發(fā)布時間：2018-01-02 10:36

  本文關(guān)鍵詞：銀屑靈治療尋常型銀屑病血清及尿液代謝組學的初步研究　出處：《廣州中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 尋常型銀屑病 銀屑靈 血清 尿液 代謝組學

【摘要】：目的：本研究主要采用液質(zhì)聯(lián)用技術(shù)分析銀屑靈片治療前后尋常型銀屑病患者血清及尿液代謝狀態(tài)的變化,并與健康對照組進行比較,從而了解尋常型銀屑病患者血清及尿液代謝輪廓的基本特征,并從代謝的層面闡述銀屑靈片治療尋常型銀屑病的可能作用機制,為銀屑靈治療尋常型銀屑病提供有效證據(jù)。方法：納入2014年2月-2015年9月在廣東省中醫(yī)院皮膚科門診就診且與課題標準要求相符合的銀屑病患者予銀屑靈片治療。在治療前后(第0周和第12周)分別對各項臨床評價指標進行評估,并用促凝管以及尿管分別采集患者晨起空腹的血液5ml及中段尿10ml。采用液質(zhì)聯(lián)用技術(shù)檢測分析患者治療前后血清及尿液代謝狀態(tài)的變化,并尋找差異性、內(nèi)源性代謝物,從而篩選出尋常型銀屑病患者及銀屑靈片治療后發(fā)生改變的潛在生物標志物。結(jié)果：本研究共納入尋常型銀屑病患者18例,同時在廣東省中醫(yī)院體檢中心納入健康對照組共32例,其與治療組在性別、年齡方面差異無統(tǒng)計學意義。主要采用具有高通量、高靈敏度和精確度的UPLC/Q-TOFMS技術(shù)對收集的血清及尿液標本進樣檢測分析,并通過主成分判別分析、偏最小二乘法-判別分析及正交潛變量投影-判別分析等方法進行模式識別,建立數(shù)學模型。尋常型銀屑病患者血清及晨尿代謝組學治療前后與健康對照組比較,代謝輪廓較為清晰,區(qū)分明顯：治療前與健康對照組的血清及尿液代謝生物標志物提示,尋常型銀屑病與脂類、維生素、氨基酸以及輔酶等相關(guān)；血清治療前后的代謝途徑主要以脂類代謝為主,考慮與銀屑病可能導致的脂類代謝紊亂相關(guān),其中多為甘油三酯與磷脂的代謝；而晨尿治療前后的代謝生物標志物與治療前與健康組趨于相似。根據(jù)治療前與健康對照組的血清及晨尿的生物標志物,銀屑病與健康組存在代謝差異,其代謝紊亂與脂類、氨基酸、維生素等相關(guān)；銀屑病患者血清與晨尿的代謝差異物中Ceramide (dl8:1/9Z-18:1)與Ceramide (dl8:1/20:0)均屬磷脂代謝中神經(jīng)酰胺類物質(zhì),經(jīng)治療后均存在明顯下降,體現(xiàn)出銀屑靈的調(diào)節(jié)作用,考慮可能為銀屑病發(fā)生發(fā)展以及銀屑靈調(diào)控作用的關(guān)鍵,但需大量的重復實驗加以證明。結(jié)論：尋常型銀屑病的血清及尿液的代謝與健康對照組之間存在明顯差異,經(jīng)銀屑靈治療后,其代謝差異發(fā)生明顯改變且治療后的代謝數(shù)據(jù)趨于健康正常組；從代謝組學上說,銀屑靈治療尋常型銀屑病具有研究價值,結(jié)合相關(guān)代謝生物標志物,可為進一步發(fā)掘銀屑靈對銀屑病的作用機制與靶點提供有力的科學依據(jù)。
[Abstract]:Objective: to study the changes of serum and urine metabolism in patients with psoriasis vulgaris before and after treatment with Yinshiling tablets by liquid / mass spectrometry, and to compare the results with those of healthy controls. In order to understand the basic characteristics of the metabolic profile of serum and urine in patients with psoriasis vulgaris, and to explain the possible mechanism of Yinshiling tablet in the treatment of psoriasis vulgaris from the level of metabolism. To provide effective evidence for the treatment of psoriasis vulgaris. Methods:. Patients with psoriasis admitted to the Department of Dermatology of Guangdong Provincial Hospital of Chinese Medicine from February 2014 to September 2015 were treated with Yinshinling tablets before and after treatment (. Each clinical evaluation index was evaluated at week 0 and week 12 respectively. The patients' fasting blood 5ml and middle urine 10ml were collected from the morning, and the changes of serum and urine metabolism before and after treatment were detected by liquid-mass spectrometry. And search for the difference, endogenous metabolites, so as to screen out the potential biomarkers of psoriasis vulgaris patients and Yinshinling tablets after treatment. Results: 18 patients with psoriasis vulgaris were included in this study. At the same time, 32 cases of healthy control group were included in the physical examination center of Guangdong traditional Chinese medicine hospital. There was no significant difference in sex and age between the treatment group and the treatment group. A highly sensitive and accurate UPLC/Q-TOFMS technique was used to detect and analyze the serum and urine samples collected and analyzed by principal component discriminant analysis (PCA). Partial least squares discriminant analysis and orthogonal latent variable projection-discriminant analysis are used for pattern recognition. The metabolic profile of serum and morning urine of patients with psoriasis vulgaris was clearer than that of healthy controls before and after treatment. The results showed that the metabolic biomarkers of serum and urine before treatment and healthy control group suggested that psoriasis vulgaris was associated with lipid, vitamins, amino acids and coenzymes. The main metabolic pathway before and after treatment was lipid metabolism, which was related to the disorder of lipid metabolism caused by psoriasis, most of which were triglyceride and phospholipid metabolism. However, the metabolic biomarkers before and after morning urine treatment were similar to those in the healthy group before and after treatment. According to the biomarkers of serum and morning urine before treatment and healthy control group, there were metabolic differences between psoriasis group and healthy group. Its metabolic disorder is related to lipids, amino acids, vitamins and so on. (Ceramide dl8: 1 / 9Z-18: 1) and Ceramide dl8: 1 / 20: 0). They all belong to ceramides in phospholipid metabolism. After treatment, there is a significant decrease, which reflects the regulatory effect of silver shillings, which may be the key to the occurrence and development of psoriasis and the regulatory role of silver shillings. Conclusion: the metabolism of serum and urine in psoriasis vulgaris is significantly different from that in healthy control group. The metabolic differences were obviously changed and the metabolic data after treatment tended to normal group. From the metabonomics point of view, Yinshinling treatment of psoriasis vulgaris has the research value, combined with the related metabolic biomarkers, it can provide a powerful scientific basis for further exploring the mechanism and target of Yinshinling on psoriasis.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R275.9

【相似文獻】

相關(guān)期刊論文 前10條

1 肖青林,常開齊,司本輝,閆韻洪,李積榮;銀膚欣系列治療尋常型銀屑病的臨床研究[J];天津中醫(yī);2000年02期

2 耿曉蘭,潘樹偉,郭景春;消u曇瘟蒲俺Ｐ鴕疾，

本文編號：1368860