目的:运用代谢组学方法研究高血压阴虚阳亢证潜在的证候标记物,同时观察镇肝熄风汤干预的临床疗效及可能作用机制。方法:选择高血压阴虚阳亢证患者25例(疾病组),给予镇肝熄风汤治疗,每次150 m L,每次两次,共治疗60天。同时收集健康体检者28例设为对照组。采集对照组及疾病组治疗前后血液,采用高效液相色谱-质谱联用仪(HPLC-MS)检测血浆代谢物,利用主成分分析(PCA)和偏最小二乘法(PLS)对数据进行统计分析,比较对照组和疾病组治疗前后的血浆代谢组学原始谱图和数据。结果:治疗后疾病组患者眩晕、头痛、腰膝酸软、五心烦热等临床症状较治疗前有明显改善(P〈0.01)。疾病组中医证候疗效临床痊愈8例,显效11例,有效5例,总有效率为96%。疾病组在治疗前的代谢谱和对照组存在明显不同,经镇肝熄风汤干预后其代谢谱有显著改变,向对照组回归;十六烷酸为高血压阴虚阳亢证的潜在证候标志物。结论:高血压阴虚阳亢证患者存在氨基酸代谢紊乱,纠正氨基酸代谢紊乱可能是镇肝熄风汤治疗高血压的作用机制之一。
Objective: Using metabonomics method to study the potential syndromes markers of hypertension of Yin deficiency and Yang hyperactivity syndrome and observe the clinical effects of Zhengan Xifeng Decoction and possible mechanism. Methods:A total of 25 patients with hypertension of Yin deficiency and Yang hyperactivity syndrome were given Zhengan Xifeng Decoction150 m L each time,twice a day,a total of 60 days. At the same time,28 healthy cases were set as control group. Before and after treatment,high performance liquid chromatography/mass spectrometry( HPLC- MS) was used to detect the plasma metabolites and principal component analysis( PCA) and partial least squares( PLS) to make the statistical analysis. Results: After treatment,dizziness,headache,lumbar debility,palms and soles heat and other clinical symptoms significantly improved( P〈0. 01). In disease group,8 cases were cured,11 cases markedly effective,5 cases effective. The total effective rate was 96%. Before treatment,the metabolic spectrum of two groups was obviously different. After Zhengan Xifeng Decoction intervention,the metabolic spectrum had significant changes,returning to the control group. Hexadecanoic acid was the hand markers for hypertension of Yin deficiency and Yang hyperactivity syndrome. Conclusion: Hypertension patients with of Yin deficiency and Yang hyperactivity syndrome have metabolism disorder. Correction of amino acid metabolism disorder may be one of the mechanism of Zhengan Xifeng Decoction treating high blood pressure.