慢性萎缩性胃炎胃黏膜EGF、VEGF、PCNA与中医证型关系的研究

目的 研究慢性萎缩性胃炎（CAG）胃黏膜表皮生长因子（EGF）、血管内皮生长因子（VEGF）及增殖细胞核抗原（PCNA）与中医证型的关系，探讨中医证型的实质，为临床治疗提供理论依据。方法 经胃镜及病理组织学检查确诊的200例CAG患者，进行中医辨证分型，采用免疫组化法检测不同证型CAG 患者EGF、VEGF及PCNA的表达水平。结果 脾胃虚弱证72例，肝胃不和证43 例，脾虚气滞证32例，胃阴不足证24例，脾胃湿热证14例，胃络瘀阻证5例。其中，PCNA表达水平肝胃不和证与脾胃虚弱证、脾虚气滞证、胃阴不足证之间差异有统计学意义(P＜0.05)；而EGF、VEGF的表达水平在各型之间差异无统计学意义（P＞0.05)。结论 CAG以脾胃虚弱证和肝胃不和证居多，PCNA的高表达可能是肝胃不和证的诊断依据。

Relationship of TCM Syndrome Type of Gastric Mucosal Epithelial Growth Factor, Vascular Endothelial Growth Factor and Proliferative Cell Nuclear Antigen in Patients with Chronic Atrophic Gastritis

OBJECTIVE: To study the relationship of TCM syndrome type of gastric mucosal epithelial growth factor (EGF), vascular endothelial growth factor (VEGF) and proliferative cell nuclear antigen (PCNA) in patients with chronic atrophic gastritis (CAG) for exploring the essence of TCM type and providing a theoretical basis of clinical treatment. METHODS: TCM syndrome type of 200 patients with diagnosis of CAG confirmed by fibro-gastroscope and pathological examination were differentially classified, and the expressions of EGF, VEGF and PCNA in different types were determined using immunohistochemistry. RESULTS: Patients were differentiated as Pi-Wei deficiency type (Type I ) in 72; Gan-Wei disharmony type (Type II ) in 43; Pi-deficiency with qi stagnation type (Type III) in 32; Wei-yin deficiency type (Type IV) in 24; Pi-Wei damp-heat type (Type V) in 14; and Wei-collateral stasis obstruction type (Type VI) in 5. The difference of PCNA expression level between Type II with Type I , III and IV was significant (P < 0.05). No significant difference in expression levels of EGF and VEGF was found among the 6 types (P > 0.05). CONCLUSION: Type I and II were the dominant TCM syndrome types in CAG patients; the high expression of PCNA might be a diagnostic evidence for Gan-Wei disharmony syndrome.