Correlation Between Allopurinol HLA-B~*5801 Gene Detection And Traditional Chinese Medicine Constitution In Patients With Gout

Objective To investigate the distribution of physique type in patients with gout and the clinical distribution characteristics of human leukocyte antigen-B(HLA-B)*5801 gene locus gene mutation group and homozygous group,analyze the association between constitution and gene,guide clinicians to use drugs regularly,and provide new ideas and methods for the integrated treatment of gout by integrated traditional Chinese and Western medicine.Methods According to the inclusion and exclusion criteria,210 patients with gout who were hospitalized in the outpatient clinic and ward of the Department of Rheumatology and Immunology of Inner Mongolia Hospital of Traditional Chinese Medicine from December 2021 to December 2022 were screened,and then whole blood specimens were collected from patients and tested for HLA-B~*5801 gene by digital fluorescence molecular hybridization.51 HLAB~*5801(T>G)is divided into wild homozygous group(TT type),mutant heterozygous group(TG type),mutation homozygous group(GG type),133 HLA-B~*5801(A>T)is divided into wild homozygous group(AA type),mutation heterozygous group(AT type),mutation homozygous group(TT type),and the above 6 groups are divided into mutant groups(TG/AA type,TG/AT type,TG/TT type,GG/AA type,GG/AT type,GG/TT type,TT/ AT type,TT/TT type)and homozygous group(TT/AA type),at the same time,two doctors attending rheumatology and above recorded the general information of the patient(including gender,age,smoking history,drinking history,Body Mass Index(BMI,etc.)through questionnaire survey,and judged the TCM constitution according to the patient’s symptoms,and the data collected were statistically processed to analyze the correlation between the physical characteristics and the gene mutation group and the gene pure group,so as to guide the clinicians to use the drugs according to the rules.Results 1.The average age of the 210 cases included in this study was(40.90±12.86)years.Among them,181 cases were male,with a mean age of(40.10±12.86)years;The 29 cases were female,with a mean age of(45.79±12.82)years,and the sex ratio of male to female was 6.24:1.The physical distribution of 210 patients with gout was mainly composed of three constitutions:moist heat,sputum and humidity,and blood stasis.The distribution ratios of the nine constitutions were,from largest to smallest: 62 cases of phlegm-dampness constitution(29.5%)>53 cases of damp-heat constitution(25.2%)> 38 cases of blood stasis constitution(18.1%)> 18 cases of qi stagnation constitution(8.6%)> 17 cases of yin deficiency constitution(8.1%)> 10 cases of yang deficiency constitution(4.8%)> 8 cases of qi deficiency constitution(3.8%)> 4cases of peaceful matter(1.9%)> 0 cases of special constitution(0.0%).2.There were 100 people with a history of smoking and 110 people without a history of smoking among the cases collected in this study;There were 114 people with a history of alcohol consumption and 96 people with no history of drinking.According to BMI classification: 40 obese people,81 people who are overweight,47 people who are normal weight,and 42 people who are underweight.Statistical analysis of physical fitness,smoking,drinking and BMI was carried out,and the results were statistically significant(P<0.05).Among them,smoking patients accounted for the highest proportion of phlegm-dampness,drinking patients accounted for the highest proportion of phlegm-dampness and blood stasis,and excessive BMI accounted for the highest proportion of phlegm-dampness and humid heat.3.51HLA-B~*5801 gene polymorphisms distribution: TT type(177 cases,84.2%),TG type(27 cases,12.9%),GG type(6 cases,2.9%).The gene mutation rate is 15.7%.Distribution of133HLA-B~*5801 gene polymorphisms: AA type(185 cases,88.1%),AT type(25 cases,11.9%),TT type(0 cases,0.0%).The gene mutation rate is 11.9%.4.The physical distribution of HLA-B~*5801 gene mutant group was mainly yin deficiency,yang deficiency and qi deficiency,and the physical distribution of homozygous group was mainly phlegm-dampness,humid heat quality,and blood stasis.The comparative analysis of the course of disease,age and physical distribution of the two groups showed that the gene mutations were not statistically significant in terms of age,course and sex(P>0.05),and there was significant in the physical distribution(P<0.05).Conclusion 1.The distribution of nine TCM constitution among gout patients is the highest proportion of phlegm-dampness,humid heat and blood stasis.2.Smoking patients have the highest proportion of phlegm-dampness,drinking patients have the highest proportion of phlegm-dampness and blood stasis,and excessive BMI accounts for the highest proportion of sputum moisture and humid heat.3.The mutation rate of the 51 HLA-B~*5801 gene locus associated with allopurinol metabolism was higher than that of the 133 HLA-B~*5801 gene loci.4.Compared with patients with phlegm-dampness,moist heat and blood stasis,patients with yin deficiency,yang deficiency and qi deficiency are more likely to have hypersensitivity reactions after taking allopurinol.