外阴硬化性苔藓中医辨证分型与HLA-A\B\DRB1基因多态性的相关性研究

目的:观察中国汉族妇女外阴硬化性苔藓患者中医辨证分型与HLA-A\B\DRB1基因多态性的相关性。方法:选取中国汉族妇女外阴硬化性苔藓中属肝肾阴虚型40例、肝经湿热型36例,正常健康中国汉族妇女62人(正常对照组),分别采用PCR-SSP方法进行基因多态性关联检测分析。结果:HLA-B*15、HLA-DRB1*12等位基因在外阴硬化性苔藓各中医证型出现的频率均升高,与正常对照组相比有极显著性差异(P<0.01);等位基因HLA-B*40在肝肾阴虚组患者中呈低表达,与正常对照组比较亦有极显著性差异(P<0.01)。结论:HLA-B*15、HLA-DRB1*12等位基因可能是中国汉族妇女VLS肝肾阴虚型与肝经湿热型的易感基因,HLA-B*40等位基因可能是中国汉族妇女VLS肝肾阴虚型的保护性基因,而与VLS肝经湿热型无相关性。HLA-B*40等位基因在两组中的显著性差异提示中医辨证分型的物质基础和异质性,对VLS的诊断、治疗、预测和中医辨证分型均具有重要意义。

Correlation between Traditional Chinese Medical Syndrome Differentiation and HLA-A/B/DRB1 Gene Polymorphisms in Vulvar Lichen Sclerosus

Objective:To observe the correlation between TCM syndrome differentiation and HLA-A/B/DRB1 gene polymorphism in Chinese Han nationality women with vulvar lichen sclerosus.Methods:40 cases of vulvar lichen sclerosus in Chinese Han nationality women were classified as pattern of liver-kidney yin deficiency,and the 36 cases of liver meridian damp-heat,62 healthy Chinese Han nationality women were selected as normal control group.Results:The expressions of HLA-B*15 and HLA-DRB1*12 alleles in each TCM syndrome type of vulvar lichen sclerosus were increased,and there was a significant difference compared with the normal control group(P<0.01);the expression of HLA-B*40 allele was decreased in liver-kidney yin deficiency syndrome and there was a significant difference compared with the normal control group(P<0.01).Conclusion:HLA-B*15 and HLA-DRB1*12 alleles may be the susceptible genes of VLS of liver-kidney yin deficiency and liver meridian damp-heat in Chinese Han nationality women with vulvar lichen sclerosus.HLA-B*40 allele may be the protective gene of VLS of liver-kidney yin deficiency in Chinese Han nationality women,but it has no correlation with VLS of liver meridian damp-heat.The significant difference of HLA-B*40 allele between the two groups indicates the material basis and heterogeneity of TCM syndrome differentiation,which is great significant for the diagnosis,treatment,prediction and TCM syndrome differentiation of VLS.