陈妍逸 陈鹏

【摘 要】目的：探讨类风湿关节炎患者中医体质与人类白细胞抗原（HLA）-DRB1基因多态性的关系。方法：根据《中医体质分类与判定》标准设计调查问卷，对200例类风湿关节炎患者进行中医体质类型的调查，以直接碱基序列分析基因分型技术结合特异性引物聚合酶链反应方法测定类风湿关节炎患者的HLA-DRB1基因型，运用统计学方法比较组间体质类型分布差异及组间基因频率的分布差异。结果：阳虚质、气郁质为类风湿关节炎患者易患体质类型;HLA-DRB1*04在不同体质类型患者中分布频率最高，其中阳虚质、气郁质人群HLA-DRB1*04（41.07%、40.00%）基因频率显著高于其他等位基因。结论：中医体质类型与HLA-DRB1基因多态性对类风湿关节炎发生有一定的影响，但其间的相互关系有待进一步研究明確。

【关键词】 类风湿关节炎;中医体质;HLA-DRB1基因;阳虚质;气郁质

Investigation on TCM Constitution of Those with Rheumatoid Arthritis and Its Correlation with HLA-DRB1

Gene Polymorphism

CHEN Yan-yi，CHEN Peng

【ABSTRACT】Objective：To explore the relationship between TCM Constitution and HLA-DRB1 gene polymorphism in patients with rheumatoid arthritis.Methods：According to the standards of Classification and Determination of Constitution in TCM，a questionnaire was designed to investigate 200 patients with rheumatoid arthritis.HLA-DRB1 genotypes of patients with rheumatoid arthritis were determined by direct base sequence analysis genotyping technology combined with specific primer polymerase chain reaction，and the differences of constitution types distribution and gene frequency distribution between groups were compared by statistical methods.Results：Yang deficiency and qi stagnation were the predisposing constitution types of rheumatoid arthritis patients.HLA-DRB1*04 had the highest frequency in different constitution types，in which the gene frequency of HLA-DRB1*04（41.07% and 40.00%）in those with Yang deficiency and qi stagnation was significantly higher than other alleles.Conclusion：TCM constitution type and HLA-DRB1 gene polymorphism have certain influence on the occurrence of rheumatoid arthritis，but the relationship between them needs further study.

【Keywords】 rheumatoid arthritis;TCM constitution;HLA-DRB1 gene;yang deficiency;qi stagnation

类风湿关节炎（rheumatoid arthritis，RA）是一种慢性、对称性、进行性多关节炎的自身免疫性疾病[1]，我国患病率约为0.42%[2]。RA发病机制尚不明确，一般认为，遗传、感染等是影响RA发病的重要因素，现已证实人类白细胞表面抗原Ⅱ类分子（HLA-Ⅱ）与自身免疫性疾病密切相关，其中HLA-DRB1是经遗传分析鉴定的第一个RA易感基因[3]。

体质的形成必须具备先天的遗传基础。不同形式的基因多态性是人与人之间疾病表现形式上种种差异的重要原因，可以推测出体质与基因多态性有着密切的关系[4]。HLA系统的多态性与连锁不平衡现象等主要特征与中医体质学说之间有很多共性[5]，但目前基于此与RA相关联的文献报道较少。……