基于血清代谢组学的高血压病中医证型代谢模式差异分析  

Analysis of the difference in the metabolic patterns of hypertension TCM syndromes based on serum metabolomics

作　　者：李超[1] 鞠建庆 潘文慧[1] 李运伦[1] 杨雯晴[1] LI Chao;JU Jian-qing;PAN Wen-hui;LI Yun-lun;YANG Wen-qing(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]山东中医药大学,济南250355 [2]中国中医科学院西苑医院,北京100091

出　　处：《中华中医药杂志》2021年第9期5515-5520,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81473653,No.81774242);泰山学者项目(No.ts201712042)。

摘　　要：目的:探索原发性高血压不同中医证候的代谢模式,试图从代谢组学的角度揭示高血压病的证候本质,为高血压病中医证候的精准阐释和诊治提供借鉴。方法:对19例高血压病肝阳上亢证患者(GYSK组)、16例阴阳两虚证患者(YYLX组)和18名健康志愿者(HC组)的血清进行了超高效液相色谱-质谱联用分析,并进行模式识别和生物标记识别。结果:GYSK组鉴定出7种特异性生物标志物:花生四烯酸、白三烯a4、3,4-二羟基扁桃酸、孕酮、2-甲氧基-雌二醇-17b-3-葡萄糖醛酸苷、创伤酸、7-羟基-D4-神经前列腺素;YYLX组检测到9种特异性生物标志物:乳清酸、5-甲基胞嘧啶、植物鞘氨醇、羊毛甾醇、石榴酸、PS(18∶0/18∶1(9z))、PE(14∶0/22∶4(7z,10z,13z,16z))、SM(d18∶1/12∶0)、PC(20∶1(11z)/20∶4(5z,8z,11z,14z))。结论:特异性生物标志物在一定程度上从微观层面揭示了高血压病肝阳上亢证与阴阳两虚证的代谢本质,有助于高血压病的中医临床诊断和治疗。Objective: To explore the different metabolic patterns of essential hypertension, confirm the existence of different TCM syndromes for hypertension, try to provide the basis for the classification of hypertension from the perspective of metabolomics, and realize the aim of precision medical treatment. Methods: Serum from 19 hypertensive patients with upper hyperactivity of liver yang syndrome(GYSK Group), 16 patients with deficiency of both yin and yang syndrome(YYLX Group) and 18 healthy volunteers(HC Group) were analyzed by Ultra-performance liquid chromatography Q Exactive ?hybrid quadrupole-Orbitrap mass spectrometer(UPLC-Q-Exactive MS/MS), pattern recognition and biomarkers identifying were detected. Results: Seven significant biomarkers were identified in GYSK Group: arachidonic acid, leukotriene a4,3,4-Dihydroxymandelic acid, progesterone, 2-methoxy-estradiol-17 b 3-glucuronide, traumatic acid, 7-hydroxy-d4-neuroprostane;9 different biomarkers were detected in YYLX Group: orotic acid, 5-methylcytosine, phytosphingosine, lanosterin, punicic acid,PS(18:0/18:1(9 z)), PE(14:0/22:4(7 z,10 z,13 z,16 z)), SM(d18:1/12:0), PC(20:1(11 z)/20:4(5 z,8 z,11 z,14 z)). Conclusion: These differential biomarkers reveal the mechanism of the syndromes of hypertension with hyperactivity of liver-yang and deficiency of both yin and yang from the microscopic level, which are helpful for the clinical diagnosis and treatment of hypertension in traditional Chinese medicine.

关 键 词：高血压病 代谢组学 肝阳上亢证 阴阳两虚证 生物标志物 

分 类 号：R259[医药卫生—中西医结合]