目的:中医的核心是辨证论治,辨证是基础,但中医"证"的内涵和规范化一直困扰着中医理论的发展。本研究运用蛋白组学的方法,旨在揭示冠心病病证结合的生物学基础,探索证候内涵研究的方法学。方法:采用荧光差异凝胶电泳和电喷雾质谱法(ESI-MS)等蛋白组学技术对冠心病四个主要证型(心气虚弱、心肾阴虚、痰浊内阻、心血瘀阻)各9例患者进行蛋白组学研究,得到的差异蛋白结合生物信息学技术进行深入的体内通路功能分析,探索冠心病不同证型的蛋白质表达差异并分析其相关性。结果:本研究发现的差异蛋白有凝血酶原、α2巨球蛋白、膜联蛋白A5、补体C3、甘露糖结合蛋白C、载脂蛋白A1、载脂蛋白E、载脂蛋白H、活化T细胞核因子5亚型b等,这些差异基因和蛋白涉及凝血系统、激肽释放酶-激肽系统、补体系统、脂代谢系统,Wnt途径、凋亡系统。结论:这些差异蛋白与不同证候的形成有关,有望作为证候实质的标志性蛋白。
Objective:The core of the traditional Chinese medicine is the syndrome differentiation and treatment,syndrome differentiation is a foundation,but the connotation and the standardization of traditional Chinese medicine have been puzzling the development of the theory of traditional Chinese medicine.This study adopts proteomics method,which aims at revealing the biological basis of the combination of disease and syndrome in coronary heart disease and explores the methodology of the study on connotation.Methods:The author used proteomics technology such as fluorescence differences gel electrophoresis and electrospray mass spectrometry(ESI-MS)to research on the four main coronary heart disease syndrome types(deficiency of heart qi syndrome,deficiency of yin of the heart and kidney syndrome,phlegm turbid retention syndrome,heart blood stasis syndrome),involving 9 patients in each type.The author then made an in-depth body pathways function analysis combining the differential protein with the bioinformatics technology in order to explore the protein expression differences of different card type of coronary heart disease and analyze the correlation.Results:The following differential proteins had been found in this study:prothrombin,alpha 2 gigantic globulin,membrane protein al A5,C3,mannose combined with protein C,apolipoprotein A1,apolipoprotein E,apolipoprotein H,activate T nuclei subtype b,five factors and so on.These differential genes and proteins involved blood coagulation,stimulating peptide release of enzyme-system,the complement system,peptide lipid metabolism system,Wnt way and apoptosis system.Conclusion:These differential proteins are involved in the creation of different syndrome,which are expected to be the symbolic proteins of the essence of the syndrome.