| Objective:1. This study focused on the correlation between TCM syndrome and the concentration of adiponectin(APN) and peroxynitrite(ONOO-) in dyslipidemia patients. In order to find the relationship between the TCM syndrome and inflammatory factors, this study provided the foundation basis for the standardization of syndrome differentiation.2. On the basis of studying the characteristics of cerebral hemodynamics, blood lipid indexes, we analyzed the relationship between TCM syndromes and cerebral hemodynamics, TCM syndromes and blood lipid index. To study the characteristics and rules of TCM syndrome, provide a clinical basis for TCM treatment of dyslipemia and syndrome differentiation.3. On the research of metabolism modes in dyslipidemia patients, we used the metabonomics detection methods. The metabolic spectrum, characteristic metabolites and the material basis of different syndromes were got after study. We want to enrich scientific connotation and provide the basis for the development of syndrome by analyzing the correlation and variation between the characteristic metabolites. It has important significance to provide a clinical basis for TCM treatment of dyslipemia.Methods:1.Cross-sectional study design was used.193 patients with dyslipidemia were assigned with corresponding TCM syndrome scores and their APN and ONOO- serum content measured. We also explored the characteristics of APN and ONOO- in different TCM syndrome and their relativity with TCM syndrome score in the patients.2.Cross-sectional study design was used.112 patients with dyslipidemia were assigned with corresponding TCM syndrome scores and their serum lipids and trancranial doppler (TCD) measured. We also explored the characteristics of serum lipids and TCD results in different TCM syndrome and their relativity with TCM syndrome score in the patients.3. Cross-sectional study design was used.60 patients with dyslipidemia were assigned with corresponding TCM syndrome scores.20 healthy person were assigned at the same time. There are 30 cases of Spleen Kidney Yang Deficiency Syndrome(SKYDS),30 cases ofPhlegm-Dampness Retention Syndrome (PDRS). After serum samples have been collected, metabonomics were detected in in dyslipidemia patients and healthy person by using ’H-NMR. Principal component analysis and evaluate partial least square analysis were used in analyzing serum metabolic pattern of dyslipidemia patients and healthy person, to find the characteristic metabolites in them.Results:1.①The results indicated the serum levels of APN and ONOO" were higher in PDRS that in SKYDS (P< 0.01). ②In SKYDS, there was significantly negative correlation between the clinical TCM symptom integrals and APN (r=-0.46, P< 0.01), and significantly positive correlation between the integrals and ONOO- (r= 0.58, P< 0.01). In PDRS. there was significantly negative correlation between the integrals and APN (r=-0.72, P<0.01), and significantly positive correlation between clinical the integrals and ONOO- (r=0.50, P<0.01).2. ①The results indicated the serum levels of TG was higher in PDRS that in SKYDS (P < 0.01).②In SKYDS, there was significantly positive correlation between the clinical TCM symptom integrals and the serum levels of CHO and ApoAl (P< 0.05). In PDRS, there was significantly positive correlation between the clinical TCM symptom integrals and the serum levels of CHO and LDL-C (P<0.01). ③The results indicated the PSV and MFV of left VA were slower in PDRS that in SKYDS (P< 0.01). The results indicated the blood flow rate (PSV. EDV and MFV) of bilateral MCA, bilateral ACA, bilateral TICA, bilateral PCA, right VA. right BA and EDV of left VA were slower in PDRS that in SKYDS (P> 0.05). ④In SKYDS, there was significantly negative correlation between the clinical TCM symptom integrals and R1 of right MCA (P< 0.05). There was significantly positive correlation between the clinical TCM symptom integrals and MFV, EDV of left VA (P< 0.05). There was significantly positive correlation between the clinical TCM symptom integrals and PSV, MFV and EDV of right VA (P< 0.05). There was significantly positive correlation between the clinical TCM symptom integrals and EDV of BA (P< 0.05). There was significantly negative correlation between the clinical TCM symptom integrals and RI of BA (P< 0.05).In PDRS, there was no significantly correlation between the clinical TCM symptom integrals and the results of TCD(P>0.05).3. ①We found that the metabolic patterns were clearly distinguished in different TCM syndromes with dyslipdemia patients and healthy person through PCA and PLS-DA. In each pairwise comparison between groups, the metabolic patterns in 3 groups have obvious differences. ②Different metabolites were compared in three groups of patients. (A)The results indicated the serum levels of isoleucine, valine. lysine, glutamic acid, glutamine. glycine, alanine, serine, glucose, creatine, creatine phosphate, creatinine. betaine and choline glycerophosphate were lower in PDRS that in healthy person (P< 0.05). The results indicated the serum levels of leucine a little lower in PDRS that in healthy person (P> 0.05). The results indicated the serum levels of lactic acid, acetone, all lipids and poly unsaturated fatty acids were higher in PDRS that in healthy person (P< 0.05). (B) The results indicated the serum levels of glutamic acid, glutamine, alanine, serine, glucose, creatine phosphate, creatinine and betaine were lower in SKYDS that in healthy person (P< 0.05). The results indicated the serum levels of isoleucine, valine, glycine, glycerol phosphatidylcholine and glycerol were a little lower in SKYDS that in healthy person (P> 0.05). The results indicated the serum levels of acetone, all lipids and poly unsaturated fatty acids were higher in SKYDS that in healthy person (P< 0.05). The results indicated the serum levels of leucine, lactic acid and creatine were a little higher in SKYDS that in healthy person (P> 0.05). (C) The results indicated the serum levels of lactic acid, acetone, all lipids and poly unsaturated fatty acids were lower in SKYDS that in PDRS (P< 0.05). The results indicated the serum levels of leucine, valine, lysine, glutamic acid, glutamine, glycine, alanine, serine, glucose, creatine, creatine phosphate, betaine and choline glycerophosphate were higher in SKYDS that in PDRS (P< 0.05). The results indicated the serum levels of isoleucine and creatinine were a little higher in SKYDS that in PDRS (P> 0.05).Conclusions:1. The serum levels of APN and ONOO- varied in different TCM syndromes, and they could be used to reflect the discrepancy and severity of the TCM syndrome and applied as objective and standardized biomarkers for TCM syndrome differentiation.2. ①TG can reflect the difference of TCM syndrome, and CHO can reflect the severity of TCM syndrome in blood lipids. ②VA can reflect the difference of TCM syndrome and the severity in SKYDS. The degree of intracranial vascular stenosis was more serious in PDRS that in SKYDS. ③The characteristics of the above changes and the etiology and pathogenesis analysis of TCM syndrome are the same in meaning. The results can enrich the connotation of TCM from a new perspective. ④Blood lipids and results of TCD could be used to reflect the discrepancy and severity of the TCM syndrome and applied as objective and standardized biological references for TCM syndrome differentiation.3. ①There are unique metabolic patterns and metabolites in dyslipidemia patients and healthy person.The different metabolic patterns and metabolites are consistent with the pathophysiological changes in dyslipidemia.Further more, we could found pathophysiological changes in metabolic level.②There are different metabolic patterns and metabolic characteristics in dyslipidemia patients with SKYDS and PDRS. Metabolism disorder of creatine metabolism, glucose metabolism, lipid metabolism, amino acid metabolism, betaine metabolism and glycerol phosphatidylcholine metabolism is closely related to the characteristics of TCM syndrome. ③These study could provide basis for enriching the scientific connotation of syndrome concept in TCM and extending the distinguishing system of syndrome as well as theoretical basis, and therefore are of great research significance.
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