肠易激综合征不同中医证型与胃肠激素关系的临床研究  

Clinical Study on Relationship Between Various TCM Syndrome Types of Irritable Bowel Syndrome and Gastrointestinal Hormones

作　　者：马军[1] 潘锦瑶[1] 方穗雄[1] 郑德俊[1] 

机构地区：[1]广州市第一人民医院中医科,广东广州510180

出　　处：《深圳中西医结合杂志》2007年第2期78-80,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：广东省中医药管理局资助项目(103106)

摘　　要：目的:探讨肠易激综合征不同中医证型血浆中胃肠激素的变化。方法:按功能性胃肠病罗马Ⅱ有关诊断标准选择病例123例,按中医分型标准再分为肝郁气滞组25例,肝气乘脾组40例,脾胃虚弱组35例,大肠燥热组23例,检测患者血浆中P物质(SP)、生长抑素(SS)、血管活性肠肽(VIP)、胆囊收缩素(CCK)的含量。结果:肝气郁结组和大肠燥热组SS、CCK较健康对照组升高,SP下降(P<0.05),两组间无明显差异(P>0.05);肝气乘脾组SS、VIP、CCK升高(P<0.05);脾胃虚弱组SP、SS、VIP、CCK均较健康对照组升高(P<0.05)。SS含量肝气乘脾组与脾胃虚弱组之间无明显差异(P>0.05),肝气郁结组与大肠燥热组无明显差异,但前两组的要高于后两组的(P<0.05);VIP含量肝气郁结组、大肠燥热组与健康对照组无明显异常,肝气乘脾组与脾胃虚弱组较健康对照组升高(P<0.05),两组之间无显著差异;SP含量肝气郁结组与大肠燥热组都低于健康对照组(P<0.05),两组间无差异,脾胃虚弱组高于健康对照组(P<0.05),肝气乘脾组无明显变化。结论:胃肠激素变化与IBS不同中医证型之间有一定的联系,但非特异性,不能作为中医辨证分型的重要依据。Objective To explore the changes of gastrointestinal hormones in patients with various TCM Syndrome types of irritable bowel syndrome 0BS）. Methods 123 patients with IBS, whose diagnosis conformed to the Rome Ⅱ diagnostic standard, were divided into four groups according to TCM Syndrome typing, 25 patients in Liver-qi Depression （LQD） group, 40 in liver Stagnancy with Spleen Deficiency （LSSD） group, 35 in Spleen Stomach Deficiency （SSD） group, 23 in Large intestinal retention of dry stool and heat （LIRDH） group. Plasma contents of substance P （SP）, somatostatin （SS）, vasoactive intestinal peptide （VIP）, cholecystokinin （CCK） were determined. Results Plasma contents of SS and CCK in LQD group and LIRDH group were higher and SP lower than those in control （P 〈 0.05）, there was no difference between two groups （P 〉 0.05）. In LSSD group, SS, VIP and CCK were higher than those in control （P 〈 0.05）. In SSD group, SP, SS, VIP and CCK were all higher than those of control （P 〈 0.05）. SS in LSSD group and SSD group had no significant difference （P 〉 0.05）, it was the same between LQD group and LIRDH group, but the former two groups were higher than the last two groups （P 〈 0.05）. VIP in LQD group and LIRDH group were not significantly different from control, while those in LSSD group and SSD group were higher （P 〈 0.05）, and there was no difference between LSSD group and SSD group. SP in LQD group and LIRDH group were lower than those in control （P 〈 0.05）, there was no difference between two groups, SP in SSD group was higher than those in control, while LQD group was similar with control. Conclusion The changes of gastrointestinal hormones were related with various TCM Syndrome types of irritable bowel syndrome in some degree, but showed non-specificity, cannot to be the diagnostic criteria for TCM Syndrome typing.

关 键 词：肠易激综合征 中医分型 胃肠激素 

分 类 号：R574[医药卫生—消化系统]