�������׵ֿ���ABCB1 3435C>T����λ���̬�Ե�Meta����

??OBJECTIVE To investigate the association between clopidogrel resistance (CR) with 3435C>T site polymorphism of ABCB1 gene. METHODS The published articles were searched in the Pubmed, Science direct, Wiley online library, Web of Science, CNKI, CDDB database, and VIP. Search and sort out the article which is clopidogrel-resistance/clopidogrel-efficacy(CE) study about the relationship between CR and 3435C>T site polymorphism of ABCB1 gene, also combined with manually retrieving the references and similar results in the attached documents. The range of searching time was all from inception to June 25,2014. RevMan5.0 software was used to conduct the Meta-analysis and other statistic analysis. RESULTS Six articles were included in our research. It showed that the total number of CR is 2 619, and the total number of CE is 2 799. While the result showed that there exist significant correlations between ABCB1 3435C>T loci polymorphism and CR in the allele gene model, dominant gene model, co-dominant gene model(CC/CT) and super-dominant gene model:the allele gene model, OR=1.27,95%CI(1.13,1.42); dominant gene model, OR=1.42,95%CI(1.22,1.65); co-dominant gene model(CC/CT), OR=1.43,95%CI(1.20,1.69); super-dominant gene model, OR=1.30,95%CI(1.11,1.52). The further race subgroup analysis showed that there possess significant relevance between ABCB1 3435C>T loci polymorphism and CR in Asia (P<0.05), but not in Europe. In the allele gene model, OR=1.57,95%CI(1.34,1.84); dominant gene model, OR=2.11,95%CI(1.71,2.60); co-dominant gene model(CC/CT), OR=2.15,95%CI(1.72,2.69); super-dominant gene model, OR=1.82,95%CI(1.48,2.24). CONCLUSION CR dose not relate to the ABCB1 3435C>T loci polymorphism among European; but CR relates to the ABCB1 3435C>T loci polymorphism among Asian.     

������ǿ���������ӻ�Ч��Һ�����÷��ƶ������������Ǽ���й����ʵĽṹ

??OBJECTIVE To establish an LC/MSⁿ method for identification of the related substances in etimicn sulfate detected under the chromatographic condition described in Chinese Pharmacopoeia 2010.METHODS The HPLC separation was carried out on a Welch Ultimate LP-C₁₈ column(4.6 mm??300 mm,5 ??m)with mobile phase consisting of 0.2 mol??L^-1trifluoroacetic acid(containing 0.1% propionic acid )-methanol(84??16) at a flow rate of 1.0 mL??min^-1. Thirty percent of the eluent was detected by ion trap mass spectrometry, and the parent ions and the corresponding product spectra of all the related substances in etimicin sulfate were determined and elucidated.RESULTS Addition of 0.1% propionic acid into the mobile phase significantly enhanced the sensitivity of MS detector without altering the chromatographic behavior such as retention time and elution order of the related substances. Twenty-eight related substances were separated and detected by the LC/MSⁿ method in a typical sample. Nine of them were identified with the help of corresponding impurity reference substances and 14 of them were elucidated by MS fragment information, while the other five were not identified due to limitated information. CONCLUSION The established method can be applied to the identification of the related substances in etimicn sulfate detected under the chromatographic condition described in Chinese Pharmacopoeia 2010, which is helpful to the quality improvement and process optimization of etmicin sulfate.     

����ƥΤ�������ƻ���1�ͱ��͸�����Ч�밲ȫ�Ե�Meta����

??OBJECTIVE To assess efficacy and safety of simeprevir-based therapy for the treatment of hepatitis C virus genotype 1. METHODS We searched Pubmed, EMBASE, the Cochrane Library, highwire, CBM, CNKI, Wanfang, VIP Database and literature from some relative paper based magazines also be retrieved. Randomised controlled trials(RCTs)of examining simeprevir plus ribavirin(RBV) and pegylated-interferon(peg-IFN) among adults with chronic HCV infection were included.Select the RCTs according to the inclusion criterion, then appraise them critiically by Cochrane handbook. All outcomes were pooled by the RevMan5.2 software of Cochrane Collaboration. Data were extracted on virological responses including sustained virological response at post-treatment week 12(SVR12), SVR24, serious adverse event(SAE),treat-ment discontinuation due to an adverse event(TDAE). RESULTS Eight RCTs were finally included involving 2 758 patients who were treated with simeprevir, RBV and peg-IFN. The RESULTS of Meta-analysis showed that SVR12 rates was[OR=3.92,95%CI(2.86,5.39), P??0.000 01], SVR24 rates was[12 week:OR=3.79,95%CI(2.86,5.01), P??0.000 01], [24 week:OR=4.12,95%CI(2.69,6.30), P??0.000 01], SAE rates was[12 week:OR=0.67,95%CI(0.47,0.95),P=0.02], TDAE rates was[12 week:OR=0.85, 95%CI(0.54, 1.33), P=0.48],[24 week:OR=0.82,95%CI(0.42,1.60), P=0.55]. CONCLUSION Evidence shows that, simeprevir-based treatment(simeprevir plus ribavirin and pegylated-interferon)for treating genotype 1 chronic HCV infection is better than PR treatment in SVR12 rates,SVR24 rates and SAE rates(course of treatment is 12 weeks). However, they are alike in TDAE rates.     

�ȸ�Ѫ��������1���弤��������2�����򲡺ϲ��Ǿƾ���֬������Ч�Ե�ϵͳ���ۺ�Meta����

??OBJECTIVE To evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RA) on nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). METHODS The randomized controlled trials (RCTs) of GLP-1 RA, placebo, and anti-diabetes drugs in the treatment of NAFLD in patients with T2DM were collected from PubMed, Embase, CNKI, Wangfang database, VIP, and CBM. The trials were evaluated for the quality and selected, and the RESULTS of the studies were reviewed and analyzed using RevMan 5.2 software. RESULTS Four RCTs were included, involving 154 patients. The Meta-analysis showed that compared with the control group, GLP-1RA could significantly improve the ALT [MD:-8.36,95%CI(-13.41-3.31), P=0.001], HbA1c [MD:-0.43%,95%CI(-0.73-0.31), P=0.005], FBG [MD:-0.71%, 95%CI(-1.39-0.03),P=0.04],BMI [MD:-1.38%, 95%CI(-2.18-0.58), P=0.000 8], TG [MD:-0.49%, 95%CI(-0.82-0.16), P=0.004]. CONCLUSION GLP-1 RA can obviously improve the metabolic index of patients with NAFLD and T2DM. Given the quality and quantity of the literature, large RCTs are still needed in the future.     

��ЧҺ��ɫ���������÷��ⶨ������������͡�й�����

??OBJECTIVE To establish an HPLC method to determine the related substances of vortioxetine hydrobromide and identify the degradation products of vortioxetine hydrobromide by HPLC-MS. METHODS An HPLC method was developed by using a CN column(Agilent Zorbax SB-CN,4.6 mm??250 mm, 5 ??m),the mobile phase consisted of CH₃CN-HCOONH₄(50??50, pH adjusted to 5.0 with phosphoric acid),the flow rate was 1.0 mL??min^-1, and the detection wavelength was set at 228 nm. The column temperature was maintained at 25 ??, and the injection volume was 20 ??L. RESULTS Vortioxetine hydrobromide was well separated from the related substances. The detection sensitivity of vortioxetine hydrobromide and its related substances met the determination requirements. The calibration curves of vortioxetine hydrobromide and related substances had good linearity. The repeatability of the method was good(RSD=6.89%, n=6). The average recoveries of the sample were all within 95%-105%. The degradation product produced by oxidation was identified by mass spectrometry as related substance D. CONCLUSION The developed method proves to be simple,accurate,specific and reliable. It can be applied to the determination of vortioxetine hydrobromide and its related substances.     

���뷢չ�³�̬��2015��桶�й�ҩ�䡷ͨ��

??Chinese Pharmacopoeia (Ch.P) 2015 edition is the 10th revision of Ch.P since the People??s Republic of China was established.The article is to describe the general situation about the development of Ch.P 2015 edition, it will play very important role for the Ch.P 2015 on improving the standards system, strengthening the quality control for the drug, increasing the application of the advance detection technology, enlarging the monographs adoption, Improving the general requirements and control for the drug safety as well as the leading the international drug standards.     

��˾������̫����ҩ����Ԥ���������ܲ��ʱ��Ѫ�ܷ�Ӧ��Ч��Meta����

??OBJECTIVE To evaluate whether esmolol is equivalent with or superior to fentanyl family of drugs (Fentanyls) on blunting the hemodynamic response to laryngoscopy and tracheal intubation (LTI).METHODS Such databases as PubMed, Embase, The Cochrane Library, CNKI, VIP,CBM,and WanFang Data were electronically searched for relevant studies from inception to July, 2012. According to the inclusion and exclusion criteria as well as the methods recommended by the Cochrane Collaboration, two reviewers independently screened literatures, extracted data, and assessed the methodological quality of the included studies. Then, Meta-analysis was performed using RevMan 5.2 software.RESULTS Finally, 14 randomized controlled trials (RCT) involving 640 patients were included. The results of Meta-analysis showed no significant difference in controlling both heart rate (HR) and mean arterial pressure (MAP) (P>0.05). However, the Fentanyls group was superior to esmolol group in reducing the systolic blood pressure (SBP), and the diastolic blood pressure (DBP). CONCLUSION Based on current evidence, Fentanyls tends to have more beneficial effects on attenuating the hemodynamic response to laryngoscopy and tracheal intubation, compared with esmolol. And choosing middle-lowerd dosage, monitoring of blood pressureafter administrating Fentanyls are important to avoid emergency during LTI.     

DPP-4���Ƽ���GLP-1���弤�����Ƚ�����2��������Ч�ԺͰ�ȫ�Ե�Meta����

??OBJECTIVE To systematically review the efficacy and safety of dipeptidyl peptidase-4(DPP-4) inhibitors versus glucagon like peptide-1(GLP-1) receptor agonists for type 2 diabetes mellitus(T2DM). METHODS Databases including EMbase,PubMed, The Cochrane Library, Clinical Trial, CBM,CNKI and WanFang Data, were searched electronically for randomized controlled trials (RCTs) of DPP-4 inhibitors versus GLP-1 receptor agonists for T2DM up to December 2015. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then Meta-analysis was performed using RevMan 5.3 soft ware. RESULTS A total of 13 RCTs were included. The RESULTS of Meta-analysis showed that compared with DPP-4 inhibitors, GLP-1 receptor agonists were more effective in reducing the levels of fasting plasma glucose [MD=0.93, 95%CI(0.48,1.38), P??0.000 1] and glycated hemoglobin [MD=0.53,95%CI(0.34,0.73), P??0.000 01] and BMI [MD=1.53,95%CI(0.83,2.22),P??0.001]. However, DPP-4 inhibitors were more effective than GLP-1 receptor agonists in the reducing the 2-hour postprandial blood glucose level. And GLP-1 receptor agonists were more prone to cause gastrointestinal adverse reactions than DPP-4 inhibitors [RR=0.44,95% CI (0.33, 0.59), P<0.000 1]. CONCLUSION GLP-1 receptor agonists are superior to DPP-4 inhibitors in controlling the fasting plasma glucose and glycated hemoglobin levels and reducing the body weight of T2DM patients, while DPP-4 inhibitors have better efficacy in reducing 2-hour postprandial blood glucose level, with better tolerability.     

��ЧҺ��ɫ��-�߷ֱ��������÷��ⶨ���������������й�����

??OBJECTIVE To establish an HPLC-HRMS/MS method for analyzing the structures and sources of the related substances in etimicin sulfate. METHODS The chromatographic separation was achieved on a broad pH range column with a basic elution system composed of[H₂O-ammonia-glacial acid(96??3.6??0.4)]-methanol(70??30). Twenty percent of the eluent was detected under positive electrospray ionization(ESI) by Q-Exactive mass spectrometry. The fragmentation pathways were elucidated according to the HRMS and HRMS/MS fragmentation of etimicin and some known compounds. Then the unknown related substances were identified by analyzing their HRMS and HRMS/MS fragmentation with the help of the rule. RESULTS Sixty-five related substances were detected by the HPLC-HRMS/MS method in the two samples from different companies,among which 38 were detected in the product of company A, 59 in that of company B, and 32 were detected for both companies. Fifty-four related substances were identified or deduced, and the other 11 were not able to be identified due to limited information. Based on the significant difference of impurity spectra between the two enterprises, the key parameters of the synthesis process were analyzed. CONCLUSION An HPLC-HRMS/MS method, which showes excellent accuracy, is developed to identify the related substances in etimicin sulfate. The resources and structures of the related substances are analyzed, which will be helpful to the process optimization.     

���Ϳڷ�����ҩ�����ڷǰ�Ĥ�Է���������Ч�ԺͰ�ȫ�Ե�Meta����

??OBJECTIVE To evaluate the efficacy and safety of new oral anticoagulants (dabigatran etexilate, rivaroxaban, apixaban, edoxaban) in the treatment of non-valvular atrial fibrillation. METHODS The randomized controlled trials about new oral anticoagulants in the treatment of non-valvular atrial fibrillation, which had been published from the time of library foundation to March 2016 were collected from Pubmed, Embase, Medline, Cochrane, ClinicalTrials.gov, Web of Science, CNKI, Wanfang database, VIP database according to the following criterias. At the same time quality of the trials was evaluated and the results of studies were analyzed using Rev Man 5.3 software and Stata 13.1 software. RESULTS Seventeen randomized controlled trials were included, involving 83 561 patients. Network Meta-analysis showed that in the prevention of all-cause mortality, the optimal sorting order of new oral anticoagulants was rivaroxaban, apixaban, edoxaban, dabigatran etexilate; in the prevention of the incidence of stroke and systemic embolism, the optimal sorting order of new oral anticoagulants was rivaroxaban, dabigatran etexilate, apixaban, edoxaban; in the prevention of the incidence of ischemic stroke, the optimal sorting order of new oral anticoagulants was rivaroxaban, apixaban, dabigatran etexilate, edoxaban; the incidence of major bleeding for the optimal sorting order of new oral anticoagulants was edoxaban, apixaban, dabigatran etexilate, rivaroxaban; the incidence of intracranial bleeding for the optimal sorting order of new oral anticoagulants was dabigatran etexilate, edoxaban, apixaban, rivaroxaban; the incidence of myocardial infarction for the optimal sorting order of new oral anticoagulants was rivaroxaban, apixaban, edoxaban, dabigatran etexilate. The inconsistency of all the outcomes indicated that there was no significant difference between direct comparison and indirect comparison. In addition, there was no statistical heterogeneity among studies. CONCLUSION Through analysis the effectiveness, safety and economy of new oral anticoagulants, apixaban has the best sort and should be used in preference.     

蒙古族ATP结合盒转运子A1基因R219K多态性与冠心病的相关性

目的探讨ATP结合盒转运子A1基因（ATP binding cassette transporter 1,ABCA1）R219K多态性在内蒙古地区蒙古族人群中的分布及其与冠心病的关系。方法采用聚合酶链反应-限制片段长度多态性方法检测115名蒙古族冠心病患者和对照组ABCA1基因相应片段的多态性。结果两组基因型频率均符合Hardy-Weinberg平衡。内蒙古地区蒙古族人群中ABCA1基因R219K多态性位点存在RR、RK、KK三种基因型,对照组的KK基因型的频率显著高于CHD组（32.7% vs 16.7%,P〈0.05）。KK基因型的OR值为0.411（95% CI0.17~0.99）。结论 ABCA1基因R219K多态性与内蒙古地区蒙古族人群冠心病的遗传易感性相关,其中基因型KK可能是冠心病的保护因子。     

CYP3A4*18A��CYP3A4*18B��MDR1 C3435T�����̬�Զ԰��з���͡ѪҩŨ�ȼ���Ч��Ӱ��

??OBJECTIVE To investigate the interindividual variabilities of plasma concentration and lipid-regulating efficacy of atorvastatin in patients with hyperlipidemia through the genotyping of CYP3A4*18A, *18B and MDR1 C3435T genes.METHODS One hundred and fifteen Chinese Han population with hyperlipidemia were genotyped by the PCR-RFLP (restriction fragment length polymorphism).The steady-state plasma trough concentrations of atorvastatin were measured by high performance liquid chromatography (HPLC)-UV.The levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were monitored by the homogeneous enzyme method before treatment and 1 month after medication.RESULTS The mutation frequencies of CYP3A4*18A,*18B and MDR1 C3435T were 3.48%,23.48% and 31.74% respectively.It shows no statistically significant difference for the SNPs frequencies between the normal population reported and patients selected.Patients with CYP3A4*18B homozygous mutant (AA) showed a significantly higher plasma concentration of ATV compared with the G/A heterozygous mutat patients or the G/G wild-type homozygous (P=0.016).However,no significant difference could be shown in the patients with CYP3A4*18A and MDR1 C3435T genotypes(P??0.05).Neither CYP3A4*18A nor MDR1 C3435T could be shown a significant difference in the lipid lowering efficiency(P>0.05).Patients carrying the homozygous mutant (AA) of the CYP3A4*18B gene showed a significantly higher TC lipid-regulating effect compared with patients with the GA or GG genetic variant (P=0.02). The LDL-C change rates among the three genotype groups were significantly different, with AA group >GA group >GG group (P=0.01) and the regulation of TG and HDL-C for AA,GA or GG was compared without finding any significant difference (P>0.05).The TC changerates and plasma concentration were significantly correlated (P=0.031) before and after treatment,while there was no statistical significance in the correlation of the other three lipid change rates with plasma concentration (P??0.05).CONCLUSION The SNPs MDR1 C3435T and CYP3A4*18A do not affect the plasma concentration and efficacy of ATV. In ATV therapy, patients with the CYP3A4*18B gene exhibit higher plasma concentrations than the non-carriers, and the lipid-lowering efficacy was more pronounced.     

中国汉族和蒙古族健康人药物代谢酶CYP3A4、CYP2C9、CYP2C19、CYP2D6基因多态性分析

 目的 用基因分型技术对中国汉族、蒙古族健康人CYP3A4、CYP2C9、CYP2C19、CYP2D6进行基因多态性分析,并对汉族人和蒙古族人基因表型和基因频率进行比较。方法 聚合酶链反应-限制性片段长度多态性(PCR-RFLP)对CYP3A4、CYP2C9、CYP2C19、CYP2D6进行分型。结果 汉族、蒙古族健康人CYP3A4*5等位基因频率为0, CYP3A4*18等位基因频率分别为0.183 8、0.202 5,CYP2C9*2等位基因频率分别为0.011 0、0.025 3, CYP2C9*13等位基因频率分别为0、0.00 32,CYP2C19*2等位基因频率分别为0.386 0、0.4146, CYP2C19*3等位基因频率分别为0.051 5、0.044 3,CYP2D6*10等位基因频率分别为0.573 5、0.465 2。结论 汉族、蒙古族健康人群CYP3A4*18、CYP2C19*2、CYP2C19*3、CYP2D6*10等位基因频率均没有显著性差异;本试验在汉族、蒙古族健康人中未发现CYP3A4*5等位基因;仅在蒙古族健康受试人群中发现1人为CYP2C9*1/*13基因型;蒙古族CYP2C9*2等位基因频率远小于汉族（P=0.023）。     

中医药治疗再生障碍性贫血的Meta分析

目的:评价中医药治疗再障的临床疗效,为中医诊疗指南再障的治法提供循证医学证据。方法:检索中医药治疗再障的随机对照或半随机对照试验,对入选文献进行Jadad量表评分,提取数据,使用RevMan 5.2.1软件进行meta分析。结果:纳入2篇六味地黄丸联合皂甙丸治疗再障的研究。Meta分析的结果发现六味地黄丸联合皂甙丸和雄激素治疗再障的总有效率差异无统计学意义(P=0.65),但前者治疗再障的肝损害、女性男性化的不良反应较后者轻(P<0.05)。其他中医药治疗再障的研究均缺少临床试验报道。结论:中医药治疗再障有一定的疗效。因所纳入的文献质量普遍偏低且样本量小,势必影响结果的论证强度,故尚需更多高质量的研究,提供高质量的证据。     

中医体质和HBV感染结局的关联及其与人类白细胞抗原-DQA1基因多态性的关系

目的 观察中医体质类型与浙江地区汉族人群乙型肝炎病毒(HBV)感染不同临床状态及人类白细胞抗原(HLA)DQA1基因多态性的关系,探讨中医体质因素在慢性乙型肝炎发病中的作用。方法 临床收集慢性乙型肝炎(CHB, 120例)、慢性HBV携带者(ASC, 60例)、自限性HBV感染者(RHBS, 60例)3组患者,前两组诊断均经肝活检证实。以王琦体质分类判定中医体质类型;聚合酶链反应序列特异性引物(PCR-SSP)法检测HLA-DQA1基因型,比较组间体质类型分布的差异及组间基因频率的差异。结果 (1) CHB组阴虚质、痰湿质的分布频率（20.0%、12.5%）显著高于RHBS组(6.7%、1.7%),平和质的分布频率(11.7%)显著低于RHBS组(31.7%),差异均有统计学意义(OR=3.500,95%CI:1.16－10.60; OR=8.400,95%CI:1.09－65.42; OR=0.161,95%CI:0.076－0.34; 均P<0.05);(2)CHB组湿热质的分布频率（24.2%）显著高于ASC组(6.7%, P<0.05,OR=4.462,95%CI: 1.49－13.36),平和质的分布频率（11.7%）显著低于ASC组(45.0%, P<0.01,OR=0.285,95%CI:0.13－0.62);(3)HLA-DQA1*0201在CHB组的分布频率（38.3%）显著高于RHBS组(5.8%,P<0.01,OR=10.04,95%CI:4.48-22.48);HLA-DQA1*0102的分布频率（9.6%）显著低于RHBS组(36.7%,P<0.01, OR=0.183, 95%CI:0.10－0.32);(4)HLA-DQA1*0201在CHB组的分布频率（38.3%）显著高于ASC组(7.5%,P<0.01,OR=7.667, 95%CI:3.7－15.87);HLA-DQA1*0102的分布频率（20%）显著低于ASC组(9.6%,P<0.01,OR=0.424, 95%CI:0.23－0.79)。结论 中医体质因素和HLA-DQA1基因多态性均可影响HBV感染的临床结局,但其间关系需进一步研究明确。     

广东汉族人群MTHFR基因C677T多态性与NSCL/P易感性的关联研究

目的:研究广东地区汉族人群非综合征型唇腭裂(NSCL/P)的发生与其亚甲基四氢叶酸还原酶(MTHFR)基因C677T多态性的关联性。方法:采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析方法对124例NSCL/P患者和273例健康人群的外周血液进行MTHFR基因C677T基因型检测,比较突变基因分布频率的差异强度。结果:病例组MTHFR基因突变纯合型(677TT)比例及携带T等位基因频率均高于对照组,差异有统计学意义(P0.05)。结论:广东地区汉族人群NSCL/P的发生与其MTHFR基因C677T多态性相关,等位基因C突变为T可能会增加患NSCL/P的风险。     

论单核苷酸多态性与中医证的个体差异

单核苷酸(nucleotide)是基因的基本组成单位，单核苷酸多态性(Single Nacl eotide Poly morPhism,SNP)是指任何两个不同个体之间的单核苷酸序列中均有不同的排列次序，导致遗传变异而形成不同个体的差异性和多样性。它是决定人的个体差异的主要因素，是遗传的变异性所引起。个体差异是个体机体功能相对偏差以保持动态稳定的特征，是潜在的病理因素，其发病具有质化特点。证以质为基础，质以证的形式表现出来，证的特征包含着质的特征，证往往随质而转移，证的个体差异与单核苷酸多态性有关，这是中西医结合研究的最佳切入点。建立证与药的单核苷酸组学，可阐明中医药防治疾病原理，实现个体化医学治疗的理想，体现中医治病求本和防治未病的思想。     

论单核苷酸多态性与中医证的个体差异

单核苷酸（nucleotide）是基因的基本组成单位,单核苷酸多态性（SingleNacleotidePolymorPhism,SNP）是指任何两个不同个体之间的单核苷酸序列中均有不同的排列次序,导致遗传变异而形成不同个体的差异性和多样性。它是决定人的个体差异的主要因素,是遗传的变异性所引起。个体差异是个体机体功能相对偏差以保持动态稳定的特征,是潜在的病理因素,其发病具有质化特点。证以质为基础,质以证的形式表现出来,证的特征包含着质的特征,证往往随质而转移,证的个体差异与单核苷酸多态性有关,这是中西医结合研究的最佳切入点。建立证与药的单核苷酸组学,可阐明中医药防治疾病原理,实现个体化医学治疗的理想,体现中医治病求本和防治未病的思想。     

Association between metabolic syndrome and body constitution of traditional Chinese medicine: A systematic review and meta-analysis

BackgroundThe constitution theory of traditional Chinese medicine (TCM) states that body constitution and disease are associated; therefore, the identification of body constitution can provide reference for disease prevention and treatment. A series of clinical studies evaluating the association between TCM constitution and metabolic syndrome (MetS) have been conducted in recent years. The aim of this systematic review is to summarize and evaluate the clinical evidence of the relationship between constitution and MetS.MethodsThe PubMed, Embase, China National Knowledge Infrastructure (CNKI), Chongqing VIP, and Wanfang Data electronic databases were searched from April 2009 to July 2020. The search terms included “metabolic syndrome,” “constitution,” and “Chinese medicine.” Observational studies evaluating the relationship between body constitution of TCM and MetS were included. The primary outcome included the distribution of constitutional types in the MetS population, and odds ratio (OR) or relative risk (RR) between constitution and MetS. Effect size was expressed as proportion or OR with 95% confidence interval (CI). Methodological quality of included studies was evaluated by the Newcastle–Ottawa Scale (NOS) or the American Agency for Healthcare Research and Quality (AHRQ) criteria.ResultsThree case–control and 26 cross-sectional studies involving 30 435 cases were included. Phlegm-dampness, qi-deficiency, and damp-heat were the main constitution types in patients with MetS, accounting for 29% (22%–39%), 18% (13%–24%), and 12% (9%–17%) of the population, respectively; the risk of MetS in people with phlegm-dampness and qi-deficiency constitution was 1.74 [1.27, 2.38] and 1.29 [1.01, 1.65] times higher than that in those with other constitutions. There were sex- and age-related differences in the distribution of TCM constitution in patients with MetS.ConclusionPhlegm-dampness and qi-deficiency were associated with the occurrence of MetS. Well-designed cohort and case–control studies are needed to provide evidence for the use of TCM to prevent and treat MetS.