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| 基于“肝郁乘脾”与“脑-肠轴”理论探讨情志致胃脘痛的孟德尔随机化研究 |
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丁雪琦1, 杨博文1, 李慧臻2, 熊可3, 张明妍3, 张浚淇4, 程宁涛5, 黄明1,6
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1.天津中医药大学中医药研究院, 天津 301617;2.天津中医药大学第二附属医院, 天津 300250;3.天津中医药大学中医学院, 天津 301617;4.湖南中医药大学, 长沙 410000;5.浙江大学医学院公共卫生学院, 杭州 310058;6.现代中药创制全国重点实验室, 天津 301617
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| 摘要: |
| [目的] 本研究旨在运用孟德尔随机化方法，从遗传学角度探讨多种情志因素与胃脘痛相关疾病（包括慢性胃炎、功能性消化不良、胃溃疡、肠易激综合征及食管炎）之间的潜在因果关联。[方法] 利用大规模全基因组关联研究的公开数据，筛选与“怒、喜、思、悲、恐”五种情志显著相关的单核苷酸多态性作为工具变量。以逆方差加权法为主要分析方法，辅以多种敏感性分析，评估情志对五种胃部疾病的因果效应。[结果] 孟德尔随机化（MendelianRandomization，MR）分析显示，“思”（焦虑）与“悲”（抑郁）显著增加了肠易激综合征、胃溃疡、功能性消化不良与慢性胃炎的发病风险（逆方差加权法P<0.05，OR=1.27~2.83）。敏感性分析表明结果稳健，未发现明显的异质性或水平多效性。[结论] 本研究提示焦虑与抑郁是胃脘痛相关疾病的潜在风险因素，从遗传学角度证实了情志内伤与胃脘痛的发生存在因果关联，支持了中医相关病机理论，为临床“形神共调”的整合干预策略提供了依据。 |
| 关键词: 胃脘痛 情志 孟德尔随机化 思虑过度 |
| DOI：10.11656/j.issn.1673-9043.2026.02.03 |
| 分类号:R256.33 |
| 基金项目:2022年国家自然科学基金面上项目（82274442）;第四届国医大师工作室项目。 |
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| A Mendelian randomization analysis of the causal relationship between emotions and epigastric pain based on the theory of “liver constraint overwhelming spleen” and “brain-gut axis” |
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DING Xueqi1, YANG Bowen1, LI Huizhen2, XIONG Ke3, ZHANG Mingyan3, ZHANG Junqi4, CHENG Ningtao5, HUANG Ming1,6
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1.Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;2.Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China;3.School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;4.Hunan University of Chinese Medicine, Changsha 410000, China;5.School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China;6.State Key Laboratory of Modern Chinese Medicine Creation, Tianjin 301617, China
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| Abstract: |
| [Objective] To explore the potential causal relationships between specific emotional factors and epigastric pain-related diseases（including chronic gastritis，functional dyspepsia，gastric ulcers，irritable bowel syndrome，and esophagitis）from a genetic perspective by using Mendelian Randomization（MR），providing scientific evidence for the Traditional Chinese Medicine（TCM）theory that“internal emotional injury causes epigastric pain”. [Methods] We utilized publicly available data from large-scale genome-wide association studies（GWAS）. Single nucleotide polymorphisms（SNPs）significantly associated with the five TCM-defined emotions（“anger”，“joy”， “overthinking”，“grief”，and“fear”）were selected as instrumental variables. The causal effects of these emotions on five gastric diseases were assessed using the inverse variance weighted（IVW）method as the primary analysis， supplemented by a range of sensitivity analyses. [Results] MR analysis demonstrated that genetically predicted “overthinking”（anxiety）and“grief”（depression）significantly increased the risk of irritable bowel syndrome， gastric ulcers，functional dyspepsia，and chronic gastritis（IVW P<0.05，OR=1.27-2.83）. Sensitivity analyses confirmed the robustness of these causal relationships，with no significant heterogeneity or horizontal pleiotropy detected. [Conclusion] This study provides genetic evidence that anxiety and depression are potential risk factors for epigastric pain-related diseases，substantiating the TCM theory of emotional pathogenesis and supporting integrated mind-body intervention strategies. |
| Key words: epigastric pain emotions Mendelian Randomization overthinking |
