慢性胃炎3种证型与胃黏膜酶组化的相关性  

Correlation between gastric mucosal enzyme activities and three kinds of TCM syndromes of chronic gastritis

作　　者：鲁香凤[1] 杨美娟[1] 李志红[1] 韩爱庆[1] 

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《中华中医药杂志》2014年第12期3998-4001,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京中医药大学自主创新课题(No.JYB22-JS059)~~

摘　　要：目的:从胃黏膜表面p H值、组织病理学变化及胃黏膜酶组化角度研究并探讨慢性胃炎肝胃气滞、脾胃气虚及脾胃湿热3种证型演变规律及证的物质基础。方法:60例慢性胃炎3种证型患者胃镜下取胃黏膜活检组织,用精密试纸检测胃黏膜表面p H值,冰冻切片酶组化法显示琥珀酸脱氢酶(SDH)、乳酸脱氢酶(LDH)及碱性磷酸酶(ALP)酶活性,石蜡切片HE及AB-PAS染色光镜观察胃黏膜组织病理学变化及黏液分泌状态。结果:3种证型胃窦黏膜表面p H值分别为:肝胃气滞(5.65±0.24)、脾胃湿热(5.43±0.05)、脾胃气虚(5.49±0.06),差异无统计学意义;胃窦黏膜SDH(-)及弱(+)面积从多至少排序为:脾胃气虚、脾胃湿热、肝胃气滞;肠化部位SDH酶活性相对较强,萎缩部位则较弱或呈(-);3种证型均未见LDH完全(-)病例,脾胃气虚及脾胃湿热证亦未见LDH弱(+)病例,肝胃气滞证仅见2例弱(+);肠化部位LDH活性强于或近似于非肠化区;脾胃气虚证ALP(-)及(+)面积明显多于脾胃湿热和肝胃气滞证,中强(+)面积明显少于肝胃气滞证和脾胃湿热证。结论:胃黏膜酶的分布及其活性变化是慢性胃炎辨证及证型演变的物质基础。Objective： To explore the material basis and evolvement rule of three types of chronic gastritis （CG） such as syndrome of stagnation of liver qi and stomach qi, syndrome of deficiency of spleen qi and stomach qi and syndrome of dampness- heat of spleen and stomach. Methods： Gastric mucosa tissues of 60 CG patients with three syndromes were collected, and the pH value of gastric mucosa surface was tested by using precision test paper. Enzyme immunohistochemical method and frozen section were used to test the enzymatic activity of SDH, LDH and ALP. Paraffin section, HE and AB-PAS staining were used to observe the gastric mucosal tissue pathological changes and mucus secretion state. Results： Distal gastric mucosal surface pH values of three syndromes were as follows： syndrome of stagnation of liver qi and stomach qi （5.65±0.24）, syndrome of dampness-heat of spleen and stomach （5.43±0.05） and syndrome of deficiency of spleen qi and stomach qi （5.49±0.06）, and the differences in pH value among the three syndromes were not significant. The proportion of SDH （-） and weak （＋） of gastric antrum were syndrome of deficiency of spleen qi and stomach qi, syndrome of dampness-heat of spleen and stomach and syndrome of stagnation of liver qi and stomach qi in order. The enzymatic activity of SDH was relatively strong in intestinal metaplasia （IM） parts, and it was weaker in atrophy parts. There was no LDH completely negative patient of the three syndromes, and no LDH weak positive patients with syndrome of deficiency of spleen qi and stomach qi and syndrome of dampness-heat of spleen and stomach. There were only 2 patients with weak positive of syndrome of stagnation of liver qi and stomach qi. The LDH activity in IM parts was stronger or similar to non-IM area. The ALP negative and positive area with syndrome of deficiency of spleen qi and stomach qi was more than that of syndrome of dampness-heat of spleen and stomach and syndrome of stagnation of liver qi and stomach qi, and the stro

关 键 词：慢性胃炎 胃黏膜 酶组化 相关性 肝胃气滞证 脾胃气虚证 脾胃湿热证 

分 类 号：R259[医药卫生—中西医结合]