胃癌前病变患者中医证型分布及与胃镜表现、Hp感染和血清PG、G-17水平的关系分析  

Distribution of TCM Syndrome Types in Patients with Precancerous Lesions of Gastric Cancer and Relationship with Gastroscopic Manifestation,Hp infection and Serum PG and G-17 levels

作　　者：苏雯静 芦希艳 SU Wenjing;LU Xiyan(Gastroenterology Department,986 Air Force Hospital,Xi'an Shaanxi 710001,China;Outpatient Department,The Second Affiliated Hospital of Air Force Medical University,Xi'an Shaanxi 710038,China)

机构地区：[1]空军第九八六医院消化内科,陕西西安710001 [2]空军军医大学第二附属医院门诊部,陕西西安710038

出　　处：《四川中医》2023年第8期76-80,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家自然科学基金(编号:31200650)。

摘　　要：目的:观察胃癌前病变(PLGC)患者中医证型分布情况,分析PLGC患者中医证型与胃镜表现、幽门螺旋杆菌(Hp)感染和血清胃蛋白酶原(PG)、胃泌素-17(G-17)水平的相关性,为PLGC的中医诊治提供一定参考。方法:选取2020年6月~2022年6月本院收治的53例PLGC患者纳入PLGC组,另选取同期在我院行体检的42例健康志愿者纳入对照组,对PLGC组患者进行中医辨证分型,比较不同中医证型患者胃镜表现、Hp感染和血清PG、G-17水平差异。分析PLGC组血清PG、G-17水平的相关性。结果:脾胃湿热证隆起性糜烂发生率最高(80.00%),胃阴不足证最低(16.67%),脾胃湿热证隆起性糜烂发生率明显高于其他证型(P<0.05);肝胃不和证凹陷性糜烂发生率最高(77.78%),明显高于其他证型(P<0.05)。PLGC组HP感染占比高于对照组(P<0.05),但不同中医辨证分型亚组Hp感染情况比较差异无统计学意义(P>0.05)。PLGC组血清G-17、PGⅡ均高于对照组,PGⅠ水平明显低于对照组(P<0.05);且脾胃湿热证血清G-17水平明显高于其他证型水平(P<0.05);脾胃湿热证、痰湿瘀阻证PGⅠ水平明显低于其他证型组,PGⅡ水平明显高于其他证型组(P<0.05)。Pearson相关性分析显示,PLGC患者PG、G-17水平均具有显著相关性(P<0.05)。结论:PLGC不同中医证型胃镜表现,Hp感染、血清G-17、PG存在一定相关性,可为临床辨证分型提供一定参考。Objective:To observe the distribution of TCM syndrome types in patients with precancerous lesions of gastric cancer(PLGC),and to analyze the correlation of TCM syndrome types with gastroscopic manifestation,Helicobacter pylori(Hp)infection,levels of serum pepsinogen(PG)and gastrin-17(G-17),and to provide a certain reference for the TCM diagnosis and treatment of PLGC.Methods:53 patients with PLGC admitted to the hospital from June 2020 to June 2022 were selected and included in PLGC group,and 42 healthy volunteers who underwent physical examination in the hospital during the same period were enrolled as control group.TCM syndrome differentiation was carried out in PLGC group.The differences in gastroscopic manifestation,Hp infection,serum PG and G-17 levels were compared among patients with different TCM syndrome types.The correlation of serum PG and G-17 in PLGC group was analyzed.Results:The incidence rate of protrusive erosion was the highest(80.00%)in spleen-stomach damp-heat syndrome and was the lowest(16.67%)in stomach-yin deficiency syndrome,and the incidence rate of protrusive erosion in spleen-stomach damp-heat syndrome was significantly higher than that in other syndrome types(P<0.05).The incidence rate of concave erosion was the highest(77.78%)in disharmony between liver and stomach syndrome,which was significantly higher than that in other syndromes(P<0.05).The proportion of HP infection in PLGC group was higher than that in control group(P<0.05),but there was no statistical significance in the Hp infection among different TCM syndrome types(P>0.05).The levels of serum G-17 and PGⅡin PLGC group were higher than those in control group while the level of PGⅠwas significantly lower than that in control group(P<0.05).Serum G-17 level of spleen-stomach dampheat syndrome was significantly higher than that of the other syndrome types(P<0.05).The PGⅠlevel of spleen-stomach damp-heat syndrome and phlegm-damp stasis syndrome was significantly lower than that of the other syndrome types while the PGⅡleve

关 键 词：胃癌前病变 中医证型 胃镜 幽门螺旋杆菌 胃蛋白酶原 胃泌素 

分 类 号：R735.2[医药卫生—肿瘤]