Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, 100029, China,
Chin J Integr Med. 2014 Jan;20(1):68-71. doi: 10.1007/s11655-012-1182-z. Epub 2012 Dec 3.
Studying the essence of a syndrome has been a key challenge in the field of Chinese medicine. Until now, due to limitations of the methods available, the progress towards understanding such complicated systems has been slow. Metabonomics encompasses the dynamics, composition and analysis of metabolites, enabling the observation of changes in the metabolic network of the human body associated with disease. Being from the point of view of the whole organism, metabonomics provides an opportunity to study the essence of a syndrome to an unprecedented level. Phlegm and blood stasis syndrome is the main syndrome associated with coronary heart disease (CHD), which bring difficulties in clinical treatment due to difficulties associated with differentiation of symptoms and signs. The fundamental differences of material between the two also need to be interpreted. The authors consider that we can use the method of combining a disease (in this case CHD) with associated syndromes (phlegm and blood stasis syndrome) to select patients with phlegm and blood stasis syndrome of CHD, and utilize metabonomics to explore the essence of the syndrome by difference analysis of metabolite spectra. Meanwhile, we can study the syndrome in CM, observe the change regularity of metabolism spectra after the treatment of corresponding and non-corresponding prescription and syndrome, in order to validate the material fundament in the progress of syndrome formation and their differences. This will not only have great significance in enhancing the ability to identify syndrome of phlegm and blood stasis in CHD and to establish the clinical curative criteria, but will also offer a new approach of studying the essence for a syndrome using metabonomics.
研究证候本质一直是中医领域的一个关键挑战。到目前为止,由于现有方法的局限性,对于理解如此复杂的系统的进展一直较为缓慢。代谢组学涵盖了代谢物的动态、组成和分析,使人们能够观察到与疾病相关的人体代谢网络的变化。从整体生物体的角度来看,代谢组学提供了一个机会,使我们能够以前所未有的水平来研究证候的本质。痰瘀证是冠心病(CHD)的主要证候,由于症状和体征的鉴别困难,给临床治疗带来困难。两者的物质基础也存在根本差异,需要加以解释。作者认为,可以采用病证结合的方法(在这种情况下是 CHD 与痰瘀证相结合)来选择 CHD 痰瘀证患者,运用代谢组学通过代谢谱差异分析来探索证候的本质。同时,可以在中医中研究证候,观察相应和非相应方剂和证候治疗后的代谢谱变化规律,以验证证候形成过程中的物质基础及其差异。这不仅对提高 CHD 痰瘀证的辨证能力和建立临床疗效标准具有重要意义,而且为利用代谢组学研究证候本质提供了一种新方法。