绝经后骨质疏松症常见实性病性证素间差异代谢产物研究

The preliminary study indicated that patients in phlegm-dampness group of postmenopausal osteoporosis have significant different metabolite with non-phlegm-dampness group. Base on the other results of the research that the phlegm-dampness, blood stasis and qi stagnation are the common excess syndrome essential elements of PMOP. We put forward a tentative idea that there were different metabolite among the common excess syndrome essential elements of PMOP. Based on this foundation, the project took the serum and follicular metabolism as the breakthrough point, applied the metabonomics method that based on HNMR detection techniques to detect the endogenous small molecules metabolites of serum and follicular liquid in kidney deficiency group, and kidney deficiency+phlegm dampness group, kidney deficiency+blood stasis group, and kidney deficiency+qi stagnation group by comparing the differences of metabolic map ,data processing and pattern recognition. This study made a qualitative and quantitative analysis for all small molecular compounds in serum and follicular liquid of PMOP, looking for different metabolite, to establish the diagnosis model based on data of metabonomics for excess syndrome essential elements of PMOP. And combined with intervention of traditional Chinese medicine, comprehensively analysed the formation, transfer mechanism and process of endogenous metabolism products for excess syndrome essential elements of PMOP, discussed the pathogenesis for excess syndrome essential elements of PMOP, thus gradually reveals its biological essence. To provide ideas and research basis in establishing related metabolic map, metabolic diagnosis model of disease and syndrome in traditional Chinese medicine. Provides a research way for TCM clinical efficacy evaluation of PMOP.

本课题组前期发现，绝经后骨质疏松症（postmenopausal osteoporosis,PMOP）痰湿组与非痰湿组间存在差异代谢产物，结合痰湿、瘀血、气滞为PMOP常见实性病性证素的研究结果，我们提出PMOP常见实性病性证素组间存在差异代谢物的设想。本项目拟以血清代谢组分为切入点，应用核磁共振氢谱（HNMR）检测技术，结合证素辨证学，对PMOP肾虚组、肾虚+痰湿组、肾虚+瘀血组、肾虚+气滞组，血清中所有小分子化合物进行定性、定量分析，通过数据处理和模式识别，比较各组代谢图谱的差异，筛选出PMOP实性病性证素组间差异代谢产物，进而建立PMOP基于证素辨证的代谢组学诊断模型；通过进一步分析差异代谢产物的形成、转移机制和过程，揭示PMOP的发病机理。本研究结果可作为痰湿、瘀血、气滞证素的生物学本质研究基础，为建立中医病证结合的代谢诊断模型研究提供依据，为PMOP的临床疗效评估提供研究思路。

本课题组前期发现，绝经后骨质疏松症（postmenopausal osteoporosis,PMOP）痰湿组与非痰湿组间存在差异代谢产物，结合痰湿、瘀血、气滞为PMOP常见实性病性证素的研究结果，我们提出PMOP常见实性病性证素组间存在差异代谢物的设想。本项目以血清代谢组分为切入点，应用核磁共振氢谱（HNMR）检测技术，结合证素辨证学，对PMOP肾虚组、肾虚+痰湿组、肾虚+瘀血组、肾虚+气滞组，血清中所有小分子化合物进行定性、定量分析，通过数据处理和模式识别，比较各组代谢图谱的差异，筛选出PMOP实性病性证素组间差异代谢产物。. 研究结果表明血清样本的谱图上有很多不同的尖锐谱峰，并且通过PCA、PLS-DA、OPLS-DA的分析，可知肾虚组与肾虚气滞组，肾虚血瘀组与肾虚气滞组，肾虚痰湿组与肾虚组，肾虚痰湿组与肾虚气滞组，肾虚痰湿组与肾虚血瘀组之间存在明显的差异代谢物，而肾虚组与肾虚血瘀组的差异代谢物并不明显。.通过进一步分析差异代谢产物的形成、转移机制和过程，我们得出结论：肾虚组的能量代谢较慢，PMOP肾虚患者会影响能量代谢、脂代谢的进程；PMOP肾虚气滞患者由于气机的阻滞使循环系统受到影响；肾虚气滞组PMOP患者对于痰湿体质对照而言在人体代谢以及人体消炎镇痛方面存在影响；肾虚血瘀组细胞外免疫力下降。.本研究结果可作为痰湿、瘀血、气滞证素的生物学本质研究基础，为建立中医病证结合的代谢诊断模型研究提供依据，为PMOP的临床疗效评估提供研究思路。为PMOP中医药临床诊疗提供有力的数据支持，促进中医诊疗的客观化，改进辨证的方法与手段。