNA表达与AST/ALT呈正相关(P<0.05);痰兼热证组PPARγ蛋白表达与GGT呈负相关(P<0.05);痰兼阴虚组PPARγ蛋白表达与SCr呈正相关(P<0.05)。结论MS痰证病性证素前三位为湿、阴虚、热;病位证素前三位是肝、肺、肾;MS患者机体PPARγ基因表达的下调可能是其痰证兼杂的生物学基础,PPARγ基因与MS痰证兼杂热证有一定联系。Objective To explore the possible genetic basis of metabolic syndrome(MS)phlegm syndrome physical and chemical indexes by analyzing its correlation of the expression of PPARγgene.Methods The MS patients were assigned to 3 groups:the MS phlegm-dampness syndrome group,the MS phlegm-heat syndrome group,and the MS phlegm and yin deficiency syndrome group by syndrome differentiation,30 cases in each group.Thirty healthy people were recruited as the healthy group.The physical and chemical testing indicators included BMI,SBP,DBP,TG,TC,HDL-C,LDL-C,ALT,AST,ALT/AST,GGT,BUN,SCr,UA and FPG.Real-time Quantitative PCR(q-PCR)and Enzyme-linked immunosorbent assay(ELISA)were used to detect PPARγgene expression.Results The concurrent syndrome elements of disease-property of MS were ranked from high to low as:dampness,yin deficiency,heat,qi stagnation,qi deficiency,yang deficiency,blood stasis,blood deficiency;the concurrent syndrome elements of disease-position of MS were sequenced from high to low as:Gan,Fei,Shen,Pi,Xin,Dan,Wei.Compared with healthy group,the value of BMI,SBP,DBP and FPG were significantly increased(P<0.01,P<0.05)in all three groups.The value of FPG in phlegm and yin deficiency groups was higher than that in healthy group(P<0.01,P<0.05)and the value of FPG in phlegm and yin deficiency group was higher than that in phlegm-heat syndrome group and phlegm-dampness syndrome group(P<0.01).The value of SCr in phlegm-heat group was higher than that in the healthy group,the phlegm and yin deficiency group and the phlegm-dampness syndrome group(P<0.01).The phlegm-heat syndrome group and phlegm and yin deficiency group had higher BUN than the phlegm-dampness syndrome group(P<0.05).Compared with the healthy group,the mRNA expression of PPARγgene in the phlegm and yin deficiency group,phlegm-heat syndrome group and phlegm-dampness syndrome group was relatively high.While the relative protein expression level of PPARγgene was lower than that in the healthy group(P<0.01,P<0.05).The relative protein expression level of PPAR�

关 键 词：代谢综合征 PPARΓ基因 痰证 证候要素 

分 类 号：R259[医药卫生—中西医结合]