中医五志与头痛关系的探究——一项孟德尔随机化研究  

Causal Relationship between Traditional Chinese Medicine Five Emotions and Headache:A Mendelian Randomization Study

作　　者：姚韵娟 刘志鹏 刘丽静 王志强[1] 朱银杏 YAO Yunjuan;LIU Zhipeng;LIU Lijing;WANG Zhiqiang;ZHU Yinxing(Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suzhou 215000,China;Taizhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Taizhou 225300,China;Wuxi Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Wuxi 214000,China)

机构地区：[1]南京中医药大学附属苏州市中医医院,苏州215000 [2]南京中医药大学泰州附属医院,泰州225300 [3]南京中医药大学附属无锡市中医医院,无锡214000

出　　处：《世界中医药》2025年第3期440-445,共6页World Chinese Medicine

基　　金：国家自然科学基金面上项目(82374220);中国博士后科学基金第74批面上资助(2023M741796);第四批江苏省名老中医药专家传承工作室建设项目(苏中医科教〔2021〕7号);泰州市中医药科技项目(TZ202301)。

摘　　要：目的:采用两样本孟德尔随机化研究中医五志与头痛的因果关系,探索头痛的潜在病因,为中西医治疗头痛提供新思路。方法:从全基因组关联分析(GWAS)数据库获取5种情志(怒、喜、思、悲、恐)及头痛、偏头痛和非偏头痛的其他头痛的汇总数据集,选择独立的单核苷酸多态性(SNP)作为每种疾病的工具变量(IVs)。采用逆方差加权法(IVW),加权中位数法(WME)、MR-Egger回归法探究五志与头痛之间的因果关系。使用MR-PRESSO进行离群值检测并矫正,Cochran Q检验进行异质性评估,Egger intercept法进行水平多效性检验,以保证结果的可靠性。结果:IVW结果表明头痛与易怒(OR=1.708,95%CI为1.079~2.703)、思虑过度(OR=1.647,95%CI为1.255~2.160)和悲伤抑郁(OR=1.535,95%CI为1.158~2.036)显著正相关;偏头痛与易怒(OR=1.017,95%CI为1.002~1.031)和思虑过度(OR=1.013,95%CI为1.002~1.021)正相关;非偏头痛与易怒(OR=1.010,95%CI为1.003~1.017)、思虑过度(OR=1.004,95%CI为1.001~1.008)和悲伤抑郁(OR=1.006,95%CI为1.003~1.010)具有潜在正相关。结论:易怒和思虑过度会增加头痛、偏头痛及非偏头痛的患病风险,悲伤抑郁会影响头痛和非偏头痛的发病。Objective:To investigate the causal relationship between the five emotions in traditional Chinese medicine(TCM)and headache by two-sample Mendelian randomization(MR),aiming to explore potential etiologies and provide novel insights for headache treatment with TCM and Western medicine.Methods:Summary statistics for five emotions(anger,joy,overthinking,sadness,and fear)and headache-related conditions,including general headache,migraine,and non-migraine headache,were obtained from genome-wide association studies(GWAS)databases.Independent single nucleotide polymorphisms(SNPs)were selected as instrumental variables(IVs)for each condition.The inverse-variance weighted(IVW)method,weighted median estimator(WME),and MR-Egger regression were used to examine causal relationships between the five emotions and headache.MR-PRESSO was applied for outlier detection and correction,Cochran's Q test was used to assess heterogeneity,and Egger intercept was employed to test for horizontal pleiotropy,ensuring the reliability of the results.Results:IVW analysis revealed that headache was significantly positively associated with anger(OR=1.708,95%CI 1.079 to 2.703),overthinking(OR=1.647,95%CI 1.255 to 2.160),and sadness/depression(OR=1.535,95%CI 1.158 to 2.036).Migraine was positively associated with anger(OR=1.017,95%CI 1.002 to 1.031)and overthinking(OR=1.013,95%CI 1.002 to 1.021).Non-migraine headache showed potential positive associations with anger(OR=1.010,95%CI 1.003 to 1.017),overthinking(OR=1.004,95%CI 1.001 to 1.008),and sadness/depression(OR=1.006,95%CI 1.003 to 1.010).Conclusion:Anger and overthinking increase the risk of developing headache,migraine,and non-migraine headache,while sadness/depression contributes to headache and non-migraine headache onset.

关 键 词：孟德尔随机化分析 头痛 情志 因果关联 易怒 思虑过度 

分 类 号：R259[医药卫生—中西医结合]