MeasurementofEmotionStateinPatientswithHepaticDepressionSyndromeandHyperpyrexiaof Liver Syndrome And The Relationship Between The Syndroms And Polymorphisms In The Serotonin Transporter, Tryptophan Hydroxylase, And Angiotensin Converting Enzyme Genes

Objective To explore the emotional characteristics of patients with hepatic depression syndrome and hyperpyrexia of liver syndrome and the relationship between the syndroms and polymorphisms in the serotonin transporter(5-HTT), tryptophan hydroxylase(TPH), and angiotensin converting enzyme(ACE) genesMethods 1. The patients were selected by considering not only their western medicine diagnosis but also their Traditional Chinese Medicine (TCM) diagnosis. Their emotion state were measured with Emotions Rating Scale for Ganzangxiang of traditional Chinese medicine(ERSG), Beck anxiety inventory(BAI) and Beck depression inventory (BDI) in 90 healthy subjects and 203 patients with hepatic depression syndrome, hyperpyrexia of liver syndrome, deficiency of hepatic Qi syndrome, or hyperhepatic Yang syndrome.2. Using a polymerase chain reaction-based technique, the frequencies of 5-HTTLPR, 5-HTT intron2 VNTR, TPH intron7 A218C, and ACE intron 16 insertion/deletion (I/D) polymorphisms were determined in all patient groups and control subjects. Genotype and allele frequency comparisons between patient groups and control subjects were carried out with chi-square tests or Fisher's exact tests.Results 1. The accumulating scores of three dimensions in ERSG, BAI and BDI of all patients were significantly higher than that of controls (PO.01) .2. When comparisons were carried out in all patients with different syndrome of TCM, the scores of Ganjing dimension and anxiety dimension in ERSG were higher in patients with hyperhepatic Yangsyndrome and hyperpyrexia of liver syndrome than that with deficiency of hepatic Qi syndrome and hepatic depression syndrome (P<0.01); The scores of depression dimension in ERSG were significantly higher in patients with hepatic depression syndrome than that with hyperhepatic Yang syndrome (P<0.01) ; the total scores of ERSG were significantly higher in patients with hyperpyrexia of liver syndrome than that with deficiency of hepatic Qi syndrome (P<0.01) ; the scores of BAI were higher in patients with hyperpyrexia of liver syndrome than that with deficiency of hepatic Qi syndrome and hepatic depression syndrome (P<0.01) ; The scores of BDI were significantly higher in patients with hepatic depression syndrome and deficiency of hepatic Qi syndrome than that with hyperhepatic Yang syndrome (P<0.01, P<0.05) .3. When comparation were carried out in neurosis patients, the scores of Ganjing dimension in ERSG were higher in patients with hyperhepatic Yang syndrome and hyperpyrexia of liver syndrome than that with deficiency of hepatic qi syndrome. The scores of anxiety dimension in ERSG and BAI were similar in patients with four liver syndromes. The scores of depression dimension in ERSG and BDI were significantly higher in patients with hepatic depression syndrome than that with hyperhepatic Yang syndrome.4. When comparisons were carried out in all patients with different syndrome of TCM, the frequencies of 5-HTTLPR short/short (SS) genotype were significantly higher in patients with hyperpyrexia of liver syndrome and hyperhepatic Yang syndrome than in control subjects (72%vs49%, P=0.026; 69vs49%, P=0.025), and the S allele frequencies were significantly higher in patients with hyperpyrexia of liver syndrome than in control subjects(85% vs 71%, P=0.009). Similarresults were observed when comparation were carried out in neurosis patients, the frequencies of 5-HTTLPR short/short (SS) genotype were significantly higher in patients with hyperpyrexia of liver syndrome and hyperhepatic Yang syndrome than in control subjects (80%vs49%, P=0.021; 72vs49%, P=0.009), and the S allele frequencies were significantly higher in patients with hyperpyrexia of liver syndrome than in control subjects(88% vs 71%, P=0.015). However, there were no differences for the distribution of 5-HTTLPR between patients with deficiency of hepatic Qi syndrome and hepatic depression syndrome and controls.5. No significant differences for the genotype distribution or the allele frequency of 5-HTT intr...