基于代谢组学的中医治疗重症肺炎疗效的机制研究

采用病证结合研究模式，以临床有效方剂为前提，从方证对应角度，以重症肺炎临床常见证候痰热壅肺、痰湿阻肺、热陷心包为切入点，通过开展中医辨证治疗重症肺炎的随机、对照试验，观察治疗失败率，临床稳定时间，病死率等评价疗效；选取两个临床中心，以临床常见痰热壅肺、痰湿阻肺为示范，从患者血尿代谢组学出发，应用液质联用(LC/MS)技术，结合医学统计学和智能信息处理等方法，发现和筛选生物标志物，探索重症肺炎常见证候与代谢组学生物标志物之间的联系，揭示重症肺炎痰热壅肺、痰湿阻肺的代谢组学特征；观察疾病发生发展过程中证侯的变化，在不同的时间点留取血液尿液标本，在疗效评价的基础上，揭示疾病发生发展的代谢组学机制，通过观察有效方剂对重症肺炎证候及代谢标记物的影响，评价有效方剂的整体效应，揭示方证相应内涵及规律，为证候诊断标准和疗效判断的建立提供科学依据，并揭示中医药治疗重症肺炎的作用机制。

Combining disease with Traditional Chinese medicine (TCM) syndrome research method, using the clinical effective prescription, we conduct a randomized control trial for three popular syndromes (Phlegm heat obstructing lung, Phlegm in the lung, Heat sinking pericardium ) of severe pneumonia， to evaluating the effect of TCM formula. We select two hospital, patients of Phlegm heat obstructing lung and Phlegm in the lung were selected, the blood and urine sample of the patients was collected for metabonomics using of liquid chromatography-mass spectrometry (LC/MS). Combined with the medical statistics and intelligent method，to explore the relationship between severe pneumonia syndromes and metabolomic biomarkers, reveal the characteristics of TCM syndrome of severe pneumonia. Based on metabonomics, to reveal the metabolic mechanism of TCM syndromes as disease development, screening of biomarkers for evaluation for disease, reveal the target of TCM prescription, and the connection of the prescriptions and syndromes, establish criteria to diagnosis and curative effection. To provide scientific basis for revealing the mechanism of TCM treatment of severe pneumonia.