隆起糜烂型胃炎的中医证型与Hp感染、胃小凹形态及其病理关系的研究  

Research on the pathological relationship between TCM Pattern identification of Verrucosa Gastritis, Hp infection and the shape of gastric pits

作　　者：梁雪[1] 宾金秀 黄祖美[1] 周德丽[1] 卢杰夫[1] 陈国忠[1] 彭卓嵛[1] 何慧[1] 刘熙荣[1] 王伟 

机构地区：[1]广西中医药大学第一附属医院

出　　处：《广西中医药》2015年第3期7-10,共4页Guangxi Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区卫生厅科研课题项目(合同号:Z2011121)

摘　　要：目的:探讨幽门螺杆菌(Hp)感染与隆起糜烂型胃炎(VG)的中医辨证分型关系,研究中医分型与胃小凹形态、胃小凹形态与病变黏膜病理组织学是否存在相关性。方法:入选患者均行电子胃镜检查和Hp检测、中医辨证分型,在放大电子内镜下予蒸馏水及二甲基硅油稀释液充分冲洗后,用0.2%靛胭脂喷洒染色进行病变黏膜及周围胃小凹形态学观察分类,并选择病变黏膜区域进行病理组织学检查。结果:Hp阳性的VG患者的中医证型多见于肝胃气滞型及湿热内蕴型,高于其他证型(P<0.05)。列联表的相关分析结果显示300例VG患者的中医辨证分型与胃小凹形态改变有正相关关系(r=0.649,P<0.01)。湿热内蕴型VG患者病变胃小凹形态多见于C型、D型,共占76.33%。同时,胃小凹形态与病理组织学的等级相关结果亦显示有正相关关系(r=0.798,P<0.01)。结论:Hp感染的VG患者中医辨证分型临床多见肝胃气滞型和湿热内蕴型。放大内镜下靛胭脂喷洒染色技术对VG患者病变胃黏膜癌变有早期诊断价值,与病理组织学比较,具有较高的准确率和可行性,对胃癌的一级预防有积极意义。To discuss the relationship between TCM Pattern identification of Verrucosa Gastritis and Hp infection and to judge whether there is a correlation between TCM Pattern identification and the shape of gastric pits and correlation between the shape of gastric pits and mucosa histopathology. Methods： The patients were selected for electronic gastroscopy, Hp detection and TCM Pattern differentiation. After the full flushing of distilled water and two methyl silicone oil dilution in amplifying electronic endoscopic, morphological observation and classification were conducted on mucosa lesion and the surrounding gastric pits with 0.2% indigo carmine spray dyeing. Lesion mucosa area was selected for histopathologic examination. Results： The TCM Patterns of Hp positive patients with VG were more common in the type ofliver qi stagnation and retention of damp-heat in the interior than other types. It has statistic significance （P〈0.05）. Correlation analysis of contingency tables showed that there is a positive correlation between the TCM pattern differentiation and the changes in the shape of gastric pits in 300 patients with VG （r= 0.649,P〈0.01 ）. The patterns of retention of damp-heat in the interior in VG patients were more common in the C and the D type,which accounts for 76.33%. Meanwhile,the results of rank correlation also showed a positive indigo carmine spray dyeing technology under the magnifying endoscopy in the patients with VG is more accurate and feasible. It has positive significance for the primary prevention of gastric cancer.

关 键 词：隆起糜烂型胃炎 中医证型 胃小凹 病理组织学 

分 类 号：R573.3[医药卫生—消化系统]