| Objectives: Cerebral arterial thrombosis was most common disease because of cerebral atherosclerosis or thromboembolism, its high disease incidence rate, the high mortality rate that had caused the paralysis, the aphasia and the aphrenia and caused patient's survival quality to be low. The significant disease had threatened to our country people health. Traditional Chinese medicine syndrome of diagnosis has much subjectivity, which affects constancy of diagnosing syndrome and repeatability of curative effect. Different pattern syndrome of cerebral arterial thrombosis maybe had different etiological factor and pathogenesis because of the distinct hereditary basis, cerebral arterial thrombosis had vary clinical feature.Therefore, we planed to traditional Chinese medicine differentiation of symptoms and signs cerebral arterial thrombosis patients pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti-vein and pattern syndrome of hyperactivity of liver-YANG, febrile disease complicated by wind. We carried the relevant analysis of the gene polymorphism distribution and the clinical phenotype characteristic on the patient and healthy people's genes ofβ- fibrinogen - 455G/A, angiotensin-convertion enzyme (ACE), low density lipoprotein acceptor (LDL-R).To research the relations of traditional Chinese medicine syndrome and related gene distribution, clinical phenotype characteristic of cerebral arterial thrombosis of different Chinese medicine syndrome, revealed biology foundation and inherent axiom of cerebral arterial thrombosis of different Chinese medicine syndrome from the gene - disease - syndrome point of view, preliminary revealed modern medicine biology foundation of traditional Chinese medicine syndrome. Methods: According to research purpose, this experiment adopted the large sample, the parallel comparison, multi-central, the cross section research testing method. In nerve internal medicine department of Hubei Province hospital of traditional Chinese medicine, Wuhan first hospital, ZHONG NAN hospital of Wuhan university, collected cerebral infarction patients altogether were 410 examples, after screening , consistent with standard and complete effective data of the cases were 382 examples; collected healthy control group 200 examples.Collected the clinical symptoms, the objective sign and the correlation data; Collected blood sample, extract whole blood DNA; adopted polymerase chain reaction restrictive fragment length polymorphism (PCR-RFLP) method to examine the gene polymorphism ofβ-fibrinogen - 455G/A, angiotensin-convertion enzyme (ACE), low density lipoprotein acceptor (LDL-R). We analyzed the relations of related gene distribution, disease clinical phenotype characteristic and traditional Chinese medicine syndrome of cerebral arterial thrombosis.Results: 1. the common data 382 examples of cerebral infarction group: Masculine 206 examples, feminine 176 examples; The average age is 67.8±13.1, 40-49 year old of 46 examples, 50-59 year old of 89 examples, 60-69 year old of 137 examples, 70-79 year old of 110 examples; In the medical history the data has the hypertension patient 219 examples, the rheumatic heart patient 34 examples, the coronary artery disease 98 examples, the diabetes patient 113 examples, the hyperlipemia 206 examples, smoke 134 examples, drink wine 78 examples, has the cerebrovascular disease high-risk factor family history 261 examples.pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein 237 examples, pattern syndrome of hyperactivity of liver-YANG, febrile disease complicated by wind 145 examples. Healthy control group: Masculine 107 examples, feminine 93 examples; The average age is 63.7±14.5, 40-49 year old of 24 examples, 50-59 year old of 58 examples, 60-69 year old of 87 examples, 70-79 year old of 31 examples; In the medical history haven't heart cerebrovascular diseases and so on hypertension, coronary artery disease, cerebral infarction, bodily various systems has no significant disease, smoke 51 examples, drink wine 37 examples, has the cerebrovascular disease high-risk factor family history 84 examples.2. hyperactivity of liver-YANG, febrile disease complicated by wind syndrome of patient's contractive pressure and resting heart rate obviously to be higher than the hyperactivity of liver-YANG, febrile disease complicated by wind syndrome of patient in the acute stage of cerebral arterial thrombosis, which coincidence with pathogenesis of febrile disease complicated by wind, "RE XING YAN SHANG". The number of white blood corpuscle of blood Routine in patients are higher than the healthy control group, which hint to be inflammatory reaction in the body of cerebral arterial thrombosis acute stage, this result is similar with related research of "the near future infect is the stroke causative factor", which provide the mentality of traditional Chinese medicine disintoxicating, modern medicine anti-inflammatory, anti-infection to obviate stroke. The raised blood-fat is the independence hazard factor of cerebral infarction. The high of LDL and the low of HDL are the one of biochemical indicators to distinguish pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein and pattern syndrome of hyperactivity of liver-YANG, febrile disease complicated by wind. The blood viscosity's change is one of factors of cerebral infarction acute stage, the blood viscosity's change in cerebral infarction acute stage has close relations with pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein, which provides the theory basis for improving circulation by using drug for invigorating blood circulation and eliminating stasis.3. In the gene polymorphism research,β- fibrinogen A- 455 allele concerned with cerebral infarction, this kind of dependablity is an independent risk factor opposite to other danger factors. A-455 allele is highly related to pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein. A-455 allele has phlegm stasis pattern syndrome characteristic in clinical manifestation, possibly through affects the level of blood plasma fibrinogen, and adjusts hemorheology. Therefore, A-455 allele possibly is the genetic predisposition symbol of pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein in cerebral arterial thrombosis.4. In LDL-R gene polymorphism research, We discovered that the anemogenous phlegm stagnant blood, arthralgia spasm anti- vein pattern syndrome patient's A+ allele frequency obviously is higher than the healthy control group and pattern syndrome of hyperactivity of liver-YANG, febrile disease complicated by wind. Indicate that A+ allele is closely related to pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein, A+ allele is genetic predisposition factor of stroke patient's pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein.At the same time, high blood TG and LDL is closely related to pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti-vein, high blood TG and LDL patient show pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein in clinical, which agree without prior consultation with academic viewpoint of blood-fat belonging to Chinese medicine phlegm muddy. But the low level of blood HDL is closely related to pattern syndrome of hyperactivity of liver-YANG, febrile disease complicated by wind, hyperactivity of liver-YANG, febrile disease complicated by wind pattern syndrome of the patient's blood HDL level is obviously lower than anemogenous phlegm stagnant blood, arthralgia spasm anti-vein pattern syndrome of patient and the healthy crowd.Above results prompt, the different LDL-R gene type possibly through affects the blood lipid metabolism to cause the stroke patient to display the different clinical pattern syndrome, A+ allele is genetic predisposition factor of stroke patient's pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein. But the different level of blood lipid also displays the different syndrome characteristic. The clinical manifestation of rising blood lipid is close related to the clinical manifestation of Chinese medicine phlegm stasis solid evil. 5. In the ACE-I/D gene polymorphism research, the ACE-DD genotype and the D allele of cerebral infarction group frequency obviously are higher than the normal control group (P<0.05). ACE-DD genotype or D allele possibly has an effect in cerebral infarction, and is close related to cerebral infarction of hyperactivity of liver-YANG, febrile disease complicated by wind pattern syndrome, which possibly is the genetic predisposition symbol. DD genotype patients of the cerebral infarction group obviously has high level of blood Ang II, patients of hyperactivity of liver-YANG, febrile disease complicated by wind pattern syndrome has more higher level of blood Ang II.The DD genotype lead to the higher level of blood Angll,which possibly is the diagnosis genetic predisposition symbol of hyperactivity of liver-YANG, febrile disease complicated by wind pattern syndrome of traditional Chinese medicine.Conclusion: Gene polymorphism related to cerebral arterial thrombosis may indirectly influence Chinese medicine pattern syndrome clinical of stroke through influence on the expression of clinical phenotype, Appearance the same syndrome of the different patients possibly exist some degree of heredity similarity, the different genetic gene may be genetic predisposition factor of some syndrome. Raised LDL, lowered HDL, the change of blood viscosity and A—455 allele are close related to pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein. The different LDL-R gene type cause the stroke patient to different clinical syndrome possibly through influence the blood lipid metabolism, A+ allele is genetic predisposition factor of stroke patient's pattern syndrome of anemogenous phlegm stagnant blood, arthralgia spasm anti- vein. The DD genotype lead to the higher level of blood Ang II, which possibly is the diagnosis genetic predisposition symbol of hyperactivity of liver-YANG, febrile disease complicated by wind pattern syndrome of traditional Chinese medicine. |
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