世界中医药

作者	单位
陶嘉磊1，汪受传1，田曼2，梁慧2，戴启刚1	1 江苏省儿童呼吸疾病（中医药）重点实验室，南京，210023； 2 南京医科大学附属南京市儿童医院呼吸科，南京，210008

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中文摘要:

目的：分析小儿支气管哮喘发作期痰热阻肺证与非痰热阻肺证尿液代谢谱，探索中医不同证候生物学标记物差异。方法：收集24例痰热阻肺证、20例非痰热阻肺证患儿尿液进行液相色谱-质谱检测，运用XCMS Online和MetaboAnalyst分析平台确定差异性代谢物及代谢通路。结果：痰热阻肺证与非痰热阻肺证间能够良好区分，一系列有机酸、氨基酸、脂、酮类等差异性代谢物及代谢通路被确定。与痰热阻肺证相比，非痰热阻肺证组患儿尿中蛋氨酸、琥珀酸、赖氨酸、肌酸、犬尿氨酸、环腺苷酸等多种有机酸、氨基酸，以及多种脂类、酮类化合物含量升高，仅有羟基吲哚乙醛含量降低，主要涉及生物素代谢、色氨酸代谢等5条代谢通路异常。结论：小儿支气管哮喘不同证型间存在代谢标记物与代谢通路基础，可能是中医不同证候区别的本质。

English Summary:

By analyzing urinary metabolic profiles of heat-phlegm obstructing lung syndrome and non-heat-phlegm obstructing lung syndrome in children with exacerbated asthma to explore potential metabolic biomarkers between different syndromes.Methods:Twenty-four sick children with Heat-phlegm obstructing lung syndrome and twenty sick children with non-heat-phlegm obstructing lung syndrome were enrolled.Urine samples were collected，and urine metabolites profiles were analyzed by LC-MS coupled with a suite of statistical analyses.Results:Clear separations between heat-phlegm obstructing lung syndrome and non-heat-phlegm obstructing lung syndrome existed.Differential metabolites and several metabolic pathways related organic acids，amino acids，fat，ketone compound were identified.Compared with heat-phlegm obstructing lung syndrome group，the levels of organic acids，amino acids，fat，ketone compound were upregulated，such as methionine，succinic acid，lysine，creatine，kynurenine，and cyclic AMP，and only hydroxy indole acetaldehyde were down in urine with non-heat-phlegm obstructing lung syndrome.Furthermore，five abnormal metabolic pathways，such as biotin metabolism，tryptophan metabolism were identified.Conclusion:The basis of metabolic biomarkers and pathways in children with bronchial asthma exists in different syndrome types，which may be the essence of different TCM syndromes.

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