【作者】 刘桂兰；

【导师】 侯丽辉；

【作者基本信息】 黑龙江中医药大学 ， 中医妇科， 2011， 博士

【摘要】 目的探讨HLA-A\B\DRB1基因多态性与中国汉族妇女外阴白色病变中医辨证分型的相关性,从而探讨遗传易感因素相互作用对外阴白色病变发生和发展的影响,为进一步研究提供参考。方法采用PCR-SSP方法对中国汉族妇女外阴白色病变的硬化性苔癣肝肾阴虚型40例(A组)、硬化性苔癣肝经湿热型36例(B组)、鳞状上皮增生肝肾阴虚型36例(C组)、鳞状上皮增生肝经湿热型38例(D组)和正常中国汉族妇女62例(对照组)进行HLA-A\B\DRB1基因多态性关联检测分析。结果结果表明：HLA-B*15等位基因在外阴白色病变各组出现频率均明显高于正常对照组,与对照组相比有极显著性差异(P<0.001);HLA-DRB1*12等位基因在A、B、D组中出现频率也较高,与对照组相比有极显著性差异(P<0.001),其中B组差异尤为显著；而HLA-B*40等位基因在A、C、D组中均呈低表达,与对照组比较亦有极显著性差异(P<0.001)。HLA-A*02等位基因在C组中出现频率明显低于对照组,与对照组比较具有极显著性差异(P<0.001)。结论HLA-B*15等位基因可能是中国汉族妇女外阴硬化性苔癣与外阴鳞状上皮增生(肝肾阴虚与肝经湿热型)的易感基因。HLA-DRB1*12等位基因可能是外阴硬化性苔癣(肝肾阴虚与肝经湿热型)及鳞状上皮增生(肝经湿热型)的易感基因,而与鳞状上皮增生(肝肾阴虚型)无相关性；其中HLA-B*15等位基因是最主要的。HLA-B*40等位基因可能是中国汉族妇女外阴硬化性苔癣(肝肾阴虚型)及鳞状上皮增生(肝肾阴虚与肝经湿热型)的保护性基因,而与硬化性苔癣(肝经湿热型)无相关性。HLA-A*02等位基因可能是中国汉族妇女鳞状上皮增生(肝肾阴虚型)的保护性基因。HLA-DRB1*12、HLA-B*40及HLA-A*02等位基因在各组中的显著性差异提示了中医辨证分型的物质基础和异质性,对外阴白色病变的诊断、治疗、预测和中医辨证分型都具有重要意义。更多还原

【Abstract】 OBJECTIVE To investigate HLA-A\B\DRB1level in TCM syndrome difference of white lesion of vulvar. We try to probe into the influence of genetic susceptibility factors on the disease of white lesion of vulva.And it also supply the reference for the next study.METHODS All150patients who suffered from white lesion of vulva were divided into four groups.38cases were chose to be squamous cell hyperplasia (SH), and36patients were chose to be lichen sclerosus (LS) by the TCM syndrome of Liver meridian hot and humid. Other36patients were chose to be squamous cell hyperplasia (SH), and40patients were chose to be lichen sclerosus (LS) by the TCM syndrome of Yin-deficiency of the Liver and Kidney. These groups of HLA-A,-B,-DRB1genes polymorphism were detected and analysed using PCR/SSP.RESULTS HLA-B*15genes in all patients were obviously higher than normal group. And HLA-DRB1*12genes in all A、B、D groups were obviously higher than normal group. On the contrary, HLA-B*40genes in A、C、D groups were obviously lower than normal group. HLA-B*40、HLA-DRB1*12genes in patients groups have statistical significance (P<0.001).The polymorphism of HLA-A\B\DRB1genes has relation with TCM syndrome of white lesion of vulva. HLA-A*02genes in C groups were obviously lower than normal group. And HLA-DRB1*12genes in patients groups have statistical significance (P<0.001)CONCLUSIONS People with HLA-B*15genes are likely to suffer from the white lesion of vulva. And people with HLA-DRB1*12genes are likely to suffer from the squamous cell hyperplasia and the lichen sclerosus by the TCM syndrome of Liver meridian hot and humid, also lichen sclerosus by the TCM syndrome of Yin-deficiency of the Liver and Kidney. On the contrary, people with HLA-B*40genes are unlikely to catch this disease. Especially in the squamous cell hyperplasia and the lichen sclerosus groups by the TCM syndrome of Yin-deficiency of the Liver and Kidney, and in the group of squamous cell hyperplasia by the TCM syndrome of Liver meridian hot and humid.In addition to the above results,we also find HLA-A*02genes are the protective genes in the group of squamous cell hyperplasia by the TCM syndrome of Yin-deficiency of the Liver and Kidney. The significant difference of HLA-B*40, HLA-DRB1*12and HLA-A*02genes in each group points out the materical evidence to TCM syndrome and the importance of individual discrepancy.And it is significant to diagnose, treat and forecase the disease.It is also important for the TCM syndrome.更多还原