Metabolomics Study On Spleen And Kidney Deficiency Syndrome And Qi And Yin Deficiency Syndrome In Patients With Chronic Kidney Disease 2-3

Objective:In this study,metabolomic techniques were used to perform nuclear magnetic resonance spectroscopy on the serum of patients with chronic kidney disease(CKD)stage 2-3 spleen and kidney qi deficiency syndrome and qi-yin deficiency syndrome and normal control group serum(~1H-NMR)spectrum analysis,looking for potential biomarkers of the two main syndrome types of CKD2-3;and exploring the material basis of TCM syndromes of the two major syndrome types of CKD2-3,with a view to establishing CKD2-3 spleen and kidney Qi deficiency and Qi The objective and quantitative scientific expression system of TCM syndrome differentiation of Yin and Yin deficiency and two major syndrome types provides new ideas and traditional Chinese medicine methods for the diagnosis and treatment of early CKD.Method:Research subjects:The study included 15 patients with stage 2-3 spleen and kidney qi deficiency syndrome and the same number patients with qi and yin deficiency syndrome,which all from the Department of Nephrology,Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine,affiliated to Shanxi University of Traditional Chinese Medicine.In addition,15 healthy volunteers,that from the patients'family members,were included as the normal control group.Research methods:In this study,the subjects'serum samples were collected,and their gender,age,blood biochemistry and other information were recorded.Prepared serum for ~1 H-NMR detection,and the obtained spectrum was imported into MestReNova 9.0 software for segmented integration,imported nuclear magnetic data into SIMCA-P 13.0 software for multivariate statistical analysis.First of all,PCA analysis was used,based on the verification of the PLS-DA model,and then OPLS-DA analysis,based on the load map(S-Plot)and VIP value(VIP>1),to determine the difference metabolites between groups,using SPSS 25.0 The software t-test performs significant difference analysis.Result:(1)Through analysis of chemical shifts,coupling constants,peak shapes,combined with literature and database control,29 endogenous components were identified from the serum nuclear magnetic spectrum.(2)The content of glutamine,arginine,lipid and?-hydroxybutyrate in the CKD2-3 patients group was higher than that of the control group,and the difference was statistically significant(P<0.05);phosphatidylcholine,glycerophosphatidyl The contents of choline,?-glucose and isoleucine were lower than those of the control group,and the difference was statistically significant(P<0.05).(3)The content of?-hydroxybutyrate,lipid,proline,glycine,betaine,and arginine in the spleen and kidney qi deficiency group was higher than that in the control group,and the difference was statistically significant(P<0.05);phosphatidylcholine,The contents of acetate,?-glucose,glycerophosphatidylcholine and isoleucine were lower than that of the control group,and the difference was statistically significant(P<0.05).(4)The content of?-hydroxybutyrate,choline,glutamine,arginine,lipid,and leucine in the Qi-Yin deficiency group was higher than that in the control group,and the difference was statistically significant(P<0.05);glycerophospholipid The content of acylcholine was lower than that of the control group,and the difference was statistically significant(P<0.05).(5)Compared with the normal control group,the content of lipid and leucine increased significantly in the qi-yin deficiency group,followed by the spleen and kidney qi deficiency group,and the difference was statistically significant(P<0.05);glycine and betaine In the spleen and kidney qi deficiency group,the content increased significantly,and in the yin and yin deficiency group,the content increased second,the difference was statistically significant(P<0.05);cysteine,glutamic acid,and acetate content in the spleen and kidney The Qi deficiency group decreased and the Qi and Yin deficiency groups increased,the difference was statistically significant(P<0.05).Conclusion:Compared with the normal control group,serum MRI metabolic profiles of patients with spleen and kidney qi deficiency syndrome and qi and yin deficiency syndrome in CKD2-3 stage are significantly different.It can be concluded that these two syndromes have a specific metabolic profile,which suggested that the disorder of metabolic pathways may mainly involve the cycle of amino acids,lipids,and tricarboxylic acids.It should be pointed out,because this metabolomic study only involved spleen and kidney qi deficiency and qi and yin deficiency syndromes,it was not compared with other syndromes.Therefore,it is not yet possible to determine which of the characteristic manifestations of the CKD2-3 stage spleen and kidney qi deficiency syndrome and the qi and yin deficiency syndromes belong to the common factors of CKD,and which belong to the CKD spleen and kidney qi deficiency syndrome and the qi and yin deficiency syndromes,the above mentioned needs to be further improved in future experiments.