广西汉族人群湿热证候易感性与HLA基因多态性的关联研究
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摘要
目的：
湿热证是中医临床常见的病证。近年来临床上湿热证呈上升的趋势,其具有发病范围广、病情缠绵、易反复等特点。岭南地区由于其特殊的气候环境和生活饮食习惯是湿热证高发的地区。广西壮族自治区位于中国的岭南地区,具有炎热多湿的气候地理环境,其作用于人体所形成的人群体质特点,决定了该地区湿热证候的易感性和多发性。因此,研究该地区人群湿热病证的特点及湿热证候易感性的相关因素具有较高的医学价值和社会学意义。
人类白细胞抗原基因系统(human leukocyte antigen, HLA)是迄今所知最为复杂的遗传多态性系统,是调控个体特异性免疫应答和决定个体疾病易感性差异的主要基因系统,多项研究已经证实人类HLA基因分布具有显著的人种、民族和地理的差别。中医理论认为,疾病过程中证候的类型、性质、病机发展的趋势和预后取决于体质与病因两个方面。其中个体体质是内因,体质是证候得以产生的重要物质基础,个体体质的特异性,往往决定着他对某种致病因子的易感性及其所产生的病变类型的倾向性。HLA基因系统的多态性与连锁不平衡现象等主要特征与中医体质学说之间有着很多共性。本研究针对特定的种群(广西汉族人群),以相对稳定的体质(湿热体质)为纲,从HLA基因多态性(Ⅰ类、Ⅱ类基因)的角度来寻找广西汉族人群湿热证候易感性的免疫遗传学基础,探讨同属岭南地区的广东和广西人群湿热证候的易感性是否存在地理差别,以助于对湿热证候本质研究的深入,同时也为中医“因地制宜”“异病同证”的机制探讨提供新的视角。
方法：
1、本课题首先采用了文献学研究方法,对湿热证的理论渊源做了历史性的回顾。通过对有关湿热证古代文献的研究,可以理清湿热证的理论渊源和明确其证候特点,为进一步研究湿热证打下坚实的理论基础。
2、为更好地研究广西人群的体质,参考有关资料并制定了湿热体质量表及湿热体质诊断标准,在2012年2月～10月采用横断面现场调查方法对322例广西地区成年人进行问卷调查后评估中医体质类型。并对其中符合纳入标准的166名18岁以上的广西籍汉族人群实施问卷调查,其中湿热体质组72例,非湿热体质组94例,重点了解湿热体质人群和非湿热体质人群的生活饮食习惯、社会人口学情况；应用单因素分析和多元逐步回归分析法对部分相关影响因素进行分析。
3、采用PCR一直接碱基序列分析基因分型技术(Sequence based genotyping, PCR一SBT)技术分别对广西籍和非广西籍的湿热证及正常人群共4组,每组18例进行HLA-A.B及DRB1基因分型检测。等位基因分布采用直接计数法,基因频率(gene frequency, Gf)按照哈迪一温伯格平衡(Hardy—Weinbergrule)计算,各组基因频率比较及两两比较采用χ2检验或者Fisher确切概率法(Fisher's Exact Text)检验。
结果：
1、对322例广西成年人进行问卷调查后评估中医体质类型,结果平和质94例,占29.2%；湿热质72例,占22.4%；痰湿质49例,占15.2%；气虚质36例,占11.2%；阴虚质23例,占7.1%；阳虚质20例,占6.2%；气郁质15例,占4.6%；血瘀质7例,占2.2%；特禀质6例,占1.9%。
2、对166例广西地区平和体质和湿热体质人群进行湿热体质影响因素问卷调查,按P<0.10,进行多元逐步回归分析,入选了7个因素,按标准化回归系数绝对值判断影响程度大小,依次是：喜甘甜、睡眠不规律、运动习惯、晚睡早起、喜酸、喜内脏、喜凉食,其中喜甘甜、喜内脏、喜凉食、睡眠不规律、晚睡早起、很少运动的人群湿热体质得分值较高,而早睡早起、喜酸者湿热体质得分值相对偏低。
3、采用PCR—SBT技术进行HLA-A、B及DRB1基因分型检测。经统计学分析,广西籍湿热组HLA-A*0207等位基因表型频率明显高于广西籍正常组,广西籍湿热组HLA-DRB1*0301及HLA-DRB1*1602等位基因表型频率明显低于广西籍正常组,P均<0.05,差异有统计学意义。
广西籍湿热组HLA-A*0201等位基因表型频率明显低于非广西籍湿热组,广西籍湿热组HLA-DRB1*1101及HLA-DRB1*1501等位基因表型频率明显高于非广西籍湿热组,差异有统计学意义(P<0.01或P<0.05)。
但HLA-B各基因型在四组之间无显著性差异(P>0.05)。
结论：
研究结果显示湿热体质是广西地区成年人最常见的偏颇体质类型,与广西地区以湿热为主的气候特征相符合。广西人群湿热体质的形成与喜食甘甜、动物内脏、生冷食物、睡眠不规律、缺乏运动锻炼等后天饮食起居因素关系密切,因此有必要对相关人群进行饮食生活习惯的指导和健康教育宣传,提倡合理的饮食结构和培养科学的生活方式,适度运动,以改善湿热体质,促进健康,预防疾病。
广西籍汉族湿热患者与HLA-A*0207基因型呈正相关,与HLA-DRB1*0301及HLA-DRB1*1602呈负相关,HLA-A*0207基因型可能是广西籍汉族人群湿热证的易感基因,HLA-DRB1*0301及HLA-DRB1*1602可能是广西籍汉族人群湿热证的保护性基因。且与非广西籍湿热患者比较,广西籍湿热组HLA-A*0201等位基因表型频率明显低于非广西籍湿热组,而HLA-DRB1*1101及HLA-DRB1*1501等位基因表型频率则明显高于非广西籍湿热组,提示广西籍湿热证候易感人群与非广西籍湿热证候易感人群可能存在不同的免疫遗传学基础。这表明广西地区汉族湿热人群可能存在着特异性的免疫遗传易感因素,故容易引起人体免疫平衡失调,导致“脾土衰弱,失健运之堤防,湿气停聚不化”(《证治汇补·湿症》),再加上该地区湿热气候环境的影响,机体容易遭受湿热外邪的入侵,内外合邪,从而导致湿热证的发生。
Objective
As one of the common syndromes in clinical practice of Chinese Medicine, damp-heat syndrome is with high-rate occurrence in Lingnan (southern part of China) because of the climate and the life style of the local. In recent years, the incidence of this syndrome increased to some extent and featured by its wide spreading, prolonged course and recurrence.
Located in Lingnan, Guangxi is in the climate zone characterized by its heat and humidity. The unique body constitution of local people, formed through the special geographical environment and distinctive features of life and diet, leads to their susceptibility and high frequency with damp-heat syndrome. Therefore, the study on damp-heat syndrome characteristics of local people and the relative factors to susceptibility have the high medical and sociological value.
As known so far, Human Leukocyte Antigen (HLA) is the most complex system of genetic polymorphism. And it is a major genetic system for regulating individual specific immune response and determining individual differences of disease susceptibility. The distribution of HLA is characterized by distinctive differences of races, nationalities and geography. It is considered in traditional Chinese medicine (TCM) theory that the type, nature and the trend and prognosis of the pathogenesis development of the syndrome depend on two factors-etiology and constitution. And constitution, the internal factors, is the background and vital material basis for different syndromes and that the specificity of individual constitution usually determines his or her susceptibility to some certain pathogenic factors and the type tendency of the generated disorders. There are some similarities in polymorphism and Linkage Disequilibrium of HLA system and TCM constitution theory. Focusing on the relative stable constitution, this study chose the specific population to explore the immune genetic basis of susceptibility to damp-heat syndrome and discuss the geographic differences of susceptibility to damp-heat syndrome between Han people in Guangxi and those in Guangdong within Lingnan area from the perspective of Human Leucocyte Antigen (HLA) gene polymorphism.(type Ⅰ and type Ⅱ). It benefits in the deep research on the nature of the syndrome and provided the new perspective for the mechanical discussion of taking actions that suit local circumstances and the same syndrome of different diseases.
Methods
1. The literature research method was used in the study project to give a historical review on the theoretical origin of the damp-heat syndrome. The theoretical origin and the syndrome characteristic of the damp-heat syndrome could be sorted out through the research on ancient literature of the damp-heat syndrome, which laid a solid theoretical foundation for further study of damp-heat syndrome.
2. In order to analyze the constitution of the Guangxi local people and consult and establish the damp-heat constitutional scale and the diagnostic standard, the method of cross sectional on-scene investigation was used to assess the TCM constitutional types after the questionnaire of322cases of adults. The questionnaire was implemented on166cases of Han people in Guangxi above18years old with72cases of damp-heat syndrome group and94cases of non damp-heat group. It is focused on understanding the living and diet habit of the damp-heat syndrome group and non damp-heat group and sociodemographic situation. The methods of one-factor ANOVA and multiple stepwise regression analysis were applied for some relevant factors.
3. Sequence-based Genotyping Technology (PCR—SBT) was conducted to4group of Gaungxi and non Guangxi people with damp-heat and normal syndrome. HLA-A, B and DRB1genetic typing detections was conducted to18cases of each group. The method of direct counting was used in allele distribution. The gene frequency (GF) was calculated according to the balance of Hardy—Weinbergrule. The x2test or Fisher's Exact Text was used for the comparison of the gene frequency for each group and two items comparison.
Results
1. The TCM constitutional types were assessed after the questionnaire of322cases of adults.94cases mild constitution account for29.2%;72cases damp-heat constitution account for22.4%;49cases phlegm-damp constitution account for15.2%;36cases qi-deficient constitution account for11.2%;23cases yin-deficient account for6.2%;15cases qi-stagnation constitution account for4.6%;7cases blood-stasis constitution account for2.2%;6cases the specific endowment constitution account for1.9%.
2. The questionnaire was applied in166cases of Guangxi people with damp-heat constitution. Multiple stepwise regression analysis was used with P<0.10. According to the influenced extend of standardized regression coefficients modulus,7factors were selected, that are the like of sweet, irregular sleeping, sports habit, late sleeping and early getting up and the like of sour, viscera, cold food. The value for the damp-heat group people with the like of sweet, viscera, cold food, irregular sleeping, late sleeping and early getting up, less sports was relatively higher. But the value for damp-heat people with the like of early getting up and sleeping and the sour was relatively lower.
3. The technology of PCR—SBT was used to conduct HLA-A, B and DRB1genetic typing detections. The allele phenotype frequency of HLA-A*0207in Guangxi damp-heat syndrome group was evidently higher than that of Guangxi normal group (P<0.05). And the allele phenotype frequency of HLA-DRB1*0301and HLA-DRB1*1602in Guangxi damp-heat syndrome group was evidently lower than that of Guangxi normal group (P<0.05). The difference was statistically significant.
The allele phenotype frequency of HLA-A*0201in Guangxi damp-heat syndrome group was evidently lower than that of Non-Guangxi group. And the allele phenotype frequency of HLA-DRB1*1101and HLA-DRB1*1501in Guangxi damp-heat syndrome group was evidently higher than that of Non-Guangxi group. The difference was statistically significant (P<0.01or P<0.05). There were no significant differences between the four groups of HLA-B genotypes.
Conelusion
The research results indicate that the damp-heat constitution is the most common constitutional type for adult in Guangxi, which meets the damp-heat climate characteristic in Guangxi. The formation of damp-heat constitution of Guangxi people is closely related with the postnatal factors of daily life and diet such as the appetite for sweet food, visceral, raw and cold food, irregular sleeping and lack of sports exercise. We need to focus on the guide for the diet and daily life habit and propagation for healthy education to advocate reasonable diet construction and habit, appropriate exercise and cultivate scientific life way in order to improve the damp-heat constitution, promote health and prevent diseases.
The damp-heat patients in Guangxi was positively correlated with HLA-A*0207genotype, and negatively associated with HLA-DRB1*0301and HLA-DRB1*1602. The HLA-A*0207genotype could be the susceptible gene of the damp-heat syndrome. The HLA-DRB1*0301and HLA-DRB1*1602could be the protective gene of the damp-heat syndrome. Compared with the damp-heat patients of non-Guangxi group, the allele phenotype frequency of HLA-A*0201in Guangxi damp-heat syndrome group is evidently lower. While the allele phenotype frequency of HLA-DRB1*1101and HLA-DRB1*1501in Guangxi damp-heat syndrome group is evidently higher than that of non-Guangxi group. It is indicated that there may exist different immune genetic basis between the susceptible group to damp-heat syndrome of Guangxi and non-Guangxi group. It shows that there are immune genetic susceptible factors in the damp-heat group of Guangxi, which will easily cause the immune imbalance of the body."The weak of the earth spleen causes the failure for transformation and damp-qi accumulation." So the occurrence of damp-heat syndrome is caused by such internal factor and the invasion due to the damp-heat climate effect of Guangxi.
湿热证是中医临床常见的病证。近年来临床上湿热证呈上升的趋势,其具有发病范围广、病情缠绵、易反复等特点。岭南地区由于其特殊的气候环境和生活饮食习惯是湿热证高发的地区。广西壮族自治区位于中国的岭南地区,具有炎热多湿的气候地理环境,其作用于人体所形成的人群体质特点,决定了该地区湿热证候的易感性和多发性。因此,研究该地区人群湿热病证的特点及湿热证候易感性的相关因素具有较高的医学价值和社会学意义。
人类白细胞抗原基因系统(human leukocyte antigen, HLA)是迄今所知最为复杂的遗传多态性系统,是调控个体特异性免疫应答和决定个体疾病易感性差异的主要基因系统,多项研究已经证实人类HLA基因分布具有显著的人种、民族和地理的差别。中医理论认为,疾病过程中证候的类型、性质、病机发展的趋势和预后取决于体质与病因两个方面。其中个体体质是内因,体质是证候得以产生的重要物质基础,个体体质的特异性,往往决定着他对某种致病因子的易感性及其所产生的病变类型的倾向性。HLA基因系统的多态性与连锁不平衡现象等主要特征与中医体质学说之间有着很多共性。本研究针对特定的种群(广西汉族人群),以相对稳定的体质(湿热体质)为纲,从HLA基因多态性(Ⅰ类、Ⅱ类基因)的角度来寻找广西汉族人群湿热证候易感性的免疫遗传学基础,探讨同属岭南地区的广东和广西人群湿热证候的易感性是否存在地理差别,以助于对湿热证候本质研究的深入,同时也为中医“因地制宜”“异病同证”的机制探讨提供新的视角。
方法：
1、本课题首先采用了文献学研究方法,对湿热证的理论渊源做了历史性的回顾。通过对有关湿热证古代文献的研究,可以理清湿热证的理论渊源和明确其证候特点,为进一步研究湿热证打下坚实的理论基础。
2、为更好地研究广西人群的体质,参考有关资料并制定了湿热体质量表及湿热体质诊断标准,在2012年2月～10月采用横断面现场调查方法对322例广西地区成年人进行问卷调查后评估中医体质类型。并对其中符合纳入标准的166名18岁以上的广西籍汉族人群实施问卷调查,其中湿热体质组72例,非湿热体质组94例,重点了解湿热体质人群和非湿热体质人群的生活饮食习惯、社会人口学情况；应用单因素分析和多元逐步回归分析法对部分相关影响因素进行分析。
3、采用PCR一直接碱基序列分析基因分型技术(Sequence based genotyping, PCR一SBT)技术分别对广西籍和非广西籍的湿热证及正常人群共4组,每组18例进行HLA-A.B及DRB1基因分型检测。等位基因分布采用直接计数法,基因频率(gene frequency, Gf)按照哈迪一温伯格平衡(Hardy—Weinbergrule)计算,各组基因频率比较及两两比较采用χ2检验或者Fisher确切概率法(Fisher's Exact Text)检验。
结果：
1、对322例广西成年人进行问卷调查后评估中医体质类型,结果平和质94例,占29.2%；湿热质72例,占22.4%；痰湿质49例,占15.2%；气虚质36例,占11.2%；阴虚质23例,占7.1%；阳虚质20例,占6.2%；气郁质15例,占4.6%；血瘀质7例,占2.2%；特禀质6例,占1.9%。
2、对166例广西地区平和体质和湿热体质人群进行湿热体质影响因素问卷调查,按P<0.10,进行多元逐步回归分析,入选了7个因素,按标准化回归系数绝对值判断影响程度大小,依次是：喜甘甜、睡眠不规律、运动习惯、晚睡早起、喜酸、喜内脏、喜凉食,其中喜甘甜、喜内脏、喜凉食、睡眠不规律、晚睡早起、很少运动的人群湿热体质得分值较高,而早睡早起、喜酸者湿热体质得分值相对偏低。
3、采用PCR—SBT技术进行HLA-A、B及DRB1基因分型检测。经统计学分析,广西籍湿热组HLA-A*0207等位基因表型频率明显高于广西籍正常组,广西籍湿热组HLA-DRB1*0301及HLA-DRB1*1602等位基因表型频率明显低于广西籍正常组,P均<0.05,差异有统计学意义。
广西籍湿热组HLA-A*0201等位基因表型频率明显低于非广西籍湿热组,广西籍湿热组HLA-DRB1*1101及HLA-DRB1*1501等位基因表型频率明显高于非广西籍湿热组,差异有统计学意义(P<0.01或P<0.05)。
但HLA-B各基因型在四组之间无显著性差异(P>0.05)。
结论：
研究结果显示湿热体质是广西地区成年人最常见的偏颇体质类型,与广西地区以湿热为主的气候特征相符合。广西人群湿热体质的形成与喜食甘甜、动物内脏、生冷食物、睡眠不规律、缺乏运动锻炼等后天饮食起居因素关系密切,因此有必要对相关人群进行饮食生活习惯的指导和健康教育宣传,提倡合理的饮食结构和培养科学的生活方式,适度运动,以改善湿热体质,促进健康,预防疾病。
广西籍汉族湿热患者与HLA-A*0207基因型呈正相关,与HLA-DRB1*0301及HLA-DRB1*1602呈负相关,HLA-A*0207基因型可能是广西籍汉族人群湿热证的易感基因,HLA-DRB1*0301及HLA-DRB1*1602可能是广西籍汉族人群湿热证的保护性基因。且与非广西籍湿热患者比较,广西籍湿热组HLA-A*0201等位基因表型频率明显低于非广西籍湿热组,而HLA-DRB1*1101及HLA-DRB1*1501等位基因表型频率则明显高于非广西籍湿热组,提示广西籍湿热证候易感人群与非广西籍湿热证候易感人群可能存在不同的免疫遗传学基础。这表明广西地区汉族湿热人群可能存在着特异性的免疫遗传易感因素,故容易引起人体免疫平衡失调,导致“脾土衰弱,失健运之堤防,湿气停聚不化”(《证治汇补·湿症》),再加上该地区湿热气候环境的影响,机体容易遭受湿热外邪的入侵,内外合邪,从而导致湿热证的发生。
Objective
As one of the common syndromes in clinical practice of Chinese Medicine, damp-heat syndrome is with high-rate occurrence in Lingnan (southern part of China) because of the climate and the life style of the local. In recent years, the incidence of this syndrome increased to some extent and featured by its wide spreading, prolonged course and recurrence.
Located in Lingnan, Guangxi is in the climate zone characterized by its heat and humidity. The unique body constitution of local people, formed through the special geographical environment and distinctive features of life and diet, leads to their susceptibility and high frequency with damp-heat syndrome. Therefore, the study on damp-heat syndrome characteristics of local people and the relative factors to susceptibility have the high medical and sociological value.
As known so far, Human Leukocyte Antigen (HLA) is the most complex system of genetic polymorphism. And it is a major genetic system for regulating individual specific immune response and determining individual differences of disease susceptibility. The distribution of HLA is characterized by distinctive differences of races, nationalities and geography. It is considered in traditional Chinese medicine (TCM) theory that the type, nature and the trend and prognosis of the pathogenesis development of the syndrome depend on two factors-etiology and constitution. And constitution, the internal factors, is the background and vital material basis for different syndromes and that the specificity of individual constitution usually determines his or her susceptibility to some certain pathogenic factors and the type tendency of the generated disorders. There are some similarities in polymorphism and Linkage Disequilibrium of HLA system and TCM constitution theory. Focusing on the relative stable constitution, this study chose the specific population to explore the immune genetic basis of susceptibility to damp-heat syndrome and discuss the geographic differences of susceptibility to damp-heat syndrome between Han people in Guangxi and those in Guangdong within Lingnan area from the perspective of Human Leucocyte Antigen (HLA) gene polymorphism.(type Ⅰ and type Ⅱ). It benefits in the deep research on the nature of the syndrome and provided the new perspective for the mechanical discussion of taking actions that suit local circumstances and the same syndrome of different diseases.
Methods
1. The literature research method was used in the study project to give a historical review on the theoretical origin of the damp-heat syndrome. The theoretical origin and the syndrome characteristic of the damp-heat syndrome could be sorted out through the research on ancient literature of the damp-heat syndrome, which laid a solid theoretical foundation for further study of damp-heat syndrome.
2. In order to analyze the constitution of the Guangxi local people and consult and establish the damp-heat constitutional scale and the diagnostic standard, the method of cross sectional on-scene investigation was used to assess the TCM constitutional types after the questionnaire of322cases of adults. The questionnaire was implemented on166cases of Han people in Guangxi above18years old with72cases of damp-heat syndrome group and94cases of non damp-heat group. It is focused on understanding the living and diet habit of the damp-heat syndrome group and non damp-heat group and sociodemographic situation. The methods of one-factor ANOVA and multiple stepwise regression analysis were applied for some relevant factors.
3. Sequence-based Genotyping Technology (PCR—SBT) was conducted to4group of Gaungxi and non Guangxi people with damp-heat and normal syndrome. HLA-A, B and DRB1genetic typing detections was conducted to18cases of each group. The method of direct counting was used in allele distribution. The gene frequency (GF) was calculated according to the balance of Hardy—Weinbergrule. The x2test or Fisher's Exact Text was used for the comparison of the gene frequency for each group and two items comparison.
Results
1. The TCM constitutional types were assessed after the questionnaire of322cases of adults.94cases mild constitution account for29.2%;72cases damp-heat constitution account for22.4%;49cases phlegm-damp constitution account for15.2%;36cases qi-deficient constitution account for11.2%;23cases yin-deficient account for6.2%;15cases qi-stagnation constitution account for4.6%;7cases blood-stasis constitution account for2.2%;6cases the specific endowment constitution account for1.9%.
2. The questionnaire was applied in166cases of Guangxi people with damp-heat constitution. Multiple stepwise regression analysis was used with P<0.10. According to the influenced extend of standardized regression coefficients modulus,7factors were selected, that are the like of sweet, irregular sleeping, sports habit, late sleeping and early getting up and the like of sour, viscera, cold food. The value for the damp-heat group people with the like of sweet, viscera, cold food, irregular sleeping, late sleeping and early getting up, less sports was relatively higher. But the value for damp-heat people with the like of early getting up and sleeping and the sour was relatively lower.
3. The technology of PCR—SBT was used to conduct HLA-A, B and DRB1genetic typing detections. The allele phenotype frequency of HLA-A*0207in Guangxi damp-heat syndrome group was evidently higher than that of Guangxi normal group (P<0.05). And the allele phenotype frequency of HLA-DRB1*0301and HLA-DRB1*1602in Guangxi damp-heat syndrome group was evidently lower than that of Guangxi normal group (P<0.05). The difference was statistically significant.
The allele phenotype frequency of HLA-A*0201in Guangxi damp-heat syndrome group was evidently lower than that of Non-Guangxi group. And the allele phenotype frequency of HLA-DRB1*1101and HLA-DRB1*1501in Guangxi damp-heat syndrome group was evidently higher than that of Non-Guangxi group. The difference was statistically significant (P<0.01or P<0.05). There were no significant differences between the four groups of HLA-B genotypes.
Conelusion
The research results indicate that the damp-heat constitution is the most common constitutional type for adult in Guangxi, which meets the damp-heat climate characteristic in Guangxi. The formation of damp-heat constitution of Guangxi people is closely related with the postnatal factors of daily life and diet such as the appetite for sweet food, visceral, raw and cold food, irregular sleeping and lack of sports exercise. We need to focus on the guide for the diet and daily life habit and propagation for healthy education to advocate reasonable diet construction and habit, appropriate exercise and cultivate scientific life way in order to improve the damp-heat constitution, promote health and prevent diseases.
The damp-heat patients in Guangxi was positively correlated with HLA-A*0207genotype, and negatively associated with HLA-DRB1*0301and HLA-DRB1*1602. The HLA-A*0207genotype could be the susceptible gene of the damp-heat syndrome. The HLA-DRB1*0301and HLA-DRB1*1602could be the protective gene of the damp-heat syndrome. Compared with the damp-heat patients of non-Guangxi group, the allele phenotype frequency of HLA-A*0201in Guangxi damp-heat syndrome group is evidently lower. While the allele phenotype frequency of HLA-DRB1*1101and HLA-DRB1*1501in Guangxi damp-heat syndrome group is evidently higher than that of non-Guangxi group. It is indicated that there may exist different immune genetic basis between the susceptible group to damp-heat syndrome of Guangxi and non-Guangxi group. It shows that there are immune genetic susceptible factors in the damp-heat group of Guangxi, which will easily cause the immune imbalance of the body."The weak of the earth spleen causes the failure for transformation and damp-qi accumulation." So the occurrence of damp-heat syndrome is caused by such internal factor and the invasion due to the damp-heat climate effect of Guangxi.
引文
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