门脉高压性胃病肝郁脾虚证与胃动素水平关系的研究

[目的]从胃动素(MTL)水平探讨门脉高压性胃病(PHG)肝郁脾虚证的病理生理基础,为PHG肝郁脾虚证的中医辨病辨证提供理论依据。[方法]入选对象120例,分为:PHG组(P组)、慢性乙型肝炎组(H组)、慢性胃炎组(G组)、正常对照组(C组),每组30例。详细询问每例患者的病史、临床症状,进行肝郁脾虚证的评分;在早晨空腹状态下采肘前静脉血,检测血浆MTL水平。[结果]①P组MTL水平最高,并与其他各组比较差异有统计学意义(P0.01);②P组McCormick分度重度患者MTL水平比轻度者为高(P0.01);③P组肝郁脾虚证积分与血浆MTL水平呈正相关(P0.01);④P组肝功能Child-Pugh分级,C级MTL水平均明显高于B级和A级,各级之间比较差异有统计学意义(P0.01)。[结论]①MTL参与PHG的形成,促进其发展,在PHG的形成与发展中起重要作用;②症状越重,积分越高,MTL水平升高越明显,PHG胃黏膜改变越重;③肝功能损害越明显,MTL水平越高,PHG胃黏膜改变越重;④MTL可作为PHG肝郁脾虚证的检测指标。

Relationship between the portal hypertensive gastropathy and motilin

[Objective]To investigate the syndromatic essentiality of portal hypertensive gastropathy(PHG)with stagnation of liver qi and deficiency of spleen(SLDS)based on the level of motilin(MTL),and to supply theoretical evidence for clinical differentiation.[Methods]All subjects were divided into four groups named P,H,G,and C,30 in eath group.The history of disease and clinical symptoms of patients were inquired in detail for the scoring of SLDS syndrome.The blood specimens were collected under fasting state in the morning and then the electronic gastroscopy was made.Radioimmunoassay was used to detect MTL in plasma.[Results]①The content of MTL in P group obviously increased as compared with those in H,G and C groups(P<0.01).②In P group,the content of MTL in the severe cases by McCormick’s grade was higher than those of the slight cases(P<0.01).③ In P group,the content of MTL was the highest in LSSA Ⅱ,and no difference was found among I,II and III of SLDS(P>0.05).④Relevance was found between scores of SLDS and the content of MTL(P<0.01).⑤In P group,the MTL content of C grade of Child-Pugh classification was higher than those of grade A and B(P<0.01).[Conclusion]MTL plays an important role in the development of PHG.It could be used to detect PHG with SLDS,but not helpful for the dialectical and type division.