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尿代谢组学探讨慢性乙型肝炎患者的虚实证差异。

Differences of excess and deficiency zheng in patients with chronic hepatitis B by urinary metabonomics.

机构信息

Center for Traditional Chinese Medicine and Systems Biology, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.

出版信息

Evid Based Complement Alternat Med. 2013;2013:738245. doi: 10.1155/2013/738245. Epub 2013 Apr 24.

Abstract

Traditional Chinese medicine (TCM) physicians stratify patients with the same disease into different subtypes in order to guide the appropriate treatment, which is called Zheng (TCM syndrome) classification. Excess and deficiency ZHENG is a couple of basic ZHENGs of maladjusted body nature, reflecting the struggling state of human body and pathogenic factor and is important and prevalently exists in the ZHENG classification of many diseases. The present work using chronic hepatitis B (CHB) as an entry point explored the substance connotation of excess and deficiency ZHENG with the metabonomic technology based on gas chromatography-mass spectrometry (GC-MS). The different substantial basis of two ZHENGs suggested that CHB patients could be categorized into two groups with diverse pathogenesis. The differential metabolites and disturbed pathways compared to not-obvious ZHENG characters patients (without ZHENG group/WZ) were selected in both of the two ZHENGs. The ROC analysis demonstrated that five metabolites had a greater potential to be the clinic biomarkers of EZ or DZ. And excess ZHENG revealed a higher level of immune function than deficiency ZHENG. We are eager to transform the concept of traditional excess and deficiency ZHENGs to modern therapeutic approaches, with the prospect to help to promote personalized medicine.

摘要

中医(TCM)医师将同一种疾病的患者分为不同的亚型,以指导适当的治疗,这被称为“证”(TCM 综合征)分类。虚实“证”是失调体质的两种基本“证”,反映了人体与致病因素的斗争状态,在许多疾病的“证”分类中重要且普遍存在。本研究以慢性乙型肝炎(CHB)为切入点,运用基于气相色谱-质谱联用(GC-MS)的代谢组学技术探索虚实“证”的物质内涵。两种“证”的不同物质基础表明,CHB 患者可以分为两种具有不同发病机制的组。与不明显“证”特征患者(无“证”组/WZ)相比,在两种“证”中都选择了差异代谢物和紊乱途径。ROC 分析表明,有 5 种代谢物具有成为 EZ 或 DZ 临床生物标志物的更大潜力。而且,实证“证”比虚证“证”显示出更高的免疫功能水平。我们渴望将传统的虚实“证”观念转化为现代治疗方法,有望有助于促进个性化医疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62ac/3655602/b0581c0938a7/ECAM2013-738245.001.jpg

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