耐药幽门螺杆菌感染的慢性糜烂性胃炎中医证型与毒力因子相关性  

Correlation Between Traditional Chinese Medicine Syndrome Types and Virulence Factors in Chronic Erosive Gastritis Infected with Drug-Resistant Helicobacter Pylori

作　　者：李彤[1] 王再见 李会霞 李敏 张强 雷雪 张洪薇 高玉璇 LI Tong;WANG Zaijian;LI Huixia;LI Min;ZHANG Qiang;LEI Xue;ZHANG Hongwei;GAO Yuxuan(Beijing University of Chinese Medicine,Beijing 100020,China;The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Beijing Daxing District Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 102600,China)

机构地区：[1]北京中医药大学,北京100020 [2]北京中医药大学第三附属医院,北京100029 [3]北京市大兴区中西医结合医院,北京102600

出　　处：《山东中医杂志》2023年第9期949-954,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划项目(编号:2019YFC1710403)。

摘　　要：目的:探讨耐药幽门螺杆菌(Hp)感染所致慢性糜烂性胃炎(CEG)患者中医证型特点,并分析各中医证型的临床特点及与细胞毒素相关基因A(CagA)和空泡毒素A(VacA)的相关性。方法:选取559例耐药Hp感染所致CEG患者为研究对象,分为肝胃不和证、脾胃湿热证、脾胃虚寒证、胃阴不足证和胃络瘀阻证5种中医证型,收集患者的年龄、性别、胃镜下表现及CagA抗体、VacA抗体检测结果等信息,分析耐药Hp感染所致CEG中医证型的临床特点,以及中医证型与CagA抗体、VacA抗体的相关性。结果:耐药Hp感染所致CEG患者中医证型分布频率从高到低依次为脾胃湿热证(46.15%)>胃络瘀阻证(25.22%)>肝胃不和证(13.24%)>胃阴不足证(11.27%)>脾胃虚寒证(4.11%),差异有统计学意义(P<0.05)。不同中医证型耐药Hp感染的CEG患者性别、年龄和胃镜下表现比较,差异无统计学意义(P>0.05);CagA抗体和VacA抗体表达比较,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,肝胃不和证、脾胃虚寒证与CagA抗体阳性呈负相关(P<0.05);脾胃湿热证与VacA抗体阳性呈正相关(P<0.05)。结论:耐药Hp感染所致CEG患者中医证型以脾胃湿热证为主,脾胃虚寒证偏少,CagA抗体和VacA抗体的表达能够为耐药Hp感染所致CEG的中医辨证分型提供一定的客观依据。Objective:To explore the characteristics of traditional Chinese medicine(TCM)syndrome differentiation and typing in patients with chronic erosive gastritis(CEG)infected with drug-resistant Helicobacter pylori(Hp),and analyze the clinical characteristics of TCM syndrome types and their correlation with cytotoxin-related gene A(CagA)and vacuolar toxin A(VacA).Methods:A total of 559 patients with CEG infected with drug-resistant Hp were selected as the research subjects,who were divided into 5 TCM syndrome types,namely disharmony between liver and stomach,dampness-heat in the spleen and stomach,deficiency and cold of spleen and stomach,deficiency of stomach yin,and stagnation of gastric collaterals.The age,gender,gastroscopic manifestations and detection results of CagA and VacA of the patients were collected,the clinical characteristics of TCM syndrome type of CEG caused by drug-resistant Hp infection,and the correlation between TCM syndrome type and CagA antibody and VacA antibody were analyzed.Results:The distribution frequency of TCM syndrome types in patients with CEG caused by drug-resistant Hp infection was from high to low:46.15%of dampness-heat in the spleen and stomach syndrome>25.22%of stagnation of gastric collaterals syndrome>13.24%of disharmony between liver and stomach syndrome>11.27%of deficiency of stomach yin syndrome>4.11%of deficiency and cold of spleen and stomach syndrome.The difference was statistically significant(P<0.05).There was no significant difference in gender,age and gastroscopic manifestations of CEG patients with different TCM syndrome types of drug-resistant Hp infection(P>0.05),while the expression of CagA antibody and VacA antibody was significantly different(P<0.05).Spearman correlation analysis showed that disharmony between liver and stomach syndrome and deficiency and cold of spleen and stomach syndrome were negatively correlated with CagA antibody(P<0.05).Dampness-heat in the spleen and stomach syndrome was positively correlated with positive VacA antibody(P<0.05).Conclusion

关 键 词：幽门螺杆菌 慢性糜烂性胃炎 中医证型 细胞毒素相关基因A 空泡毒素A 胃痛 

分 类 号：R256.3[医药卫生—中医内科学]