萎缩性胃炎中医证候与胃肠激素相关性研究

目的:探讨慢性萎缩性胃炎中医证候与胃肠激素的相互关系。方法:选取了慢性萎缩性胃炎病人90例,分为脾胃虚弱证30例、脾胃湿热证30例、胃络瘀血证30例。空腹经胃镜取CAG患者胃黏膜组织后,立即称重、均浆、离心取上清液,-70℃保存。同时抽取静脉血,制备血清和血浆,也于-70℃保存。同批运用放射免疫法(RIA)测定胃黏膜中表皮生长因子(Epidermal growth factor,EGF)、胃泌素(Gastria,GAS)、胃动素(Motilin,MTL)、生长抑素(Somatostatin,SS)及血清中EGF、GAS和血浆中MTL、SS含量,运用统计学方法,对中医不同证候间激素水平进行比较。结果:脾胃虚弱证患者胃黏膜中GAS、MTL水平显著低于脾胃湿热证患者和胃络瘀血证患者(P0.05);脾胃虚弱证患者胃黏膜中SS、EGF水平显著高于胃络瘀血证患者(P0.05);脾胃湿热证患者胃黏膜中GAS、MTL水平显著低于胃络瘀血证患者,而SS、EGF水平显著高于胃络瘀血证患者(P0.05)。脾胃虚弱证患者血中GAS、MTL水平显著低于脾胃湿热证患者和胃络瘀血证患者,而SS、EGF水平显著高于脾胃湿热证患者和胃络瘀血证患者(P0.05);脾胃湿热证患者血中GAS、MTL水平显著低于胃络瘀血证患者(P0.05)。结论:胃黏膜及血中GAS、MTL、SS、EGF的异常表达,及其调节关系可能是慢性萎缩性胃炎发生发展的部分内在因素,是不同中医证候转化的部分客观物质基础,可以作为慢性萎缩性胃炎不同中医证候转化的重要参考指标。

Study on the Relationship Between TCM Syndromes of CAG and Gastro-intestinal Hormone

Objective：To study the relationship between traditional Chinese medicine（TCM） syndromes of Chronic Atrophy Gastritis（CAG）and gastrin（GAS）、motilin（MTL）、somatostatin（SS）、epidermal growth factor（EGF）of stomach mucous and EGF、GAS of serum and MTL、SS of plasma in order to study the relationship between the syndrome of TCM and gastro-intestinal hormones.Methods：90 cases with CAG were selected as research subjects,among them 30 cases with Spleen-Stomach asthenia Syndrome（SSAS） of TCM,30 cases with Spleen-Stomach Damp-Heat Syndrome（SSDH） of TCM,and 30 cases with Stomach blood stagnation Syndrome（SBSS）.The gastric mucosa and the venous blood from the empty-stomach patients with CAG were collected in the morning.The gastric mucosa and the venous blood were detected after being preserved in low temperature（-70℃） by radioimmunoassay（RIA）,the level of four gastro-intestinal hormones（GAS,MTL,SS,EGF） were compared with the control groups by statistical method.Results：The GAS and MTL of gastric mucosa with SSAS is significantly lower than those of SSDH and SBSS（P0.05）.The EGF and SS of gastric mucosa with SSAS is significantly higher than those of SBSS（P0.05）.The GAS and MTL of gastric mucosa with SSDH is significantly lower than those of SBSS（P0.05）.The EGF and SS of gastric mucosa with SSDH is significantly higher than those of SBSS（P0.05）.The GAS and MTL of blood with SSAS is significantly lower than those of SSDH and SBSS （P0.05）.The EGF and SS of blood with SSAS is significantly higher than those of SSDH and SBSS （P0.05）.The GAS and MTL of blood with SSDH is significantly lower than those of SBSS （P0.05）.Conclusion：The study results show：The difference of the four gastro-intestinal hormone could reflect the essence of differentiation of TCM syndromes.The adapting of the four gastro-intestinal hormone each other may be inner factor for the change of CAG and can used be the important reference indexes for the change of TCM syndromes of CAG.