高血压病肝阳上亢证、阴阳两虚证代谢物差异研究

目的 观察高血压病肝阳上亢证、阴阳两虚证的代谢物差异。方法 选择2009年6月—2010年5月高血压中医临床研究基地门诊及住院高血压病患者26例，其中肝阳上亢证12例(肝阳上亢证组)，阴阳两虚证14例(阴阳两虚证组)，另选择附属社区健康志愿者14名作为对照组。通过液质联用技术检测分析各组血浆并进行主成分分析(PCA)，通过Metlin数据库鉴定相关代谢物及代谢通路。结果 主成分得分图中健康志愿者的数据离散度较大，而阴阳两虚证组和肝阳上亢证组的数据则呈聚集，进一步PCA结果显示，两证候组数据在空间上分离良好，组间存在较大差异；共鉴定出6种代谢物，其中肝阳上亢证组雌二醇、白三烯、葡萄糖神经酰胺、神经酰胺相对增多，而阴阳两虚证组中甘油三酯和甘油二酯相对增多。结论 液质联用技术能初步区分并阐释高血压病肝阳上亢证及阴阳两虚证不同的代谢模式，在两种证候中代谢趋势不同的雌二醇、白三烯、葡萄糖神经酰胺、神经酰胺、甘油三酯及甘油二酯或能成为两种高血压病证候的鉴别点。

Study on the Metabolin Difference of Hypertension Patients of Gan-yang Hyperactivity Syndrome and Yin-Yang Deficiency Syndrome

Objective To observe the metabolin difference between hypertension patients of Gan-yang hyperactivity syndrome(GYHS) and those of yin-yang deficiency syndrome(YYDS).Methods Totally 26 hypertension patients at the Base for Chinese Medicine Clinical Research of Hypertension from June 2009 to May 2010 were assigned to two groups,the GYHS group(12 cases) and the YYDS group(14 cases).Besides,14 healthy volunteers from the affiliated community were recruited as the control group.Their blood plasmas and principle component analysis(PCA) were analyzed by high performance liquid chromatography-time of flight mass spectrometry(HPLC-TOFMS) technology.The correlated metabolin and their metabolic pathways were identified using Metlin Database.Results The PCA chart showed that the dispersion was larger in the control group than in the other two groups.The data of the GYHS group and the YYDS group showed gathering tendency.Further PCA results showed good spatial separation between the two groups,with significant difference between them.Totally 6 metabolins were detected.Of them,estrodiol,leucotriene,ceramide,and glucose-ceramide increased more in the GYHS group,while triglyceride and diacylglycerol increased more significantly in the YYDS group.Conclusions HPLC-TOFMS is capable of primarily identifying and clarifying different metabolic modes of the GYHS and the YYDS.Different contents of estrodiol,leucotriene,ceramide,glucose-ceramide,triglyceride,and diacylglycerol might probably become the differential points for identifying the two syndrome types.