应用内镜荧光强度分析法研究溃疡性结肠炎中医证型特征

目的 研究溃疡性结肠炎(ulcerative colitis,UC)不同中医证型自发荧光成像(auto fluorescence imaging,AFI)内镜下荧光强度［绿/红(the ratio of green to red,G/R比值)］的特征,为UC中医辨证提供客观依据。方法 收集UC患者49例,根据白光内镜(white light endoscopy,WLE)黏膜形态和G/R比值对大肠湿热组(19例)、脾胃气虚组(30例)和健康对照组(21名)进行统计分析。结果 脾胃气虚组和大肠湿热组G/R比值分别为(1.147±0.137)和(0.915±0.114),较健康对照组(1.227±0.137)降低,差异均有统计学意义(P<0.05,P<0.01),其中大肠湿热组G/R比值较脾胃气虚组更低(P<0.01)。大肠湿热组活动期内镜活动指数(endoscopic index,EI)以中度（11例）和重度（5例）为主;脾胃气虚组以缓解期（17例）和活动期EI轻度（7例）为主。活动期G/R比值小于缓解期(0.963 vs 1.220,P<0.01),且活动期EI轻、中、重度的G/R比值依次降低,分别为1.044、0.967和0.830(P<0.01)。结论 UC大肠湿热证的炎症程度高于脾胃气虚证。AFI能较好地反映UC的炎症程度。

The Chinese Medicine Syndrome Features of Ulcerative Colitis by Using Fluorescence Intensity of Auto Fluorescence Imaging

Objective To study the Chinese medicine (CM) syndrome features of ulcerative colitis (UC) by using fluorescence intensity (the ratio of green to red, G/R ratio) of auto fluorescence imaging, thus providing objective evidences for the CM syndrome typing of UC. Methods Totally 49 patients were recruited. They were typed as Dachang damp-heat syndrome (19 cases), Pi-Wei qi deficiency syndrome (30 cases), and the healthy control group (21 cases) on the bases of mucosal morphology of white light endoscopy (WLE) and the G/R ratio of AFI. Results Compared with the healthy control group (1.227±0.137), the G/R ratio in Dachang damp-heat syndrome (0.915±0.114) and Pi-Wei qi deficiency syndrome (1.147±0.137) decreased with statistical difference (P<0.05,P<0.01). Of them, it was lower in Dachang damp-heat syndrome group (P<0.01). The case number was mainly dominated in moderate endoscopic index (EI) (11 cases) and severe EI (5 cases) in Dachang damp-heat syndrome group. The case number was mainly dominated in the remission phase (17 cases) and mild EI (7 cases) in Pi-Wei qi deficiency syndrome group. The G/R ratio of the remission phase was higher than that of the active phase (1.220 vs 0.963,P<0.01). There was statistical difference in the G/R ratio of the mild EI (1.044), the moderate EI (0.967), and the severe EI (0.830) (P<0.01). Conclusions The inflammation degree of Dachang damp-heat syndrome was more severe than that of Pi-Wei qi deficiency syndrome. AFI could better reflect the inflammation degree of UC.