【作者】 陈文炎；

【导师】 柯晓；

【作者基本信息】 福建中医药大学 ， 中西医结合临床， 2010， 硕士

【摘要】 目的：通过观察隆起糜烂性胃炎(raised erosive gastritis, REG)脾胃湿热证、脾胃虚弱证及正常对照组胃粘膜G细胞、D细胞、壁细胞数目以及G、D细胞数目比值(G／D),研究三者之间上述指标的差异,初步探讨REG脾胃湿热证与胃酸分泌的关系,为中西医结合防治该病提供临床及理论依据。方法：选择REG患者65例,其中符合脾胃湿热证者30例,符合脾胃虚弱证者35例,并设正常对照组11例。所有受试者均空腹行胃镜检查,取胃窦部标本行快速尿素酶试验及组织染色法检测幽门螺旋杆菌(H.pylori,Hp),另取胃窦大弯、胃体大弯粘膜各1块用于免疫细胞化学染色及HE染色,观察G细胞、D细胞、壁细胞数目,计算G/D。结果：1 REG组、REG Hp阳性(Hp+)组、REG Hp阴性(Hp-)组较正常对照组的G、D细胞数目有下降趋势,但无统计学意义(均P>0.05),G/D比较无统计学意义(P>0.05),而壁细胞数目均非常显著的低于正常对照组(均P<0.01)；REG Hp+组与REG Hp-组之间的G、D、壁细胞数目及G/D比较均无统计学意义(均P>0.05)；2 REG萎缩组、REG非萎缩组较正常对照组的G、D细胞数目有下降趋势,但均无统计学意义(均P>0.05),G/D比较无统计学意义(P>0.05),而壁细胞数目则分别显著和非常显著的低于正常对照组(P<0.05,P<0.01);REG萎缩组与REG非萎缩组之间的G、D、壁细胞数目及G/D比较均无统计学意义(均P>0.05)；3 REG50岁以上组、REG50岁以下组较正常对照组的G、D细胞数目有下降趋势,但均无统计学意义(均P>0.05),G/D比较无统计学意义(P>0.05),而壁细胞数目则均非常显著的低于正常对照组(均P<0.01)；REG50岁以上组和REG50岁以下组之间的G、D、壁细胞数目及G/D比较均无统计学意义(均P>0.05)；4 REG脾胃湿热证组、脾胃虚弱证组较正常对照组的G、D细胞数目有下降趋势,但均无统计学意义(均P>0.05),G/D比较无统计学意义(P>0.05),而壁细胞数目则分别显著和非常显著的低于正常对照组(P<0.05,P<0.01)；脾胃湿热证组和脾胃虚弱证组之间的G、D、壁细胞数目比较均无统计学意义(均P>0.05),而脾胃湿热证组的G/D非常显著的高于脾胃虚弱证组(P<0.01)；5 REG脾胃湿热证、脾胃虚弱证Hp+组与Hp-之间的G、D、壁细胞数目及G/D比较均无统计学意义(均P>0.05)。结论：1 REG组壁细胞数目较正常对照组低；2 REG组较正常对照组的G、D细胞数目有下降趋势,但无统计学意义；3 REG组较正常对照组的G/D无统计学意义；4 REG脾胃湿热证组的G/D较脾胃虚弱证组高,但无统计学意义；5 REG脾胃湿热证组与脾胃虚弱证组的G、D、壁细胞数目均无统计学意义；6针对REG可以尝试以保护胃粘膜为主进行治疗。更多还原

【Abstract】 Objective:Through the observation of the number of gastric G cells, D cells and parietal cells and the ratio of the number of G and D cells (G/D ratio) in the raised erosive gastritis (REG) with spleen-stomach damp-heat syndrome(SSDHS) and spleen-stomach weakness syndrome(SSWS), as well as the control group, this study aims to investigate the differences among the three groups mentioned above, and explore the relationship between the REG with SSDHS and the gastric acid secretion, furthermore to provide clinical and theoretical bases for REG prevention and treatment with integrated traditional Chinese and Western Medicine.Method:This study chose 65 REG patients, which consisted of 30 REG patients with SSDHS and 35 REG patients with SSWS.In addition, a control group with 11 cases were found. All the subjects with fasting for 10 hours received a gastroscopy examination. During the examination, a piece of mucosa collected from the gastric antrum was used to do a rapid urease test and a histological staining, to detect the existence of H.Pylori (Hp). Two pieces of mucosa were also collected, one from the gastric antrum used for immunocytochemical staining, and the other from the gastric body used for HE staining. Finally, the number of gastric G cells, D cells and parietal cells, as well as the G/D ratio were computed.Results:1 Compared with the control group, the number of the gastric G and D cells in the overall REG group, the REG group with Hp (REG Hp+) and the REG group without Hp (REG Hp") fell.However, significant differences were not found (P>0.05). There were no significant differences in the G/D ratio (P>0.05), either. Whereas, the gastric parietal cells in the three groups mentioned above were significantly fewer than those in the control group (P <0.01). Significant differences were not found (P>0.05) in the number of the gastric G, D and parietal cells as well as the G/D ratio between the REG Hp- group and the REG Hp+ group.2 Compared with the control group, the number of the gastric G and D cells in the REG group with mucosa atrophy and the REG group without mucosa atrophy decreased. However, there were no significant differences (P>0.05). Significant differences were not found in the G/D ratio, either(P>0.05). Whereas, the gastric parietal cells in the REG group with mucosa atrophy and the REG group without mucosa atrophy were significantly fewer than those in the control group (P<0.01). There were no significant differences in the number of the gastric G, D and parietal cells as well as the G/D ratio (P>0.05) between the REG group with mucosa atrophy and the REG group without mucosa atrophy.3 Compared with the control group, the number of the gastric G and D cells in the over-50-year-old REG group and the under-50-year-old REG group declined. However, there were no significant differences (P>0.05). Significant differences were not found in the G/D ratio, either (P>0.05). Whereas, the gastric parietal cells in the over-50-year-old REG group and the under-50-year-old REG group were significantly fewer than those in the control group (P<0.01). There were no significant differences in the number of the gastric G, D and parietal cells as well as the G/D ratio (P>0.05) between the over-50-year-old REG group and the under-50-year-old REG group.4 Compared with the control group, the number of the gastric G and D cells in the REG group with SSDHS and the REG group with SSWS dropped. However, there were no significant differences (P>0.05). Significant differences were not found in the G/D ratio, either (P>0.05). Whereas, the gastric parietal cells in the two groups were significantly fewer than those in the control group (P<0.01). There were no significant differences in the number of the gastric G, D and parietal cells between the REG group with SSDHS and the REG group with SSWS (P>0.05). Nevertheless, the G/D ratio in the REG group with SSDHS was significantly higher than that in the REG group with SSWS (P<0.01).5 Significant differences were not found in the number of the gastric G, D and parietal cells,as well as the G/D ratio,between REG Hp+ group and REG Hp- group(P>0.05),both in REG with SSDHS and SSWS.Conclusion:1 The gastric parietal cells in REG are fewer than those in the control group.2 Compared with the the control group, the number of the gastric G and D cells in the REG group decreases. However, significant differences have not been found.3 Significant differences have not been found in the G/D ratio between the REG group and the control group.4 The G/D ratio in REG with SSDHS is higher than that in REG with SSWS. However, significant differences have not been found.5 Significant differences have not been found in the number of the gastric G, D and parietal cells between the REG with SSDHS and the REG with SSWS.6 To treat the REG may be implemented on the basis of protecting the gastric mucosa.更多还原