慢性萎缩性胃炎伴肠化中医证型与Hp感染、COX-2、p53表达的相关性研究  

Correlation Study of Hp Infection,COX-2 and p53 Expression in the Chronic Atrophic Gastritis with Intestinal Case Groups Classified by TCM Syndrome

作　　者：朱日[1] 骆峻[1] 朱长乐[2] 徐陆周[2] 孙国庆[1] 李惠[2] 

机构地区：[1]江苏建康职业学院中西医结合系,江苏南京211800 [2]南京中医药大学附属医院,江苏南京210029

出　　处：《南京中医药大学学报》2014年第6期520-523,共4页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：江苏省中医药局科研基金资助课题(LB13048)

摘　　要：目的探讨慢性萎缩性胃炎伴肠化不同中医证型与Hp感染、COX-2、p53表达的相关性,找出其中的联系与规律。方法将220例慢性萎缩性胃炎伴肠化病例按《中药新药临床研究指导原则》进行中医证候分类,将其病理标本进行免疫组化检测。结果肝胃不和、脾气虚弱、脾胃湿热3组Hp总阳性率分别为32.08%、55.07%、55.10%,脾胃湿热、脾胃虚弱组显著高于肝胃不和组,差异有统计学意义(P<0.05);3组COX-2表达率分别为75.47%、84.05%、71.42%,差异无统计学意义(P>0.05),但脾胃虚弱组显著高于肝胃不和组,P<0.05;3组p53表达率分别为41.51%、59.42%、47.96%,差异有统计学意义(P<0.05),脾胃虚弱组显著高于肝胃不和组与脾胃湿热组。结论慢性萎缩性胃炎伴肠化中脾胃虚弱证是一个应予以特别重视的证型,尤其是同时见有Hp感染、COX-2、p53高表达时,应及时对该证进行干预,以防其向突变、恶化方向转化。OBJECTIVE To explore the correlation between different TCM syndrome types of chronic atrophic gastritis with intestinal diseases and COX-2 and p53 expression,and find out their relations.METHODS The traditional Chinese medicine syndrome types of 220 cases of chronic atrophic gastritis with intestinal diseases were classified according to the new traditional Chinese medicine clinical research guiding principles,and the immunehistochemical of these pathologic specimens were detected.RESULTS The expression rate of Hp in disharmony between liver and stomach,deficiency of spleen qi,dampness in spleen and stomach group were 32.08%,55.07%,and 55.10 %,showing significantly statistical differences（P〈0.05）.The expression rate of COX-2 in three groups were 75.47%,84.05% and 71.42%.The positive expression of COX-2 distribution among the three groups by the statistical test did not show significant difference （P〉0.05）.However,the rate in the group of deficiency of spleen qi was significantly higher than that of the disharmony between liver and stomach group,showing statistical test has significant differences （P〈0.05）.On the other hand,the expression rate of p53 among these three groups were 41.51%,59.42% and 47.96% respectively.The positive expression of p53 distribution by the statistical test showed significant differences （P〈0.05）.The rate in the spleen qi deficiency group was significantly higher than that of the disharmony between liver and stomach group with statistically significant differences （P〈0.05）.CONCLUSION The pattern of spleen qi deficiency of chronic atrophic gastritis with intestinal diseases should be emphasized,especially with HP infection,high expression of COX-2 and p53 at the same time.The pattern of spleen qi deficiency also should be controlled persistently and timely,preventing its conversion in the direction of mutation or getting worse.

关 键 词：慢性萎缩性胃炎伴肠化 HP感染 COX-2 P53 中医证型 

分 类 号：R256.3[医药卫生—中医内科学]