CAJ | 학술논문

目的探讨慢性浅表性胃炎部分中医证型与Hp感染、胃黏膜细胞凋亡基因表达的相关性,从基因分子水平揭示慢性浅表性胃炎中医证候的实质,初步建立慢性浅表性胃炎证候分子水平的辨证指标体系.方法电子胃镜下取胃黏膜组织,采用免疫组化方法检测慢性浅表性胃炎不同证型胃窦黏膜组织Hp感染及凋亡基因Fas、bcl-2的表达情况,并设10名正常成人为对照组,进行多因素非条件logistic回归分析.结果脾胃湿热组、肝胃不和组的Hp阳性率分别为52%、22%,与对照组比较均有显著性差异(分别为P＜0.01、＜0.05).脾胃湿热组、肝胃不和组的bel-2表达率分别为76%和24.2%,前者与对照组比较有显著性差异(P＜0.05).脾胃湿热组Fas表达率46%,与肝胃不和组(70.7%)、对照组(70%)比较有显著性差别(P＜0.05).肝胃不和组、脾胃湿热组的凋亡指数有显著性差异(P＜0.05).结论与肝胃不和型相比,脾胃湿热型Hp、bel-2呈较高的表达率,Fas呈较低表达率.Hp、bcl-2表达率越高,诊断脾胃湿热型的可能性越大、诊断为肝胃不和型的可能性越小;Fas表达率越高,诊断脾胃湿热型的可能性越小、诊断肝胃不和型的可能性越大.Hp、bel-2和Fas对于慢性浅表性胃炎的辨证分型可能有价值.
목적 탐토만성천표성위염부분중의증형여Hp감염、위점막세포조망기인표체적상관성,종기인분자수평게시만성천표성위염중의증후적실질,초보건립만성천표성위염증후분자수평적변증지표체계.방법 전자위경하취위점막조직,채용면역조화방법 검측만성천표성위염불동증형위두점막조직Hp감염급조망기인Fas、bcl-2적표체정황,병설10명정상성인위대조조,진행다인소비조건logistic회귀분석.결과 비위습열조、간위불화조적Hp양성솔분별위52%、22%,여대조조비교균유현저성차이(분별위P＜0.01、＜0.05).비위습열조、간위불화조적bel-2표체솔분별위76%화24.2%,전자여대조조비교유현저성차이(P＜0.05).비위습열조Fas표체솔46%,여간위불화조(70.7%)、대조조(70%)비교유현저성차별(P＜0.05).간위불화조、비위습열조적조망지수유현저성차이(P＜0.05).결론 여간위불화형상비,비위습열형Hp、bel-2정교고적표체솔,Fas정교저표체솔.Hp、bcl-2표체솔월고,진단비위습열형적가능성월대、진단위간위불화형적가능성월소;Fas표체솔월고,진단비위습열형적가능성월소、진단간위불화형적가능성월대.Hp、bel-2화Fas대우만성천표성위염적변증분형가능유개치.
Objective: The purpose of this study was to determine the relationship between TCM pattern and Hp infection and apoptosis of stomach mucosa in chronic gastritis, to discover the substance of TCM Pattern of chronic gasuitis on genetic molecular level and to establish syndrome differentiation system of chronic superficial gastritis on molecular level Methods: Get gastric mucosa tissue by electronic gastroscope. Hp infection, expression of Fas and bel-2 of 41 cases of incoordination between the liver and stomach group (IBLS group) and 50 cases of Dampness-beat in spleen and stomach(DHSS group) of chronic superficial gastritis were investigated by immunohistocbemistry examination, with 10 healthy persons as control group. Muti-factor non-condition logistic regression analysis was adopted to analyze the data. Results: The positive rate of HP was of 22%, 52% and 10% respectively in the IBLS group, the DHSS group and the control group. The positive rate of HP in the DHSS group was significant higher than in the IBLS and control group, showing there is a significant correlation between DHSS patern and HP infection. The expression rate of bcl-2 antigen was 24.2%, 76.0% and 30.0% respectively in the IBLS, DHSS and control group. The expression rate of bcl-2 antigen in the DHSS group was significant higher than in and the IBLS and control group(P＜0.01), showing there was significant correlation between DHSS pattern and expression rate of bcl-2 antigen(P＜0.01). The expression rate of Fas antigen was 70.7% and 46% respectively in the IBLS and DHSS group, the expression rate of Fas antigen in the IBLS group was significant higher than in DHSS group(P＜0.01), showing there was a significant correlation between IBLS pattern and expression rate of Fas antigen(P＜0.01).Conclusion: The result suggested that there was a certain relationship between HP infection and TCM pattern, the positive rates of HP was higher in DHSS pattern compared with the IBLS group. There was a certain relationship between the expression of bcl-2 and Fas in DHSS pattern, IBLS pattern may probably promoted apoptosis in gastritis, whereas HP infection performed as a main role in apoptosis in DHSS pattern. Bcl-2, liP and Fas might contribute to syndrome differentiation of chronic gastritis.