目的：本文主要探讨大肠癌和肝癌术后肝肾阴虚证、脾虚证和湿热证“异病同证”的血浆共同代谢物及其代谢机制。方法：对大肠癌和肝癌术后肝肾阴虚证、脾虚证、湿热证和隐证的血浆代谢物谱进行代谢组学（GC-MS）检测，采用主成分分析（PCA）方法寻找其“异病同证”的共同代谢物，并通过KEGG数据库分析代谢通路。结果：大肠癌和肝癌术后肝肾阴虚证共同的代谢物是甘氨酸，尿素，色氨酸和丙氨酸，其代谢调控以氨基酸的降解为主；脾虚证共同的代谢物是甘氨酸、尿素、色氨酸、葡萄糖、赖氨酸和肌醇，氨基酸的降解和糖类的分解功能受到影响；湿热证的共同代谢物是甘氨酸、尿素、色氨酸、葡萄糖、丙酸、甘露醇、山梨醇和赖氨酸，以影响糖类物质分解和供能过程为主要特征。结论：代谢组学方法是研究“异病同证”的有效工具之一。大肠癌、肝癌术后在肝肾阴虚证、脾虚证和湿热证各有其共同的代谢物以及代谢机制。

This study aimed to investigate the common metabolites in the same syndrome in traditional Chinese medicine(TCM)in postoperative patients with liver cancer(PLC)and colorectal cancer(PCC)underlying its metabolic mechanisms.Plasma metabolic profiles in PCC and PLC patients with liver- and kidney-yin deficiency syndrome(LKYDS),spleen deficiency syndrome(SDS),dampness heat syndrome(DHS)and latent syndrome(without any obvious TCM symptoms and signs)were detected using gas chromatography-mass spectrometry(GC-MS).The common metabolites of the same TCM syndrome in different diseases were identified via principal component analyses(PCA),while the metabolic pathways were analyzed by means of KEGG database.As a result,glycine,urea,tryptophan and alanine were altered in the PCC and PLC patients with LKYDS and were involved in the degradation of amino acid; Glycine urea,lysine,tryptophan glucose and inositol were the metabolites in the patients with SDS and could affect the degradation and the decomposition process of amino acids and sugars;Glycine glucose,urea,acid tryptophan,sorbitol and mannitollysine were the common metabolites in the patients with DHS and influenced the process of carbohydrates’decomposition and energy supply.It was conclusion that metabolomics was effective on exploring the material basis of the“same syndrome in different diseases”in TCM.The PCC and PLC patients shared some altered metabolites in the same TCM syndrome.

国家自然科学基金委重点项目（81330084）：基于系统生物学的原发性肝癌和大肠癌“异病同证”和“异病同治”的研究，负责人：苏式兵。上海市卫生和计划委员会科研课题资助项目(20134173)：固肠方保护肠屏障功能减少大肠癌术后转移的临床研究，负责人：王文海；浦东新区卫生系统重点学科群建设项目(PWZxq2014-12)：肝癌和大肠癌的辩证施治研究，负责人：王文海。