[1]胡钢锋,肖鲁伟,童培建.关节液代谢组学在类风湿关节炎诊断 及寒热证候分型中的应用[J].中医正骨,2015,27(01):5-8.
　HU Gangfeng,XIAO Luwei,TONG Peijian.Application of joint fluid metabolomics to diagnosis and COLD-HEAT SYMPTOM COMPLEX typing in patients with rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):5-8.
点击复制

关节液代谢组学在类风湿关节炎诊断 及寒热证候分型中的应用()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年01期
页码:
5-8
栏目:
临床研究
出版日期:
2015-01-15

文章信息/Info

Title:
Application of joint fluid metabolomics to diagnosis and COLD-HEAT SYMPTOM COMPLEX typing in patients with rheumatoid arthritis
作者:
胡钢锋1; 肖鲁伟2; 童培建3
1.浙江省杭州市萧山区第一人民医院,浙江 杭州 311201;
2.浙江中医药大学,浙江 杭州 310053;
3.浙江省中医院,浙江 杭州 310006
Author(s):
HU Gangfeng1; XIAO Luwei2; TONG Peijian3
1.The First People's Hospital of Xiaoshan district in Hangzhou,Hangzhou 311201,Zhejiang,China.
2.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China.
3.Zhejiang Provincial hospital of TCM,Hangzhou 310006,Zhejiang,China.
关键词:
关节炎; 类风湿;  诊断;  证候;  湿热;  寒湿;  代谢组学;  主成分分析
Keywords:
arthritis; pheumatoid;  diagnosis;  symptom complex;  dampness-heat;  cold-dampness;  metabolomics;  principal component analysis
摘要:
目的:探讨关节液代谢组学在类风湿关节炎诊断及寒热证候分型中的价值。方法:采集12例类风湿关节炎患者(寒湿阻络证6例,湿热阻络证6例)和7名健康志愿者的膝关节关节液,对其进行气相色谱-质谱分析,并对选定的主要色谱峰的气相色谱-质谱分析数据进行主成分分析。结果:共选定23个主要色谱峰为共有峰描述关节液化学组成特征,健康志愿者和类风湿关节炎患者的气相色谱-质谱分析总流离子图总体特征基本相同。经主成分分析将23个描述关节液化学组成特征的色谱峰综合成4个主成分。对所有被测试者的关节液样品进行主成分分析,在第3和第4主成分得分图中类风湿关节炎患者的关节液样品得分分布集中,健康志愿者关节液样品得分分布较为分散。单独对类风湿关节炎患者的关节液样品进行主成分分析,在第3和第4主成分得分图中湿热阻络证患者和寒湿阻络证患者的关节液样品得分分布均较为集中。结论:膝关节液的代谢组数据能准确区分类风湿关节炎患者和健康志愿者,以及类风湿关节炎湿热阻络证和寒湿阻络证患者,为类风湿关节炎的诊断及其中医证候量化分型提供了一种思路。
Abstract:
Objective:To explore the value of joint fluid metabolomics in diagnosis and COLD-HEAT SYMPTOM COMPLEX typing of rheumatoid arthritis(RA).Methods:The knee joint fluid of 12 patients with RA(COLD-DAMPNESS BLOCK COLLATERALS(寒湿阻络)in 6 patients and DAMPNESS-HEAT BLOCK COLLATERALS(湿热阻络)in 6 patients)and 7 healthy volunteers were collected respectively and gas chromatography-mass spectrometry(GC-MS)was performed on the samples.The principal component analysis(PCA)was performed on GC-MS data of selected main chromatographic peak.Results:Twenty-three main chromatographic peaks were selected as common peaks for describing the chemical composition characteristics of joint fluid.The general characteristics of GC-MS total ion chromatogram of healthy volunteers was basically the same as that of RA patients.Twenty-three chromatographic peaks for describing the chemical composition characteristics of joint fluid were integrated into four principal components by using PCA.The PCA were performed on joint fluid samples of all the subjects.The scores of joint fluid samples of RA patients were characterized by concentrated distribution in the third and fourth principal component score plots,while those of healthy volunteers were characterized by relative dispersion.The PCA were performed only on joint fluid samples of RA patients,and the results showed that the scores of joint fluid samples were characterized by relative dispersion distribution in both patients with DAMPNESS-HEAT BLOCK COLLATERALS and patients with COLD-DAMPNESS BLOCK COLLATERALS in the third and fourth principal component score plots.Conclusion:The metabolome data of knee joint fluid can be used to accurately distinguish RA patients from healthy volunteers and distinguish DAMPNESS-HEAT BLOCK COLLATERALS from COLD-DAMPNESS BLOCK COLLATERALS,therefore it provides a new way for diagnosis and TCM symptom complex quantitative classification of RA.

参考文献/References:

[1] Prevoo ML,Van't Hof MA,Kuper HH,et al.Modified disease activity scores that include twenty-eight-joint counts.Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis[J].Arthritis Rheum,1995,38(1):44-48.
[2] Arnett FC,Edworthy SM,Bloch DA,et al.The American rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis[J].Arthritis Rheum,1995,38(1):44-48.
[3] 徐昊,林东海,刘昌孝.代谢组学研究现状与展望[J].药学学报,2005,40(9):769-773.
[4] 吕诚.类风湿性关节炎寒热证候分类的系统生物学基础[D].北京:中国中医科学院,2010.
[5] 肖长虹,吴启富,张丽华,等.类风湿关节炎关节液抗环瓜氨酸肽抗体的检测及意义[J].中华风湿病学杂志,2006,10(3):184-186.
[6] 简维雄,袁肇凯.中医“证候”与代谢组学研究[J].中华中医药学刊,2009,27(2):351-352.
[7] 阿基业.代谢组学数据处理方法——主成分分析[J].中国临床药理学与治疗学,2010,15(5):481-489.
[8] 李琳琳,杨永利,施学忠,等.HIV/AIDS患者中医四诊信息的主成分分析[J].郑州大学学报:医学版,2007,42(4):679-682.

相似文献/References:

[1]齐新宇,向黎黎,熊辉,等.基于高蛋白饮食建立鸡痛风性关节炎模型的量效关系研究[J].中医正骨,2015,27(02):1.
　QI Xinyu,XIANG Lili,XIONG Hui,et al.A dose-effect relationship study of gouty arthritis chicken model built by high-protein diet[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):1.
[2]齐新宇,熊辉,周彪,等.蠲痹历节清方干预鸡急性痛风性关节炎模型的 实验研究[J].中医正骨,2015,27(03):5.
　QI Xinyu,XIONG Hui,ZHOU Biao,et al.Juanbilijieqing Fang(蠲痹历节清方)interfere with acute gouty arthritis chiken model[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):5.
[3]熊辉,曲良烨,向黎黎,等.痛风性关节炎湿热证病证结合模型的建立[J].中医正骨,2014,26(03):14.
　Xiong Hui*,Qu Liangye,Xiang Lili,et al.A rat model of gouty arthritis combined with dampness-heat syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(01):14.
[4]孙克民,王平,卢启贵,等.关节镜下滑膜切除术联合中药口服 治疗早期膝关节类风湿关节炎[J].中医正骨,2013,25(09):39.
[5]李峰,郭艳幸,曹向阳,等.贯叶连翘灌胃联合光动力疗法对类风湿关节炎白兔膝关节滑膜组织病理形态的影响[J].中医正骨,2014,26(09):6.
　Li Feng*,Guo Yanxing,Cao Xiangyang,et al.Effect of intragastric administration of hypericum perforatum combined with photodynamic therapy on the pathological morphology of synovial tissue of knee joints in rabbits with rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(01):6.
[6]严超,刘喜德,张金禄,等.蜂针疗法治疗膝骨性关节炎的护理[J].中医正骨,2013,25(01):74.
[7]王笑青,张永红,侯宏理,等.顽痹清丸联合非甾体抗炎药及改善病情的抗风湿药治疗湿热痹阻型类风湿关节炎[J].中医正骨,2013,25(03):41.
　WANG Xiao-qing*,ZHANG Yong-hong,HOU Hong-li,et al.Curative effect and safety of WANBIQING pills combined with nonsteroidal antiinflammatory drugs and disease modifying antirheumatic drugs in the treatment of rheumatoid arthritis of dampness-heat stagnation type[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(01):41.
[8]黄建武,黄建华,林爱丽.扶中清痹通络汤联合益赛普对活动期类风湿关节炎患者肿瘤坏死因子-α及血管内皮生长因子血清含量的影响[J].中医正骨,2013,25(05):9.
　HUANG Jian-wu*,HUANG Jian-hua,LIN Ai-li.*.Effect of FUZHONG QINGBI TONGLUO decoction combined with etanercept on the serum contents of tumor necrosis factor-alpha and vascular endothelial growth factor in patients with active rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(01):9.
[9]赫军,李丽华,王相奇,等.痛风四妙汤加味治疗痛风性关节炎[J].中医正骨,2013,25(05):56.
[10]雷桂平.血清网膜素在类风湿关节炎发病中的作用[J].中医正骨,2013,25(07):28.
　LEI Gui-ping*.*.Study on the effects of serum omentin in the onset of rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(01):28.
[11]邓伟哲,王宏晶,王宇恒,等.微创针刀镜治疗难治性膝关节类风湿关节炎[J].中医正骨,2015,27(11):42.
[12]李艺彬,朱勇,吴昭克.关节镜下多入路全关节滑膜清理术治疗肘关节类风湿关节炎[J].中医正骨,2015,27(11):56.
[13]杨晓峰.超声和MRI检查在类风湿关节炎手腕部病变诊断中的应用[J].中医正骨,2018,30(05):24.
[14]龚辉,邓奕辉,王衡新,等.TOLL样受体2、4及其介导的NF-κB信号通路参与类风湿关节 炎发病的研究进展[J].中医正骨,2018,30(07):29.
[15]高保红,路艳,赵艳菊,等.个性化功能锻炼在类风湿关节炎护理中的应用[J].中医正骨,2019,31(06):77.
[16]吴海洋.骨髓间充质干细胞移植对胶原诱导性关节炎大鼠血清细胞因子的影响[J].中医正骨,2019,31(08):14.
　WU Haiyang.Effects of bone marrow mesenchymal stem cells transplantation on serum cytokines in rats with collagen-induced arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(01):14.
[17]伊力夏提·买买提,帕尔哈提·热甫开提,热扑开提·赛吾力丁,等.维医诊疗类风湿关节炎的学术思想探讨[J].中医正骨,2020,32(08):45.
[18]杨群政,章先锋,陈英,等.类风湿关节炎与骨质疏松症的关系研究[J].中医正骨,2021,33(02):26.
　YANG Qunzheng,ZHANG Xianfeng,CHEN Ying,et al.A clinical study on the relationships between rheumatoid arthritis and osteoporosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(01):26.
[19]张华燕,何援军.薯蓣皂苷元改善类风湿关节炎模型大鼠关节肿胀的效果及作用机制研究[J].中医正骨,2021,33(04):44.
　ZHANG Huayan,HE Yuanjun.Efficacy and mechanism of diosgenin against joint swelling in rat models with rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(01):44.
[20]王笑青,张依山,王庆丰,等.滋阴益骨方在类风湿关节炎合并骨质疏松症肝肾不足证治疗中的应用及作用机制研究[J].中医正骨,2021,33(11):13.
　WANG Xiaoqing,ZHANG Yishan,WANG Qingfeng,et al.A clinical study of oral application of Ziyin Yigu Fang(滋阴益骨方)to treatment of rheumatoid arthritis and liver-kidney deficiency type osteoporosis and its mechanism of action[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(01):13.

备注/Memo

备注/Memo:
2013-11-01收稿 2014-03-12修回
基金项目:浙江省中医药管理局项目(2007GA002)
通讯作者:童培建 E-mail:13758191112@163.com
更新日期/Last Update: 2015-01-30