慢性浅表性胃炎脾胃湿热证胃粘膜病理、幽门螺杆菌感染及胃粘膜分泌特点  

Pathological Features, Secretion and Helicobacter Pylori Infectionin Gastric Mucosa of Chronic Superficial Gastritis withSpleen-Stomach and Damp-Heat Syndrome

作　　者：冯春霞[1] 劳绍贤[2] 黄志新[2] 周福生[2] 

机构地区：[1]广州中医药大学网络有限公司,广州510310 [2]广州中医药大学脾胃研究所,广州510405

出　　处：《广州中医药大学学报》2003年第3期187-190,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家中医药管理局重点课题(编号:97A102)

摘　　要：[目的]探讨慢性浅表性胃炎脾胃湿热证与胃粘膜的病理改变、胃粘膜分泌白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)和分泌型免疫球蛋白A(sIgA)、及幽门螺杆菌(HP)感染的关系。[方法]选择55例慢性浅表性胃炎患者为观察对象,其中脾胃湿热证35例,脾虚证20例,并设无临床症状者15例为正常对照组,检测胃粘膜病理组织学改变,观察胃粘膜组织中IL-8、TNF-α和sIgA水平以及HP感染情况。[结果]脾胃湿热证患者的HP感染率、胃粘膜炎症程度要高于脾虚证组和正常组(P<0.05或P<0.01);脾胃湿热证胃粘膜组织中的IL-8、TNF-α要高于脾虚证组(P<0.05或P<0.01),而sIgA却低于脾虚证组(P<0.01);在脾胃湿热证中,HP阳性者的胃粘膜炎症程度明显重于阴性者(P<0.01),且HP阳性者胃粘膜组织中的IL-8、TNF-α要高于阴性者(P<0.05),而sIgA在两组间无显著性差异(P>0.05)。[结论]脾胃湿热证的胃粘膜呈现一种活动性炎症改变,这可能与局部炎症因子(IL-8、TNF-α)分泌增加、防御因子(sIgA)分泌减少有关;而HP感染可能是引起和加重脾胃湿热证内在病理变化的因素之一。[Objective] To investigate the pathological features, secretion of interleukin-8 (IL - 8), tumor necrosis factor alpha (TNF-α) and secretory immunoglobulin A (sIgA) and helicobacter pylori (HP) infection in gastric mucosa (GM) of chronic superficial gastritis with spleen-stomach and damp-heat syndrome (SSDHS) and to explore their correlations. [Methods] Fifty-five cases of chronic superficial gastritis included 35 cases of SSDHS (Group A) and 20 cases of spleen-deficiency syndrome (Group B). Fifteen asymptomatic volunteers served as normal control group (Group C). Pathological changes, HP infection rate, levels of IL - 8, TNF -α and sIgA in GM were observed. [Results] HP infection rate was higher and inflammatory change was more obvious in Group A than those in Group B and Group C (P < 0.05 or P<0.01); IL-8 and TNF-α levels were higher (P<0.05 or P<0.01) and sIgA level was lower (P< 0.01) in Group A than those in Group B. In Group A, inflammatory change was more obvious and levels of IL - 8 and TNF -α were higher in HP-positive patients than those in HP-negative (P < 0.01 or P < 0.05) . The difference of sIgA level between HP-negative and HP-positive was not significant (P > 0.05). [Conclusion] Gastric mucosa of chronic superficial gastritis with SSDHS presents inflammatory changes, which is related with the increase of IL - 8 and TNF -α secretion and the decrease of sIgA, and HP infection may be one of the factors inducing and enhancing the pathological changes.

关 键 词：慢性浅表性胃炎 脾胃湿热证 胃粘膜 病理特点 幽门螺杆菌 

分 类 号：R256.3[医药卫生—中医内科学]