血瘀体质理论及其外周血基因表达谱的研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的
     挖掘传统中医理论中血瘀体质的相关内容,总结近现代研究成果,补充中医血瘀体质的相关理论;检测血瘀体质的外周血基因表达谱,探索其基因表达特征,为防治血瘀体质相关疾病提供依据。
     方法
     采用传统文献梳理与现代文献分析的方法,进行中医血瘀体质理论研究。在临床流行病学调查的基础上,选择13例典型血瘀体质和30例典型平和体质受试对象,抽取空腹静脉血各10ml,分离白细胞,提取总RNA,纯化后进行单轮扩增,生物素标记cRNA,应用Illumina公司的Sentrix(?)Human-6 Expression BeadChip芯片检测基因表达谱。以平和体质作为对照,得出血瘀体质的差异表达基因,对差异表达基因进行GO注释和pathway分析,并对差异表达基因的生物学功能进行评价,从基因水平阐明血瘀体质成因、特征及其发病倾向性的机制。
     结果
     理论研究发现血瘀体质的形成受先后天多种因素的影响,多因先天遗传、年老、性别、跌扑损伤、内伤七情、饮食不节、劳逸过度以及久病等因素而形成;
     基因研究发现,当P<0.05时,血瘀体质与平和体质表达差异基因共592个位点,其中上调基因167个位点,下调425个位点;当P<0.001时,血瘀体质与平和体质表达差异基因共有96个位点,其中上调基因24个位点,下调基因72个位点。与平和体质相比,血瘀体质者血小板易凝集,易患缺血性疾病和肿瘤类疾病;血瘀体质者参与蛋白合成、核酸合成、类固醇激素合成等生物合成功能的基因表达下调,说明血瘀体质者生物合成与代谢功能有下降的趋势;血瘀体质者与基因转录相关的基因表达下调,说明血瘀体质者在遗传信息传递方面的功能可能呈现下降状态;而血瘀体质者部分与生长发育相关的基因表达下调,以及与二氢嘧啶脱氢酶、人甲基转移酶、蛋白精氨酸甲基转移酶、UDP葡萄糖焦磷酸化酶、转磷酸胆碱酶、1-磷酸半乳糖尿苷酸转移酶、钙蛋白酶、内酰胺酶等酶活性相关的基因下调,又揭示了血瘀体质者可能有生长发育下降的趋势。
     结论:
     血瘀体质理论体系对指导临床用药及养生保健具有重要意义。基因研究表明,与平和体质相比,血瘀体质者血小板易凝集,易患缺血性疾病和肿瘤类疾病;血瘀体质在生物合成与代谢功能、遗传信息传递方面的能力以及生长发育均有下降的趋势。
Objective To excavate the related theories of Stagnant Blood Constitution(SBC) from Traditional Chinese Medicine theory,summarize contemporary research achievement and expatiate the theories of SBC and its application.To reveal the characteristics of gene expression for SBC by detecting the gene expression profiles of peripheral blood of SBC.It will provide theory basis to prevent related diseases early.
     Methods By the hods of the traditional literature research and the contemporary literature analysis,we discuss the correlative theories of SBC from origin to development,from connotation to extension.
     13 typical subjects of SBC and 30 subjects of normal constitution were selected on the basis of clinical epidemiological investigation.Ten milliliters of fasting venous blood were collected from each subject.The white blood cells were isolated,and the total RNA was extracted,purified and amplified.The complement RNA(cRNA) was labelled with biotin.The gene expression profiles of peripheral blood were detected with Sentrix Human-6 Expression BeadChip gene chip.The differentially expressed genes as compared with normal constitution were analyzed,and they were GO annotated and statistically pathway analyzed.The biological functions of differentially expressed genes were evaluated in order to reveal the cause,characteristics and liability of SBC at the level of gene.
     Results Theoretical studies found that the formation of blood stasis constitution was influenced by various of congenital and inherent factors,which included genetic factors, oldness,sex,tramatic injuries,seven emotions and internal injuries,improper diet, excessive labour and ease,and the prolonged disease.
     Genetic researches revealed that there were 592 differential gene locus expressed in blood stasis constitution group as compared with the balanced constitution group when P<0.05,which included 167 up-regulated gene locus and 425 down-regulated gene locus; When P<0.001,the differential gene locus expressed in blood stasis constitution group dcreased by 96 as compared with the balanced constitution group.Of these,24 were up-regulated gene locus and 72 were down-regulated gene locus.Patients with blood stasis constitution were more easily to have the platelet aggregation status,and had a high likelihood of suffering ischamic and tumor disease.A lot of biosynthesis-related genes which takes part in the process of protein,nucleic acid,and steroid hormone sythesis were down-regulated in population with blood stasis constitution,which indicates the decreasing status of genetic information transmission functions in blood stasis population.While the facts of many other genes which included growth and development-related and enzyme activity-related genes such as dihydropyrimidine dehydrogenase,human methyltransferase,protein-arginine n-methyltransferase,UDP glucose pyrophosphorylase,cholinephosphotransferase,phosphate galactose uridylic acid transferase,calpain,lactamase,down-regulated indicated again the possibility of decreasing in growth and development in population with blood stasis constitution.
     Conclusions The theoretical system of SBC could contribute to clinical medication and health preservation.There were significant differences of peripheral blood gene expression profile between the SBC and the normal constitution.The blood platelet of SBC is easier to aggregate and has the tendency to suffer from ischemic disease and cancer.The biosynthesis and metabolism function,the ability of genetic message transmission and the growth and development have downtrend.
引文
[1]王琦.高等中医药院校创新教材·中医体质学.第1版[M].北京:人民卫生出版,2005:2,81
    [2]王琦,朱燕波.中国一般人群中医体质流行病学调查[J].中华中医药杂志,2009,35(1):4-8.
    [3]王琦.9种基本中医体质类型的分类及其诊断表述依据[J].北京中医药大学学报,2005,28(4):1
    [4]王琦.中医体质学[M].北京:中国医药科技出版社,1995:69-85,71
    [5]邵致格,胡曼菁,王长松.现代人群的体质病理学特征:气虚血瘀[J].医学与哲学,2005,26(4):74
    [6]何裕民,王莉,石凤亭,等.体质的聚类研究[J].中国中医基础医学杂志,1996,2(5):7-9
    [7]唐德志,陈卫,黎高明.体质与脉象的相关调查研究[J].江西中医药,2003,34(6):21
    [8]李玉清.论瘀血体质的状态及形成因素[J].江西中医药,2003,34(4):10-11
    [9]朱秉匡,周国雄,赵长樱,等.1075例老年人体型与体质关系的分析[J].中国医药学报,1988,3(5):57
    [10]有地滋.一贯堂医学在现代医学中的价值[J].国外医学·中医中药分册,1986,8(4):22-24
    [11]王莉.男女体质特点及其异同的研究[J].中国中医基础医学杂志,1998,4(2):7-8
    [12]姚实林,吴芳斌,许霞,等.1003例中医体质类型流行病学调查分析[J].安徽中医学院学报,2007,26(1):10-13
    [13]柴雅倩,陈群,徐志伟.论瘀血体质的特征[J].国医论坛,2006,21(4):12-14
    [14]王琦,骆斌.肥胖人痰湿型体质与冠心病相关性研究(上)[J].江苏中医,1994,16(4):42-44
    [15]李东涛,田代华.论气虚体质的特征[J].山东中医杂志,1998,17(9):389-391
    [16]林齐鸣,虞学军.试论兼挟体质[J].四川中医,2002,20(7):9-111
    [17]何裕民,王莉,石凤亭,等.体质的聚类研究[J].中国中医基础医学杂志,1996,2(5):7-9
    [18]秦国政,骆斌.勃起功能障碍中医体质学规律研究[J].北京中医药大学学报,2005,28(4):74-77
    [19]袁婉丽,胡节惠.2型糖尿病表型与中医体质分类关系的研究[J].现代医药卫生,2004,20(24):2602
    [20]张敏,戴晓勇,刘瑶,等.1763例社区人员中医体质筛查分析[J].河南中医,2002,22(4):72
    [21]欧阳涛,宋剑南,林谦,等.冠心病体质表型和低密度脂蛋白受体基因AvaⅡ位点多态性关系的研究[J].中国中医基础医学杂志,2005,11(7):521-523
    [22]陈立典,韩平,杜建,等.福建省高血压影响因素与中医体质分型的研究[J].中国老年学杂志,2007,27(13):1297-1299
    [23]谭萍,夏文雯.下肢静脉曲张患者中医体质辨证施护体会[J].医学理论与实践,2008,21(8):964-965
    [24]林秀华,杨志敏,老膺荣.轻度认知功能障碍患者的中医体质特点[J].中华中医药学刊,2008,26(10):2237-2238
    [25]周小军,田道法.鼻咽癌家系体质调查研究[J].中国中医基础医学杂志,2002,8(11):60
    [26]刘华,梁国珍,罗颂平.广州市部分育龄妇女早期自然流产的中医病因流行病学研究[J].中国中医急症,2004,13(2):101-102
    [27]张正庆,罗薇,刘亚刚.系统生物学研究及其在医学中的应用[J].生物技术通讯,2007,18(4)723-726
    [1]祁明浩.基因芯片技术在中医证研究中的思考与应用[J].中医药学刊,2006,24(11):2022.
    [2]姚实林.阳虚质理论及其外周血基因表达谱研究[D].北京中医药大学博士研究生学位论文,2007:13,45-87.
    [3]王睿林.气虚体质者外周血基因表达谱初步研究[D].北京中医药大学硕士研究生学位论文,2005:3.
    [4]倪红梅,吴艳萍,何裕民.用基因芯片技术研究青少年肾阳虚体质差异表达基因[J].上海中医药杂志,2004,38(6):3-5.
    [5]王东坡.痰湿体质及其基因表达特征研究[D].北京中医药大学博士研究生学位论文,2006:57-93.
    [6]董静.痰湿体质基础研究及其与代谢综合征相关性的探索[D].北京中医药大学博士研究生学位论文,2007:49-65.
    [7]高京宏.痰湿体质机制及基因表达谱研究[D].北京中医药大学博士研究生学位论文,2005:4.
    [8]任小娟.中医阴虚体质的理论和实验研究[D].北京中医药大学博士研究生学位论文, 2008:36-59.
    [9]王睿林.人类基因组学及基因芯片技术与中医体质学[J].中医药学刊,2004,22(9):1613-1614.
    [1]蒋森.血瘀论[M].北京:中国医药科技出版社,2001:6-9.
    [2]王琦.9种基本中医体质类型的分类及其诊断表述依据[J].北京中医药大学学报,2005,28(4):4.
    [3]王琦.中医体质学2008[M].北京:人民卫生出版社,2009:109.
    [4]姚实林.阳虚质理论及其外周血基因表达谱研究[D].北京中医药大学博士研究生学位论文,2007:13,28-29.
    [5]日·有地滋.一贯堂医学在现代医学的价值(六)[J].国外医学·中医中药分册,1986(4):22
    [6]日·有地滋.中国和日本文献中的瘀血(五)[J].国外医学·中医中药分册,1985(5):18
    [7]田栓磊,王琦.血瘀体质研究的几个相关问题[J].吉林中医药,2009,29(2):93-95.
    [8]李玉清.论瘀血体质的状态及形成因素[J].江西中医药,2003,34(4):10-11.
    [9]易发银.中医瘀血证诊疗大全[M].北京:中国中医药出版社,1996:1-4.
    [10]柴雅倩,陈群,徐志伟.论瘀血体质的特征[J].国医论坛,2006,21(4):12-14
    [11]王琦,朱燕波.中国一般人群中医体质流行病学调查[J].中华中医药杂志,2009,35(1):4-8.
    [12]王琦.中医体质学[M].北京:人民卫生出版社,2005:23,27.
    [1]任小娟.中医阴虚体质的理论和实验研究[D].北京中医药大学博士研究生学位论文,2008-36-59.
    [2]王琦.高等中医药院校创新教材·中医体质学[M].北京:人民卫生出版社,2005:2.
    [3]王东坡.痰湿体质及其基因表达特征研究[D].北京中医药大学博士研究生学位论文,2006:5.
    [4]江雁,穆红,唐志琴,等.定量测定45例血小板膜糖蛋白及其在急性脑梗死中的意义[J].陕西医学杂志,2008,37(12):1672-1674.
    [5]汤建民,张丽华.急性冠脉综合征患者纤溶活性和血小板活性的相关性研究[J].天津医药,2003,31(10):642-644.
    [6]田兆华,刘柏炎.血管新生与脑缺血损伤[J].中国脑血管病杂志,2008,5(3):132-134.
    [7]刘彦卿,王亚利.治疗性血管新生与缺血性心脏病[J].临床误诊误治,2008,21(6):78-83.)
    [8]Asahara T,MasudaH,TakahashiT,et a.l Bonemarrow origin of endothelial progenitor cells responsible for postnatal vascu-logenesis in physiological and pathological neovascularization[J].Circ Res,1999,85(3):221-228.
    [9]Abo-AudaW,Benza R L.Therapeutic angiogenesis:review of current concepts and future directions[J].J Heart Lung Transplant,2003,22(4):370-382.)
    [10]Krupinski J,Kaluza J,Kumar P,el al.Role of angiogene-sis in patients with cerebral ischemic stroke[J].Stroke,1994,25:1794-1798.
    [11]Morris DC,Yeich T,KhalighiMM,et a.l.Microvascular structure after embolic focal cerebral ischemia in the rat[J].Brain Res,2003,972:31-37.
    [12]Cheung WM,Chen SF,NianGM,et a.l Induction of angio-genesis related genes in the contralateral cortexwith a rat three-vessel occlusion model[J].Chin J Physio,12000,43:119-124.)
    [13]白雪,李世拥,于波,等.结直肠癌原发灶及其肝转移灶的蛋白表达差异研究[J].解放军医学杂志,2008,33(5):487-492.
    [14]宋勇莉,胡国华.细胞周期蛋白G2与头颈肿瘤[J].国际耳鼻咽喉头颈外科杂志,2006,30(1):8-11.
    [15]孙继丽,贺修胜,余艳辉,等.BNIP3L基因在肺癌组织中的表达及结构分析[J].癌症,2004,23(1):8-14.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700