| Objective 1.To explore the correlation between RAS biaxial key genes and essential hypertension in patients with Yin deficiency constitution.2.To clarify the molecular mechanism of auricular acupoint pressing on the hypotensive effects of yin deficiency constitution in patients with essential hypertension.Method From September 2018 to June 2019,76 EH patients with Yin deficiency and 30 EH patients with mild constitution from two community health service centers in Jiaxing city were enrolled in present study.In the first stage,venous blood were collected for all patients,13 SNPs of 4 genes which include ACE(rs 12709426,rs4291,rs4309,rs4331,rs4343,rs4459609,rs4461 142),AT1R(rs5186,rs5182),AT2R(rs5194,rs1403543),MasR(rs220729,rs926657)were sequenced and typed.Meanwhile,ELISA was used to detect the contents of ACE,ACE2,Ang Ⅱ and Ang(1-7)in samples.The correlation between Yin deficiency constitution and essential hypertension was analyzed by statistics.In the second stage,70 patients which express EH Yin deficiency constitution in the first stage were selected.The control group(n=34):routine use of anthypertensive drugs;intervention group(n=36):on the basis of the control group,auricular acupoint sticking therapy.All patients received a course of treatment for 4 weeks,with a total of 8 weeks of intervention.Blood pressure,body mass score,ACE,ACE2,Ang Ⅱ and Ang(1-7)before and 8 weeks after intervention in the two groups were recorded;blood pressure and body mass score at 4 weeks also were recorded.The statistical methods were used to analyze the effect of auricular acupoint sticking on patients with Yin deficiency constitution of essential hypertension.Result The first stage:(1)There was no significant difference of age,sex,BMI and course of hypertension between two groups(P>0.05),when the data were comparable.(2)All 13 SNP loci conformed to HWE equilibrium law(P>0.05),and the samples were well represented.(3)The frequencies of CC,CT and TT genotypes of AT1R rs5182 in patients with essential hypertension were 16.7%,36.7%and 46.7%,respectively,meanwhile the frequencies of Yin deficiency constitution were 2.9%,58.6%and 38.6%.There was significant difference between two groups(P<0.05).The frequency of genotype CC and CT+TT in patients with essential hypertension was 16.7%and 83.3%,and that of Yin deficiency was 2.9%and 97.1%.There was significant difference between two groups(P<0.05).The second stage:(1)There was no statistical difference of the age,sex,BMI,course of hypertension,blood pressure and Yin deficiency constitution score between the two groups(P>0.05),comparable.(2)The systolic and diastolic blood pressures and Yin deficiency constitution score showed significant changes before,4 weeks after and 8 weeks after the intervention(P<0.05).(3)After 8 weeks of auricular acupoint pressing intervention,there was significant difference in ACE content between groups(P<0.05),and there was no significant difference in ACE content between groups(P>0.05).(4)After 8 weeks of auricular acupoint pressing intervention,there was significant difference in Ang-(1-7)content between groups(P<0.05).Conclusion 1.The allele T of the rs5182 locus of the AT1R gene may be a susceptibility gene in patients with yin deficiency EH.2.Auricular acupoint pressing can reduce the blood pressure of patients with EH yin deficiency and improve the physical condition of yin deficiency.3.The protein expression of ACE was down-regulated after 8 weeks of auricular acupressure,while the expression of Ang-(1-7)protein was up-regulated.The mechanism of acupoint pressing and antihypertensive effect may be through the regulation of the expression of ACE and Ang-(1-7). |
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