慢性胃炎脾虚证分型的病理学基础  

Study on Pathological Basis of Classification of Splenasthenic Syndrome in Chronic Gastritis

作　　者：尹光耀[1] 张武宁[2] 沈小静[3] 何雪芬[3] 陈一[2] 

机构地区：[1]江苏昆山市中医医院,昆山215300 [2]复旦大学,上海200433 [3]江苏无锡市第三人民医院,无锡214041

出　　处：《中华中医药杂志》2006年第3期142-147,共6页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的：整合中医学与现代医学研究慢性胃炎脾虚证分型的病理学基础.方法：取188例脾虚证患者胃黏膜和42例平素无临床症状的志愿献血者的胃黏膜,应用光学显微镜、扫描电镜、透射电镜和组织化学染色,进行组织病理学、亚细胞超微结构（细胞核和线粒体）分析.结果：脾气虚证和脾阳虚证胃黏膜既可有器质性病变存在[G型--发生在慢性浅表性胃炎（CSG）、慢性萎缩性胃炎（CAG）基础上];也可无器质性病变存在（F型--多为功能性消化不良）;脾阴虚证和脾虚气滞证均发生在CSG、CAG基础上,且CSG、CAG的炎症细胞浸润黏膜层程度、固有膜腺体减少程度和胃黏膜肠化生Ⅱb（IMⅡb）发生率也较G脾气虚证、G脾阳虚证的CSG、CAG为重,P＜0.05～0.01.结论：对①有病有证（既有CSG或CAG,又有脾虚证）、有证无病（虽有脾虚证,但无CSG或CAG）及有病无证（虽有CSG或CAG,但无脾虚证的临床症状）都应足够重视.②脾阴虚证和脾虚气滞证的CSG或CAG其病变程度和IMⅡb发生率较G脾气虚证、G脾阳虚证的CSG、CAG为重.Objective： To explore the pathological basis of classification of splenasthenic syndrome in chronic gastritis by integrating TCM with modem medicine. Methods ： Histopathology and sub cellular ultra structure （nuclei and mitoehondrial） of gastric mucosa of 188 eases of splenic asthenia patients and 42 cases of voluntary blood donors usually devoid of clinical symptoms were analyzed by means of optical microscope, SEM, TEM and histochemieal staining. Results： The gastric mucosa of patients with syndrome of deficiency of spleen-QI （SDSQ） and syndrome of deficiency of spleen-YANG （SDSY） could either be affected by organic lesion （ type G： occurring on the basis of CSG, CAG ） or unaffected （ type F ： chiefly belonging to functional indigestion ） ; syndrome with splenie-yin asthenia （SSYA） and syndrome of spleen-deficiency and QI-stagnation （SSDQS） both occurred on the basis of CSG and CAG ; and the degree of mucosa inflammatory ceils infiltration , the degree of the decrease of gl and ular organs in lamina propria, and the incidence of IM Ⅱ b in CSG, CAG were more serious than those of G- SDSQ, G- SDSY, P 〈 0. 05 -0. 01. Conclusion： （1） Splenasthcnic syndrome was likely to occur on the basis of organic lesion of gastric mucosa （disease with syndrome： that is, there is both CSG or CAG and splenasthenic syndrome）, as well as not on the basis of organic lesion of gastric mucosa （syndrome without disease ： that is, only splenasthenic syndrome, there is no CSG or CAG）. Besides, the clinical phenomenon of disease without syndrome （only CSG or CAG, there is no splenasthenic syndrome） occurred because of such factors as genetic diathesis and compensation. （2） The lesion degree of CSG or CAG and the incidence of IM Ⅱb of SSYA and SSDQS were more serious than those CSG and CAG of G- SDSQ and G- SDSY.

关 键 词：慢性胃炎 脾虚证 有病有证 有证无病 有病无证 

分 类 号：R259.7[医药卫生—中西医结合]