广东地区胃窦溃疡患者幽门螺杆菌CagA基因型与中医证型相关性分析  

Analysis of the relationship between helicobacter pylori CagA gene and TCM syndromes in patients with gastric antral ulcer from Guangdong province

作　　者：吴炜景[1,2] 李立平[1,3] 林延超[4] 陈婷婷[4] 谢子英[1] 马艳春[1] 赵亚刚[1] 

机构地区：[1]广州军区总医院,广州510010 [2]福建医科大学附属第二医院,泉州362000 [3]广州中医药大学,广州510010 [4]厦门市中医院,厦门361001

出　　处：《中华中医药杂志》2013年第6期1803-1807,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：广东省科技计划项目(No.2011B031800317);广州中医药大学第一临床医学院学生科技创新研究项目(No.yyyx1023)~~

摘　　要：目的:研究广东地区胃窦溃疡患者幽门螺杆菌感染情况,探讨该地区胃窦溃疡患者中医证型的分布规律,分析中医证型与幽门螺杆菌CagA基因型的相关性。方法:收集广州军区广州总医院及广州中医药大学第一附属医院消化内科同期经胃镜下活检,病理诊断为"胃窦溃疡"和"慢性浅表性胃窦炎"的病例各150例,分别进行14C呼气试验,明确幽门螺杆菌感染情况;应用聚合酶链式反应(PCR)对Hp阳性标本进行CagA基因检测;同时对入选病例按中医"胃脘痛"进行辨证分型。结果:①胃窦溃疡组患者幽门螺杆菌感染率为80.67%,明显高于慢性浅表性胃窦炎组的39.33%(P<0.05);②胃窦溃疡组中医证型以"脾胃湿热证"为主,占39.33%,明显高于其他证型(P<0.05);③感染Hp的"脾胃湿热证"患者CagA阳性率为96.43%,明显高于其他证型组(P<0.05)。结论:广东地区胃溃疡患者以"脾胃湿热证"常见,其幽门螺杆菌感染率、CagA基因阳性率明显高于其他证型。Objective： To study the infection rate of Helicobacter pylori in patients with gastric antral ulcer from Guangdong province and investigate their TCM syndromes, then analyze their relationship. 300 patients whose chief complaints were ＇Epigastric pain＇ from Guangzhou general hospital of Guangzhou Military command and the First Hospital of Guangzhou University of Chinese Medicine from January 2010 to October 2010 were selected. Half of the patients were diagnosed as ＇gastric antral ulcer＇ after gastroscopy and mucosal biopsy, the others as ＇chronic superficial gastritis＇. The objects were divided into different TCM syndromes of Epigastralgia. 14C urea breath tests （ UBT ） were used to investigate the infection rate of Helicobacter pylori in these patients. PCR was performed to detect the CagA gene. Results： ①The infection rate of Helicobacter pylori in patients with ＇gastric antral ulcer＇ was 80.67%, which was significantly higher than the patients with ＇chronic superficial gastritis＇ （P〈0.05）. ②The primary TCM syndrome of the patients with ＇gastric antral ulcer＇ was ＇functional dyspepsia of spleen and stomach dampness and heat syndrome＇, accounting for 39.33%, which was significantly higher than other TCM syndrome. The statistical difference was significant （P〈0.05） ③The infection rate of Helicobacter pylori CagA（＋） in patients with ＇functional dyspepsia of spleen and stomach dampness heat syndrome＇ was 96.43%, higher than other groups. The statistical difference was significant （P〈0.05）. Conclusion： The primary TCM syndrome of the patients with ＇gastric antral ulcer＇ was ＇functional dyspepsia of spleen and stomach dampness heat syndrome＇. These patients were susceptible to Hp CagA（＋） strain. Therefore, it was necessary to advise this type of patients to have gastroscopy, mucosal biopsy and investigate the genotype of Hp.

关 键 词：胃溃疡 幽门螺杆菌 中医证型 胃脘痛 CAGA 

分 类 号：R259[医药卫生—中西医结合]