慢性非萎缩性胃炎及重症肌无力脾气虚证患者唾液淀粉酶活性比值上升的影响因素研究  

Study on the influencing factors of the increasing salivary amylase activity ratio in patients with chronic non-atrophic gastritis and myasthenia gravis syndrome with spleen-deficiency

作　　者：谢海媚 梁裕琪 黄也 杨龙[1,2] 王丽辉[1,2] 邱向红 陶双友[2,3] 林传权[1,2] XIE Hai-mei;LIANG Yu-qi;HUANG Ye;YANG Long;WANG Li-hui;QIU Xiang-hong;TAO Shuang-you;LIN Chuan-quan(Science and Technology Innovation Center,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Institute of Spleen and Stomach,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学科技创新中心,广州510405 [2]广州中医药大学脾胃研究所,广州510405 [3]广州中医药大学第一附属医院,广州510405

出　　处：《中华中医药杂志》2021年第6期3648-3652,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81973723,No.81403297);广州中医药大学“薪火计划”项目(No.XH20170113)。

摘　　要：目的:运用“异病同证”的研究策略,探讨慢性非萎缩性胃炎(CSG)及重症肌无力(MG)脾气虚患者唾液淀粉酶(sAA)活性比值上升的影响因素。方法:选取CSG脾气虚证患者35例,MG脾气虚患者32例,健康志愿者36名;采集CSG、MG脾气虚证患者的证候进行半定量评分,采集受试柠檬酸负荷前后唾液,并检测唾液pH值、流率、总蛋白浓度、Ca2+、Cl-浓度以及sAA活性;分析sAA活性比值下降患者与比值上升患者在pH值、流率、总蛋白浓度及Ca2+、Cl-浓度和临床症候的差异及其关联性。结果:CSG、MG脾气虚患者sAA活性比值均显著低于健康人(P<0.01);CSG、MG脾气虚证分别有23%(8/35)、19%(6/31)的患者sAA活性比值上升;CSG、MG脾气虚患者sAA比值与脘腹胀满、食后腹胀、疼痛性质及脘腹疼痛呈正相关(P<0.05);CSG脾气虚患者sAA比值与身重困倦呈负相关(P<0.05),而MG脾气虚患者sAA比值与身重困倦呈正相关(P<0.05)。结论:脘腹胀满、食后腹胀、脘腹疼痛、疼痛性质等症状可能是干扰脾气虚证sAA活性比值下降的关键影响因素,而唾液指标与sAA活性比值改变关联性不大。Objective:To explore the influencing factors of the increasing salivary amylase activity ratio in patients with chronic non-atrophic gastritis(CSG)and myasthenia gravis(MG)with spleen-deficiency by using the research strategy of‘different diseases and identical syndromes’.Methods:A total of 35 patients with CSG,32 patients with MG and 36 healthy volunteers were selected.The syndromes of CSG and MG patients with spleen-deficiency were collected for semi-quantitative scoring.Saliva was collected before and after citric acid loading,and saliva pH value,saliva flow rate,total protein concentration,Ca2+,Cl-concentration and sAA activity were detected.To analyze the differences in pH value,flow rate,total protein concentration,Ca2+,Cl-concentration and clinical symptoms in patients with decreased sAA activity ratio and patients with increased sAA activity ratio and their correlations.Results:The sAA activity ratio of CSG and MG patients with spleen-deficiency was significantly lower than that of healthy patients(P<0.01).The sAA activity ratio increased in 23%(8/35)and 19%(6/31)of CSG and MG patients with spleen-deficiency.The sAA ratio of CSG and MG patients with spleen-deficiency was positively correlated with abdominal distention and fullness,abdominal distention after eating,the nature of pain and abdominal pain(P<0.05).sAA ratio was negatively correlated with body weight and sleepiness in CSG patients with spleen-deficiency(P<0.05),while sAA ratio was positively correlated with body weight and sleepiness in MG patients with spleen-deficiency(P<0.05).Conclusion:Symptoms such as abdominal distention and fullness,abdominal distention after eating,abdominal pain and pain nature may be the key influencing factors for the decrease of sAA activity ratio in spleen-deficiency syndrome,while there is little correlation between saliva index and sAA activity ratio.

关 键 词：脾气虚证 唾液淀粉酶 慢性非萎缩性胃炎 重症肌无力 活性比值 相关性 症状评分 

分 类 号：R259[医药卫生—中西医结合] R277.7[医药卫生—中医内科学]