基于代谢组学的实寒证、虚寒证原发性痛经患者尿液的比较研究

目的:比较实寒证、虚寒证原发性痛经患者尿液内源性代谢物的异同,从整体角度分析两证的病理生理学机制,揭示同病异证的生物学本质差异。方法:采用病证结合模式,以实寒证、虚寒证原发性痛经患者为研究对象,选择N-甲基-N-三甲基-硅基三氟乙酰胺(MSTFA)作为衍生化试剂对月经周期第2d(MC2)尿液代谢产物进行气相色谱-飞行时间质谱(GC-TOFMS)检测,得出两组总离子流色谱图(TIC),结合非监督的主成分分析(PCA)进行多维统计分析,寻找实寒证、虚寒证原发性痛经的差异代谢产物。结果:两组检测出的差异性代谢产物有葡萄糖、果糖、异柠檬酸、乳酸、甘氨酸、原藻醇、马尿酸7种。与实寒组比较,虚寒组升高的有乳酸,降低的有葡萄糖、果糖、异柠檬酸、甘氨酸、原藻醇、马尿酸。结论:实寒证、虚寒证原发性痛经患者尿液的差异代谢物质涉及到糖、氨基酸代谢及肠道菌群的异常,主要差异点为糖代谢。

Comparative Study of Excess - cold Syndrome and Deficiency Cold Syndrome in Patients with Primary Dysmenorrhea based on Metabolomics

Objective：To compare the differences between the excesscold syndrome and deficiencycold syndrome in patients with primary dysmenorrhea in urinary endogenous metabolites, to elaborate the path physiological mechanisms of two syndromes in patients with primary dysmenorrheal, and to reveal the biology essence of the same disease with different syndromes. Methods ： The excesscold syndrome and deficiencycold syndrome of primary dysmenorrheal patients were studied. NMethyl N （ Trimethylsi lyl） Tri fluoroacetamide （MSTFA） was selected as the derivatization reagent. The urine metabolites were detected at the second day in menstrual cycle （MC2） of the two groups using gas chromatographytime of flight mass spectrometer （GC TOFMS）, and the total ion chromatogram （TIC） of each group was drawn. Combination with unsupervised principal component analysis （PCA） was used for the multi dimensional statistical analysis to look for variability material between the two groups. Results ： Compared with excesscold group, seven variability materials in deficiencycold group were detected. They were glucose, fructose, isocitric acid,lactic acid,glycine, erythritol, and hippuric acid. Among the total materials, only lactic acid in deficiencycold group was higher than that in excesscold group; the rest materials in deficiencycold group were all lower than those in excesscold group. Conclusion： Excesscold syndrome and deficiencycold syndrome of dysmenorrheal patients suggested significant difference in urine metabolites. These variability materials are related to several metabolic pathways such as glycolmetabolism, amino acid metabo lism, and disturbance of enterobacteria. Two groups main discrepancy is glycometabolism.