Screening And Identification Of The Target Protein Of Lumbar Intervertebral Disc Protrusion With Five Non Surgical Combined Therapy Of Traditional Chinese Medicine And Western Medicine

Objective:To observe the clinical therapeutic effect of combination of five non surgical combined therapy in the treatment of lumbar intervertebral disc protrusion(LIDP)of traditional Chinese medicine and Western medicine.Using isotope labeling relative and absolute quantitative combined liquid chromatography and tandem mass spectrometry on patients with LIDP by five method combined with non-surgical combination therapy of traditional Chinese and western medicine treatment of before and after the differentially expressed proteins.Providing a basis for the search for the serum molecular targets in LIDP therapy.Methods: In 35 cases of LIDP patients,all patients were treated with the five non surgical combined therapy of traditional Chinese medicine and western medicine for 4 weeks,and the clinical efficacy was observed.Serum samples were collected from the peripheral blood of the patients before and after treatment,and were extracted by protein,protein concentration,protein enzymatic hydrolysis,iTRAQ labeling,high performance liquid chromatography and LC-MS/MS mass spectrometry.Analysis of inventory identification and quantitative mass spectrometry data,screening and identification of differentially expressed proteins,and the proteins were analyzed by bioinformatics.Results:(1)The five non surgical combined therapy by combining traditional Chinese and Western medicine group of patients after 4 weeks of treatment,postoperative visual analogue score is significantly reduced,thedifference was statistically significant(p < 0.05),32 cases were improved,the improvement rate reached 91.4%.The standard of efficacy was evaluated according to the JOA scale.Compared with the JOA score before treatment,the JOA score increased significantly after treatment.The difference was statistically significant(p < 0.05),and 19 cases were clinically controlled,7cases were markedly effective,5 cases were effective,4 cases were ineffective,and the total effective rate was 88.6%.(2)A total of 209 marked differential proteins were screened out by mass spectrometry,and 21 differentially expressed proteins(p<0.05)were identified,of which 13 were up-regulated,and 8 were down regulated.(3)Gene Ontology(GO)analysis of these differential proteins revealed that there were 182 annotated biological processes,43 cell components and 90 molecular functions.Analysis of these differentially expressed proteins in Kyoto Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway revealed that 14 differential proteins were enriched to 25 KEGG signaling pathways.Conclusion(s):(1)The application of the five non surgical combined therapy by combining traditional Chinese and Western medicine of LIDP curative effect,worthy of clinical application.(2)The complement C3,fibronectin 1,apolipoprotein A-IV,apolipoprotein B and apolipoprotein A-I may become a potential molecular target for the treatment of LIDP with the five non surgical combined therapy by combining traditional Chinese and Western medicine.