【作者】 王宇；

【导师】 窦丹波；

【作者基本信息】 上海中医药大学 ， 中医内科学（专业学位）， 2019， 硕士

【摘要】 研究目的:运用聚类分析统计方法和代谢组学技术,观察功能性腹泻患者中医证候分型以及功能性腹泻患者与健康人群的代谢产物变化,探索功能性腹泻潜在标志物,寻找功能性腹泻不同中医证候的特征差异代谢物及中医证候分型的可能客观临床依据。研究方法:本研究共分为三个部分:第一部分是对功能性腹泻患者进行临床调查,通过聚类分析方法探讨功能性腹泻的中医证候。第二部分采用代谢组学技术分析功能性腹泻患者血清中的特征差异代谢物。第三部分是对基于聚类分析得出的不同中医证型进行代谢组学研究和对比。研究结果:1.根据系统聚类分析方法得出的树状图,将出现频率大于30%的中医症状分为两类,第一类的症状包括:紧张焦虑、急躁易怒、受凉加重、怕冷、倦怠乏力、肠鸣音、矢气增多、四肢冷。第二类的症状包括:排便不尽、大便粘滞、里急后重、汗多、口苦口臭、口渴。2.通过对功能性腹泻组和健康正常组的血清采用液相-色谱质谱联用仪分析测定,发现功能性腹泻组和健康正常组的血清代谢物存在脂质及类脂分子、羧酸及其衍生物代谢的差异。3.功能性腹泻患者组上述两类不同中医证候之间的血清代谢组学无明显差异。结论:(1)功能性腹泻临床症状特点经聚类分析,倾向分为肝郁脾虚证和脾胃湿热证。(2)功能性腹泻患者血清的代谢物与正常人存在较大偏离。功能性腹泻的发生和疾病进展与脂质及类脂分子、羧酸及其衍生物代谢紊乱有关。\(3)在本研究的非靶向代谢组学方法下,未发现肝郁脾虚证和脾胃湿热证两组间血清代谢物方面的差异。更多还原

【Abstract】 Research purpose: Using cluster analysis method and the metabonomics technology,observe functional diarrhea patients with TCM syndrome classification and functional metabolites of diarrhea patients and healthy people change,explore functional diarrhea potential markers,looking for functional diarrhea characteristics of different syndromes differences metabolites and TCM syndrome classification may be objective clinical basis.Methods: This study was divided into three parts: the first part was a clinical investigation of patients with functional diarrhea,and the TCM syndromes of functional diarrhea were discussed through cluster analysis.In the second part,characteristic metabolites in serum of patients with functional diarrhea were analyzed by metabolomics.The third part is the metabolomics study and comparison of different TCM syndromes based on cluster analysis.Results: 1.According to the tree diagram obtained by systematic cluster analysis method,TCM symptoms with a frequency of more than 30% are divided into two categories.The first category includes: tension and anxiety,impatience and irritability,aggravation of cold,coldness,fatigue,intestinal ringing,increased arrow qi,and cold limbs.The second type of symptoms include: endless bowel movements,sticky stools,tendesmus,sweating,bitter mouth,bad breath,and thirst.2.The serum of functional diarrhea group and healthy normal group was analyzed and determined by liquid-chromatography-mass spectrometry,and it was found that there were differences in metabolism of lipids,lipid molecules,carboxylic acids and their derivatives in serum metabolites of functional diarrhea group and healthy normal group.3.There was no significant difference in serum metabolomics between the two TCM syndromes mentioned above in patients with functional diarrhea.Conclusion :(1)by cluster analysis,the clinical symptoms of functional diarrhea tend to be divided into liver depression and spleen deficiency syndrome and dampness-heat syndrome of spleen and stomach.(2)the metabolites in the serum of patients with functional diarrhea were significantly different from those of normal people.The occurrence and progression of functional diarrhea are related to metabolic disorders of lipids,lipids,carboxylic acids and their derivatives.(3)with the untargeted metabolomics method in this study,no differences in serum metabolites between the two groups were found in liver stagnation and spleen deficiency syndrome and spleen and stomach dampness and heat syndrome.更多还原