| BackgroundChina was the earliest country recognizing high mountain disease, the recognition of the disease abroad on high mountain disease started late, but the naming and typing high mountain disease was earlier than China. In foreign countries, chronic high mountain disease consisted only of high mountain heart disease and high mountain polycythemia. There was no chronic mountain recession disease and very few scientific research in this area. Our country put forward high mountain chronic recession disease as early as in 1995, but the relevant studies were rarely carried out. The current understanding of the disease basically remained in some symptoms, the name of the disease level, and very little about the pathogenesis, clinical characteristics, pathogenesis, risk factors, treatment of strategy was studied. There were also no effective control measures.ObjectionThe objection of this study is to clarify the syndrome distribution rules of chronic chronic mountain recession and the clinical features and related factors from two angles of traditional Chinese medicine and Western medicine by method of epidemiological survey, to clarify Chinese medicine for the treatment of this disease by clinical study, and to explore the pathogenesis of this disease from gene level by method of combined research of the microRNA and mRNA.Methods1.Study of TCM syndrome and related factors of mountain recession diseaseBy using the method of epidemiological survey, this research included 722 patients with chronic plateau recession. The study started from two aspects of traditional Chinese medicine and modern medicine. On the one hand, using of traditional Chinese medicine theory, it is demonstrated syndrome distribution characteristics and regularity of disease which can provide the principles and guidance for the prevention and treatment of chronic mountain recession of traditional Chinese medicine in prevention and treatment. On the other hand, with the use of modern medical physicochemical examination, it showed difference between mountain recession disease population and normal population and showed the clinical characteristics and related factors of mountain recession disease. Besides, it revealed the pathogenesis of mountain recession disease.2.Traditional Chinese medicine for the treatment of mountain recession disease(Qi deficiency and blood stasis), a random double-blinded and placebo controlled studyOn the basis of previous research, we carried out random double blind and placebo controlled clinical study to show effect of traditional Chinese medicine in prevention and treatment of mountain recession disease.3.Combined analysis of microRNA and mRNA in mountain recession diseaseThis study used molecular biology techniques of microRNA and mRNA in patients with mountain recession diseas to screen different expressed genes of intersection and inferred signal pathway which was involved in and further clarify the pathogenesis of mountain recession disease.ResultsStudy of TCM syndrome and related factors of mountain recession diseaseHematocrit of red cell in mountain recession disease were higher than the normal population. Multiple factors such as high mountain work experience more than 31 years, acute high mountain disease history, family history of hypertension, poor quality of sleep, life stress, exercise more than 6 hours may be risk factors for mountain recession disease.Symptoms accounting for more than 50% from high to low order were: hypomnesis (66.34%), fatigue (61.63%), soreness and weakness of waist and knees (60.39%), (56.93%), shortness of breath (56.23%). Respondents tongue mainly see red tongue, pale tongue, dark purple tongue. The common pulse inTCM were string pulse and empty pulse. The main TCM syndrome were two or three phase. Factor analysis showed that the syndrome can be differentiated as six types heart and spleen deficiency syndrome, yin deficiency of heart and kidney syndrome, qi deficiency of lung and kidney syndrome, yang deficiency of kidney syndrome, blood stasis syndrome, dampness-heat of the liver syndrome. Clustering analysis mainly focused on four types heart and spleen deficiency syndrome with phlegm and dampness, liver stagnation and spleen deficiency syndrome, yin deficiency of heart and kidney, yang deficiency of kidney syndrome.2.Traditional Chinese medicine for the treatment of mountain recession disease(Qi deficiency and blood stasis), a random double-blinded and placebo controlled studyThe study included 80 cases and divided into 38 cases in the drug group 42 cases in placebo group. After 8 weeks of therapy, VC MAX and FEV1/VC MAX of lung function, the A/T ratio of X-ray, ET-1, VEGF, integral symptom scores of traditional Chinese medicine and Western medicine were improved significantly.3.Combined analysis of microRNA and mRNA in mountain recession diseaseHigh mountain recession disease hypoxia related genes based on the previous research has not been validated in the present study. The study found that 13 different genes such as SLC25A25, KIAA1486, ANKFY1, ZEB2, CSMD3, RBM3, PCGF5, RAPH1, TNFRSF11B, EVI5, PBX1, GPRIN3, KCNJ10 may be associated with mountain recession disease. High mountain recession disease may be related with cancer, cancer migration, pluripotency of stem cell, gastric acid secretion and receptor interaction pathway.Conclusion1. Hematocrit of red cell in mountain recession disease were higher than the normal population. Multiple factors such as high mountain work experience more than 31 years, acute high mountain disease history, family history of hypertension, poor quality of sleep, life stress, exercise more than 6 hours may be risk factors for mountain recession disease.2. Disease mainly distributed in heart, lung, liver and kidney. Deficiency syndromes such as Qi deficiency, blood stasis, Yin deficiency in different organs were common.3. Chinese medicine treatment can improve VC MAX and FEV1/VC MAX of lung function, the A/T ratio of X-ray, VEGF, integral symptom scores of traditional Chinese medicine and Western medicine.4. High mountain recession disease hypoxia related genes based on the previous research has not been validated in the present study. The study found that 13 genes may be associated with mountain recession disease. High mountain recession disease may be related with cancer, cancer migration, pluripotency of stem cell, gastric acid secretion and receptor interaction pathway. |
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