Abstract

Blood stasis (BS) is characterized as a disorder of blood circulation. In traditional Korean medicine (TKM), it is viewed as a cause factor of diseases such as multiple sclerosis and stroke. This study investigated differences in the plasma metabolites profiles of subjects displaying BS or non-BS patterns. Thirty-one patients with cerebral infarction diagnosed with BS and an equal number of sex- and age-matched non-BS patients were enrolled. Metabolic profiling was performed using UPLC-MS. The ratio of subjects with a rough pulse and purple coloration of the tongue was higher in patients presenting with BS pattern. Through metabolomics analysis, 82 metabolites that differed significantly between the BS and non-BS pattern were identified, and the two groups were significantly separated using an orthogonal partial least square-discriminant analysis model (P < 0.001). Of these 82 metabolites, acetyl carnitine, leucine, kynurenine, phosphocholine, hexanoyl carnitine, and decanoyl carnitine were present in significantly higher levels in patients with a BS pattern than those with a non-BS pattern. Our results also demonstrated that seven plasma metabolites, including acyl-carnitines and kynurenine, were associated with a BS pattern, suggesting that variant plasma metabolic profiles may serve as a biomarker for diagnosis of BS in patients with cerebral infarction.

Highlights

  • Traditional Korean medicine (TKM) assigns diseases to subtypes according to the combination of symptoms experienced by patients, a process known as pattern identification (PI)

  • According to Korean Standard PIs for Stroke-II, we investigated the distribution of 11 diagnostic symptoms and signs of Blood stasis (BS) from patients with stroke

  • The description of BS symptoms is similar in TKM [24], the subjects in our study showed more exaggerated signs of purple color on tongue and rough pulse (Table 2)

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Summary

Introduction

Traditional Korean medicine (TKM) assigns diseases to subtypes according to the combination of symptoms experienced by patients, a process known as pattern identification (PI). In TKM, stroke is assigned to five PI subtypes: Qideficiency (QD), dampness-phlegm (DP), blood stasis (BS), Yin-deficiency (YD), and fire and heat (FH) [1]. Blood stasis (BS) is characterized as a disorder of blood circulation with hallmarks including extravagated or sluggish blood circulation and viscous or congested blood, all of which may contribute to various disease pathologies [1]. Similar to its definition in TKM, BS is described in traditional Chinese medicine (TCM) as a slowing or pooling of the blood caused by disruption of heart Qi. BS can be understood in biomedical terms in the context of hematological disorders such as hemorrhage, congestion, thrombosis, and local ischemia (microclots) [2]

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