基于1HNMR代谢组学的绝经综合征肾阴虚、肾阳虚证代谢标志物研究

Traditional Chinese medicine has a good effect in the treatment of menopausal syndrome, but there are some problems such as the diagnosis, syndrome differentiation is not standardized, the lack of objective indicators.. This study applies 1HNMR metabolomics research techniques, 80 cases of patients with menopausal syndrome, 40 cases of normal women perimenopausal period, 40 cases of normal women in childbearing age, all the low molecular metabolites in blood and urine were detected ,by information extraction, comparative analysis, looking for menopause syndrome disease specific metabolic markers.The blood and urine metabolites of 60 cases of menopausal syndrome with kidney-yin deficiency and kidney-yang deficiency were compared and analyzed to find the specific metabolic markers of kidney-yin deficiency and kidney-yang deficiency syndrome, verify the expected disease and evidence Metabolic markers for the diagnosis of menopausal syndrome diagnosis of objective, Chinese medicine to provide a theoretical basis for microcosmic.. According to the experimental screening of metabolic markers specific, combined with KEGG databases and literature to explore its possible biological significance and possible metabolic pathways,Tracing the pathogenesis of menopausal syndrome and its kidney deficiency and kidney deficiency syndrome.

绝经综合征中医药治疗有良好的效果，但存在诊断、辨证不规范、缺乏客观指标等问题。. 本研究应用1H-NMR代谢组学研究技术，对80例绝经综合征患者、40例围绝经期的正常妇女、40例育龄期正常妇女血液、尿液中全部低分子代谢产物进行检测，通过信息提取、对比分析，寻找绝经综合征疾病特异性代谢标志物。对绝经综合征肾阴虚、肾阳虚各60例患者血、尿代谢物谱进行比较分析，寻找肾阴虚、肾阳虚证证侯特异性代谢标志物为绝经综合征疾病诊断客观化、中医辨证微观化提供理论依据。. 根据实验筛选出的特异代谢标志物，结合KEGG数据库及相关文献挖掘其可能的生物意义及其可能的代谢通路，追溯绝经综合征及其肾阴虚、肾阳虚证的病理机制。

目的：基于代谢组学技术，寻找绝经综合征疾病特异性代谢标志物和肾阴虚、肾阳虚证证侯特异性代谢标志物。.方法：应用1H-NMR代谢组学研究技术，对80例绝经综合征患者、40例围绝经期正常妇女、40例育龄期正常妇女血液、尿液中全部低分子代谢产物进行检测处理、统计分析，比较发现疾病特异性代谢标志物并进行诊断能力评估，确定其血、尿诊断代谢标志物。同法对绝经综合征肾阴虚、肾阳虚各60例患者血、尿代谢物谱进行扫描、数据统计分析，并与围绝经期正常女性进行比较，发现证侯特异性代谢标志物并进行诊断能力评估，确定其血、尿证候诊断代谢标志物。.结果：.1.绝经综合征组和围绝经期正常组比较，发现血液丙氨酸、TMAO的含量显著上升，谷氨酸、丙酮酸、N-乙酰糖蛋白和胆碱的含量显著下调；尿液甲基丙二酸的含量显著上升，醋酸、苯乙酰甘氨酸、肌酐和乳酸的含量显著下调。通过诊断能力评价确定谷氨酸、丙酮酸、N-乙酰糖蛋白、胆碱为绝经综合征血清诊断代谢标志物；甲基丙二酸为绝经综合征尿液诊断代谢标志物。.2.绝经综合征肾阴虚证和围绝经期正常组比较，发现血清丙氨酸、醋酸、谷氨酸、甘油磷酸胆碱、TMAO和甘氨酸显著升高；尿液甲基丙二酸显著升高，缬氨酸、二甲胺、马尿酸显著下降。通过诊断能力评价确定6个血清代谢物、尿液缬氨酸、二甲胺、马尿酸为绝经综合征肾阴虚证的血、尿诊断代谢标志物。.3.绝经综合征肾阳虚证组和围绝经期正常组比较，发现血清N-乙酰糖蛋白显著上升、异亮氨酸、醋酸、谷氨酸、丙酮酸、肌酸和缬氨酸显著下降；尿液苯乙酰甘氨酸、丙氨酸、亮氨酸、马尿酸、甜菜碱和缬氨酸显著上升。通过诊断能力评价确定除N-乙酰糖蛋白和醋酸外，其余代谢物均可作为绝经综合征肾阳虚证的血、尿诊断代谢标志物。.结论：试验捕获了具有诊断价值的血、尿绝经综合征疾病和肾阴虚、肾阳虚证侯特异性代谢标志物，为绝经综合征疾病诊断客观化、中医辨证微观化进行了有益探索。