胃黏膜异型增生证候结构特征及其与血清肿瘤标志物水平的关系  

Study on the Structural Characteristics of Syndromes of Gastric Mucosal Dysplasia and Their Relations with the Level of Serum Tumor Marker

作　　者：沈舒文[1] 宇文亚[2] 陈丽英[3] 王捷虹[4] 杨志宏[4] 刘梅君[5] 牛阳[6] 彭宁[7] 惠建萍[1] 

机构地区：[1]陕西中医学院中医临床医学院,咸阳市世纪大道712046 [2]中国中医科学院中医临床基础医学研究所 [3]陕西省商洛市中心医院 [4]陕西中医学院附属医院 [5]陕西省延安市人民医院 [6]宁夏医学院 [7]陕西省人民医院

出　　处：《中医杂志》2009年第6期541-543,共3页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(30572383)

摘　　要：目的探讨胃黏膜异型增生(Dys)虚实关联证候结构类型特征及最具癌变趋向的证型。方法多中心临床协作,采集324例Dys虚实关联证,聚类统计证候结构类型,同步检测血清肿瘤标志物(TSGF)或癌胚抗原(CEA),并以TSGF、CEA水平判断癌变趋向程度。结果Dys虚实关联证有5类11种,5类中肝胃气滞并/兼气阴两虚类占30.9%;湿热蕴胃并/兼胃阴不足类占23.5%;瘀阻胃络并/兼气阴两虚类占15.4%;湿热蕴胃并/兼脾胃虚寒证占12.3%;痰湿中阻并/兼脾气虚弱类占11.1%。TSGF、CEA水平的高峰值出现在湿热蕴胃并/兼脾胃虚寒证、瘀阻胃络并/兼气阴两虚证,表明是最具癌变趋向的证型。结论Dys证候呈11种虚实关联结构的多态性分布,从证候层面向临床揭示了趋向癌变的两种高危证型。Objective To explore the structural characteristic of deficiency-excess-related syndromes of gastric mucosal dysplasia and the syndrome which was with the tendency of carcinogenesis. Methods With multi-center collaboration, 324 dysplasia cases were selected and the statistical clustering was applied for analyzing the structure of syndromes. Simultaneously the detection on tumor specific growth factor （TSGF） and earcinoembryonic antigen （CEA） were carried out to judge the carcinogenesis of syndromes. Results The deficiency-excess-related syndrom of dysplasia had 5 types 11 syndromes. Of the 5 types, Qi stagnation of liver and stomach accompanied with both Qi and Yin deficiency occupied 30.9%, damp-heat accumulated in the stomach accompanied with insufficiency of stomach Yin occupied 23.5 %, blood stasis in stomach collaterals accompanied with both Qi and Yin deficiency occupied 15.4 %, damp- heat accumulated in the stomach accompanied with deficiency cold of spleen and stomach occupied 12.3%, and retention of phlegm damp in the middle Jiao accompanied with Qi deficiency of spleen occupied 11.1 %. The high peaks of TSGF and CEA appeared in the syndromes of damp-heat accumulated in the stomach accompanied with deficiency cold of spleen and stomach and blood stasis in stomach collaterals accompanied with both Qi and Yin deficiency, implying that they were the ones with the tendency of carcinogenesis. Conclusion Gastric mucosal dysplasia with 11 syndromes shows its structural characteristics of polymorphism distribution, and two syndromes have the tendency of carcinogenesis.

关 键 词：胃黏膜异型增生 虚实关联证 证候特征 癌变趋向证型 

分 类 号：R259[医药卫生—中西医结合]