Study on Correlation Among Traditional Chinese Medicine Syndrome Types,Genetics and Prognosis in Myelodysplastic Syndromes

WANG Shuo; QIN Lerong; LIU Junxia; GUO Ming; CHEN Haiyan; LI Ling; LIAO Junyao; LIAO Jing; DING Xiaoqing

doi:10.16295/j.cnki.0257-358x.2024.02.008

Abstract：Objective:To explore the correlation among traditional Chinese medicine(TCM)syndrome types,molecular biology,cytogenetics and prognosis in patients with myelodysplastic syndrome(MDS).Methods:The statistical methods of nonparametric rank sum test or chi-square test were used to retrospectively analyze the TCM syndrome types,peripheral blood indicators,disease classification,molecular biology,cytogenetics,prognosis of 85 newly diagnosed MDS patients and to discuss the correlation between TCM syndrome types and the latter factors.Results:The TCM syndrome types of the 85 patients with MDS were mainly qi-yin deficiency and toxin-stasis obstruction syndrome,followed by spleen and kidney deficiency and toxin-stasis obstruction syndrome,and pathogenic heat exuberance and toxin-stasis obstruction syndrome.The level of absolute neutrophil count(ANC)in patients with pathogenic heat exuberance and toxin-stasis obstruction syndrome was significantly lower than that in patients with spleen and kidney deficiency and toxin-stasis obstruction syndrome(P＜0.01).The level of hemoglobin(HGB)in patients with qi-yin deficiency and toxin-stasis obstruction syndrome was significantly lower than that in patients with spleen and kidney deficiency and toxin-stasis obstruction syndrome(P＜0.001).The difference in the distribution of disease types among the three syndrome types was statistically significant(P＜0.05).All patients with pathogenic heat exuberance and toxin-stasis obstruction syndrome had a disease classification of excess blasts of primitive cell(EB type).The differences in mutation rate of transcription regulator 1(ASXL1)gene,the mutation rate of chromatin remodeling and transcription regulation gene function group,and the scores of three prognostic scoring systems among the three syndrome types were statistically significant(P＜0.05).The mutation rate of transcription regulation gene function group and the scores of three prognostic scoring systems in the pathogenic heat exuberance and toxin-stasis obstruction syndrome group were higher than those in the other two groups(P＜0.05).In the higher-risk categories of the three prognostic scoring systems,patients with pathogenic heat exuberance and toxin-stasis obstruction syndrome had a higher proportion than those with the other two syndrome types.Conclusions:The pathogenesis of MDS is primarily based on deficiency,and clinically,patients often present with mixed deficiency and excess syndrome types.The prognosis of pathogenic heat exuberance and toxin-stasis obstruction syndrome is poor,and it is speculated that the mechanism may be related to genetic conditions such as ASXL1 gene mutation,complete loss of chromosome 7,and partial deletion of its long arm(-7/7q-).