The Correlation Of CYP2C19 Polymorphisms And Traditional Chinese Medicine Syndrome Types Of Cerebral Infarction At Acute Phase

ObjectiverThe objective of this study was to survey the CYP2C19 genetic and TCM syndromes to explore the correlation of CYP2C19 genetic polymorphisms with TCM syndromes of cerebral infarction patients at acute stage so as to provide evidence for the TCM intervention of CR at genetic level,enhancement of clopidogrel sensitivity.Method:Following the method of epidemiological cross-sectional,this study randomly selected 151 cases of patients with cerebral infarction at acute phase from Affiliated Hospital Chengdu University of traditional Chinese and Sichuan Province Peoples Hospital neurology department of outpatient and inpatient into standard from April 2015 to December 2015,and detected these enrolled patients-genotype of CYP2C19?extensive metabolizer type?intermediate metabolizer type and poor metabolizer type?,collected clinical data respectively by Four Diagnostic Methods and explored the correlation of CYP2C19 genetic polymorphisms with TCM syndromes of cerebral infarction at acute phase.Applied SPSS22.0 software to do the statistic analysis on the collected data.Results:In the 151 cases of acute cerebral infarction patients,80 cases of male,71 cases of female, male to female ratio was 1.13:1, age range 46-80 years, mean age 67.51 ± 8.782 years old.27 patients with diabetes,60 patients with hypertension,23 patients with hyperlipidemia alone.In this study, three types of alleles were detected ?CYP2C19* 1,* 2 and* 3? and six kinds of genotypes ?CYP2C19* 1/* 1,* 1/* 2,* 1/* 3,* 2/* 2,* 2/* 3,* 3/* 3?, CYP2C19* 1,* 2, and* 3 allele frequencies were 59.93%,34.44%,5.63%.A11 into the group of patients with TCM syndrome types were divided into five kinds:wind phlegm, liver yang hyperactivity,phlegm-heat accumulation,Qi deficiency and blood stasis and stirring wind due to Yin deficiencyin the correlation of gender,age with CYP2C19 gene polymorphisms,CYP2C19 genotypes, genetic metabolizer in diferent gender and diferent age groups?middle-aged and agedness,early old age? in the distribution frequency of no significant difference?p>0.05?.In TCM syndrome type distribution,acute stroke in the meridian of wind phlegm Syndrome largest proportion?P<0.005?, combination TCM syndrome of empirical and deficiency syndrome after,empirical proportion is the largest?P<0.05?.In terms of the influence factors of TCM syndrome distribution,gender,age,blood pressure,blood lipid and smoking were not the main factors of TCM syndrome distribution?P>0.05?,glucose may affect the distribution of TCM syndrome?P<0.05?.Correlation between CYP2C19 gene polymorphism and TCM Syndromes:1) Relative to the TCM syndrome of Qi deficiency and blood stasis syndrome rather than stirring wind due to Yin deficiency patients,EM-type compared with the PM-type and wild alleles compared with mutant alleles,the difference was statistically significant?P<0.05?.with genotype metabolic type of EM is the PM-type 0.104 times.The number of patients Carrying the allele* 1* 2 is 0.264 times compared with carrying* 3 allele;2) Combination of metabolic type of EM+IM-type and PM-type, the results show that C YP2C19 PM-type compared with EM+IM-type,the difference was statistically significant ?P<0.05,OR=4.185?. Relative to the TCM syndrome of Qi deficiency and blood stasis syndrome rather than stirring wind due to Yin deficiency patients,PM-type is characterized by EM+IM-type 1.185 times; 3) combined TCM Syndrome empirical and deficiency, the results shoe that the EM-type and IM-type compared with PM-type,difference was statistically significant ?P₁?P₂<0.05,OR₁=7.955 , OR₂=4.136?.EM-type and IM-type,in the form of empirical patients fare for PM-type of 7.955 times and 4.136 times.Conclusion:1.Acute cerebral infarction occurs mainly in older age groups, the incidence of male slightly higher than women,and often associated with other chronic underlying diseases.2.CYP2C19* 1,* 2* 3 allele frequencies were 59.93%,34.44%,5.63%. Compared with CYP2C19*3,*2 is the most common loss-of-function allele.3.Gender, and age is not a major factor in CYP2C19 gene polymorphism and TCM Syndrome Distribution in the older age groups.4.Empirical syndrome was the most common type in meridian-stroke at acute phase,especially the wind phlegm syndrome.5.Bblood pressure, blood lipids, smoking dose not affect the distribution of TCM syndrome in meridian-stroke at acute phase. Glucose may affect the distribution of TCM syndromes, particularly phlegm-heat syndrome.6.Relevance of CYP2C19 gene polymorphism and TCM Syndrome:there is a correlation between CYP2C19 gene polymorphism and TCM Syndrome in the patients of acute cerebral infarction.Carry the The loss-of-function alleles and PM-type more performance for Qi deficiency and blood stasis;compared with PM-type,the EM-type and IM-type more performance the empirical syndrome.