Ma Zikun,Han Ran,Yang Xinwei,et al.Correlation between indexes of exfoliated cells of tongue coating and Traditional Chinese Medicine syndrome differentiation in patients with chronic gastritis[J].,2021,43(01):22-26.[doi:10.3760/cma.j.cn115398-20200518-00158]
舌苔脱落细胞理化指标与慢性胃炎患者中医证型相关性分析
- Title:
- Correlation between indexes of exfoliated cells of tongue coating and Traditional Chinese Medicine syndrome differentiation in patients with chronic gastritis
- Keywords:
- Gastritis; Abnormal tongue fur; Exfoliated cells of tongue coating; Syndrome differentiation classification; Spleen stomach weakness; Syndrome of incoordination beteeen liver and stomach; Stomach-yin deficiency pattern; Spleen stomach dampness heat; Correlation of data
- 摘要:
- 目的 探讨舌苔脱落细胞理化指标与慢性胃炎患者中医辨证分型的相关性。方法 选择2017年3月－2018年5月本院慢性胃炎患者148例，经辨证分为脾胃虚弱证36例、肝胃不和证39例、胃阴不足证32例、脾胃湿热证41例，分别入组相应的中医证型组；再选择无寒热虚实证候的50位健康志愿者作为健康对照组。于高倍镜下观察各组受试者舌苔脱落细胞，分别行表、中、底层细胞计数，并计算成熟指数(maturity index, MI)及成熟价值(mature value, MV)，检测舌苔脱落细胞中酸性磷酸酶(acid phosphatases, ACP)、LDH、琥珀酸脱氢酶(succinate dehydrogenase, SDH)及巯基含量，采用流式细胞术检测舌苔脱落细胞的细胞周期；采用Spearman等级相关法分析舌苔脱落细胞理化指标与中医证型分布的相关性。结果 与健康对照组比较，脾胃虚弱证组、肝胃不和证组、胃阴不足证组、脾胃湿热证组受试者中层细胞百分比[(26.47±3.94)%、(22.32±5.41)%、(31.47±3.28)%、(35.62±3.96)%比(14.85±4.03)%]升高(P＜0.05)，表层细胞百分比[(73.53±6.47)%、(77.68±5.38)%、(68.53±4.20)%、(64.38±4.39)%比(85.15±5.33)%]降低(P＜0.05)，MV值[(83.52±3.10)%、(87.64±2.95)%、(79.38±3.21)%、(75.63±2.83)%比(92.61±3.74)%]降低(P＜0.05)。与健康对照组比较，脾胃虚弱证组、肝胃不和证组、胃阴不足证组受试者舌苔脱落细胞中ACP、LDH、SDH、巯基均降低(P＜0.05)，脾胃湿热证组受试者ACP、LDH、SDH、巯基均升高(P＜0.05)；胃阴不足证组、脾胃湿热证组受试者G1期细胞百分降低(P＜0.05)，S期细胞百分升高(P＜0.05)。Spearman等级相关法分析，脾胃虚弱证组、肝胃不和证组、胃阴不足证组、脾胃湿热证组与ACP、LDH、SDH、巯基均有相关性(r值分别为0.608、0.712、0.704、0.631，P值均＜0.05)。结论 慢性胃炎不同中医证型患者可出现不同的舌苔脱落细胞形态学变化、细胞周期差异较大且细胞生化指标水平不同。
- Abstract:
- Objective To explore the correlation between the indexes of tongue coating exfoliated cells and the Traditional Chinese Medicine (TCM) syndromes of patients with chronic gastritis. Methods One hundred and forty-eight patients with chronic gastritis in our hospital from March 2017 to May 2018 were selected and divided into 4 groups, including 36 patients with spleen and stomach weakness syndrome, 39 patients with liver-stomach discordance syndrome, 32 patients with stomach yin deficiency syndrome, and spleen and 41patients with stomach damp-heat syndrome according to the TCM classification. In addition, another 50 healthy people without cold and heat deficiency syndrome were selected as healthy control group. The maturity index (MI) and mature value (MV) of tongue coating exfoliated cells, chemical indicators and cell cycle of tongue coating exfoliated cells were detected. The spearman rank correlation method was used to analyze the indicators of tongue coating exfoliated cells and TCM syndromes. Results Compared with the healthy control group, the subjects with spleen and stomach weakness syndrome, liver-stomach discord syndrome, stomach-yin deficiency syndrome, spleen-stomach damp-heat syndrome showed significantly higher percentage of intermediate cells [(14.85 ± 4.03) % vs. (26.47 ± 3.94) %, (22.32 ± 5.41) %, (31.47 ± 3.28) %, (35.62 ± 3.96) %, P<0.05], significantly lower percentage of surface cells [(85.15 ± 5.33) % vs. (73.53 ± 6.47) %, (77.68 ± 5.38) %, (68.53 ± 4.20) %, (64.38 ± 4.39) %, P<0.05], and significantly lower percentage of MV value [(92.61 ± 3.74) % vs. (83.52 ± 3.10) %, (87.64 ± 2.95) %, (79.38 ± 3.21) %, (75.63 ± 2.83) %, P<0.05]. Compared with the healthy control group, the ACP, LDH, SDH, and -SH in tongue coating exfoliated cells of subjects with spleen and stomach weakness syndrome, liver and stomach discordance syndrome, and stomach yin deficiency syndrome were all significantly decreased (P<0.05), while ACP, LDH, SDH, and -SH in subjects with spleen and stomach damp-heat syndrome were all significantly increased (P<0.05). the percentage of cells in G1 phase of subjects with gastric yin deficiency and spleen and stomach damp-heat syndrome were significantly decreased (P<0.05), while the percentage of S phase cells were significantly increased (P<0.05). Spearman rank correlation analysis showed that each syndrome type was correlated with ACP, LDH, SDH, -SH (r values were 0.608, 0.712, 0.704, 0.631, respectively, all Ps<0.05). Conclusion Patients with different TCM syndromes of chronic gastritis may have different morphological changes of tongue coating exfoliated cells, large differences in cell cycle, and different levels of cell biochemical indicators.
参考文献/References:
［1］ 付晶晶,李福凤,陆雄,等. 慢性胃炎中医证候舌象信息特征研究[J]. 中国中医基础医学杂志,2015,21(9):1107-1108. ［2］ 武梦依,孙士鹏,庞博,等. 舌苔形成相关蛋白的研究进展[J]. 辽宁中医杂志,2016,43(12):2664-2666. DOI:10.13192/j.issn. 1000-1719.2016.12.067. ［3］ 刘丹,陈慧娲,兰汉超. 慢性胃炎中医治疗的研究进展[J]. 内蒙古中医药,2017,36(11):101-102. DOI:10.16040/j.cnki. cn15-1101.2017.11.098. ［4］ 李建祯,叶晖,刘倩,等. 从舌象变化探讨HP感染慢性萎缩性胃炎的病机演变[J]. 北京中医药,2018,37(10):923-925. DOI:10.16025/j.1674-1307.2018.10.004. ［5］ 苏泽琦,李培彩,郭强,等. 慢性胃炎中医证候演变规律研究[J]. 北京中医药大学学报,2015,38(11):762-766,771. DOI:10.3969/ j.issn.1006-2157.2015.11.010. ［6］ 玉叶,王建超,曹献,等. 慢性胃炎从湿热论治研究进展[J]. 辽宁中医杂志,2019,46(11):2436-2442. DOI:10.13192/j.issn. 1000-1719.2019.11.056. ［7］ 中华中医药学会脾胃病分会,张声生,唐旭东. 慢性胃炎中医诊疗专家共识意见(2017)[J]. 中华中医药杂志,2017,32(7): 3060-3064. ［8］ 中华人民共和国卫生部. 中药新药临床研究指导原则[M]. 第三辑. 1997:324-327. ［9］ 汪辉,石一杰,钟国辉. 香砂六君子汤治疗慢性胃炎的中医药临床优势研究[J]. 广州中医药大学学报,2017,34(6): 828-832. DOI:10.13359/j.cnki.gzxbtcm.2017.06.009. ［10］ 何峰. 中西医结合序贯疗法治疗慢性胃炎伴幽门螺杆菌感染疗效观察[J]. 蚌埠医学院学报,2018,43(3):307-309. DOI:10. 13898/j.cnki.issn.1000-2200.2018.03.008. ［11］ 赵盛云,李玉锋,王垂杰. 浅析近30年慢性胃炎中西医结合诊疗共识的演变[J]. 中华中医药杂志,2017,32(10):4605-4607. ［12］ 王慧雯,李莉,李福凤,等. 慢性萎缩性胃炎患者舌苔菌群的特异性菌属分析[J]. 中国微生态学杂志,2018,30(5): 497-501. DOI:10.13381/j.cnki.cjm.201805001. ［13］ 付晶晶,李福凤,陆雄,等. 慢性胃炎中医证候舌象信息特征研究[J]. 中国中医基础医学杂志,2015,21(9):1107-1108.
相似文献/References:
[1]郑艳 何丹 孙云松.益肾健脾汤对慢性萎缩性胃炎大鼠血清骨硬化蛋白水平和骨矿物质密度的影响[J].国际中医中药杂志,2015,37(02):145.[doi:10.3760/cma.j.issn.1673-4246.2015.02.013]
Zheng Yan,He Dan,Sun Yunsong..Effects of Yishen-Jianpi decoction on serum sclerostin level, bone mineral density in chronic atrophic gastritis in rats [J].,2015,37(01):145.[doi:10.3760/cma.j.issn.1673-4246.2015.02.013]
[2]安贺军 朱宏 张波 郭雁冰 李玉华 王普艳 李洁 许继宗 郑晓鹏.脾胃虚寒型慢性萎缩性胃炎患者胃经穴位电阻分析[J].国际中医中药杂志,2015,37(07):590.[doi:10.3760/cma.j.issn.1673-4246.2015.07.004]
An Hejun*,Zhu Hong,Zhang Bo,et al.Analysis of the resistances at the stomach meridian acupoints in chronic atrophic gastritis patients with spleen-stomach deficiency-cold syndromes[J].,2015,37(01):590.[doi:10.3760/cma.j.issn.1673-4246.2015.07.004]
[3]张秋霞 杨亦龙 姚晓泉 常佳慧 陆跃.基于中医传承辅助系统分析高忠英治疗慢性萎缩性胃炎的用药规律[J].国际中医中药杂志,2016,38(01):67.[doi:10.3760/cma.j.issn.1673-4246.2016.01.017]
Zhang Qiuxia*,Yang Yilong,Yao Xiaoquan,et al.Analysis on professor Gao Zhongying herbal administration experience for chronic atrophic gastritis by using traditional Chinese medicine inheritance support system [J].,2016,38(01):67.[doi:10.3760/cma.j.issn.1673-4246.2016.01.017]
[4]肖定洪 吴晓华 黄智萍 倪伟英 杨伟 尚莹莹 郭召平.不同季节原发性胆汁反流性胃炎患者中医体质特征的调查[J].国际中医中药杂志,2018,40(6):490.[doi:10.3760/cma.j.issn.1673-4246.2018.06.003]
Xiao Dinghong*,Wu Xiaohua,Huang Zhiping,et al.Constitutional types of Chinese medicine of primary bile reflux gastritis among different season: a cross-sectional study[J].,2018,40(01):490.[doi:10.3760/cma.j.issn.1673-4246.2018.06.003]
[5]马银平 靳秀芳 徐凤超 陈明岩.乌梅丸联合三联疗法治疗慢性萎缩性胃炎临床研究 [J].国际中医中药杂志,2018,40(8):702.[doi:10.3760/cma.j.issn.1673-4246.2018.08.005]
Ma Yinping*,Jin Xiufang,Xu Fengchao,et al.Clinical observation of Wumeiwan combined with triple therapy for treatment of chronic atrophic gastritis [J].,2018,40(01):702.[doi:10.3760/cma.j.issn.1673-4246.2018.08.005]
[6]麦丽珍.自拟健脾益气方治疗慢性萎缩性胃炎[J].国际中医中药杂志,2019,41(2):125.[doi:10.3760/cma.j.issn.1673-4246.2019.02.005]
Mai Lizhen.Clinical study on self-made Jianpi-Yiqi decoction in the treatment of chronic atrophic gastritis[J].,2019,41(01):125.[doi:10.3760/cma.j.issn.1673-4246.2019.02.005]
[7]华秋雯 奚肇宏.石丹颗粒对慢性萎缩性胃炎伴异型增生模型大鼠NF-κB信号通路的影响[J].国际中医中药杂志,2019,41(2):160.[doi:10.3760/cma.j.issn.1673-4246.2019.02.013]
Hua Qiuwen,Xi Zhaohong.Study on the Shidan granules for chronic atrophic gastritis with dysplasia rat model based on NF-κB signaling pathway [J].,2019,41(01):160.[doi:10.3760/cma.j.issn.1673-4246.2019.02.013]
[8]王静 孙玉凤 李宽红 东艳蕊 邵翠翠 王文正.安中复元方联合四联疗法治疗幽门螺杆菌阳性慢性萎缩性胃炎临床研究[J].国际中医中药杂志,2019,41(6):556.[doi:10.3760/cma.j.issn.1673-4246.2019.06.002]
Wang Jing,Sun Yufeng,Li Kuanhong,et al.Clinical study on Anzhong-Fuyuan decoction combined with western routine therapy for helicobacter pylori positive chronic atrophic gastritis[J].,2019,41(01):556.[doi:10.3760/cma.j.issn.1673-4246.2019.06.002]
[9]梁秋 兰鹏 杨闯 朱伟军 孔庆云.胃苏颗粒联合四联疗法治疗慢性萎缩性胃炎临床研究[J].国际中医中药杂志,2019,41(7):688.[doi:10.3760/cma.j.issn.1673-4246.2019.07.004]
Liang Qiu,Lan Peng,Yang Chuang,et al.Clinical study on treatment of chronic atrophic gastritis with Weisu granule combined with quadruple therapy[J].,2019,41(01):688.[doi:10.3760/cma.j.issn.1673-4246.2019.07.004]
[10]苏秋菊 于雁 邢建伟.斛香养胃脐贴结合西医常规疗法对慢性萎缩性胃炎患者胃动力与胃肠道激素的影响[J].国际中医中药杂志,2019,41(7):692.[doi:10.3760/cma.j.issn.1673-4246.2019.07.005]
Su Qiuju,Yu Yan,Xing Jianwei.Clinical efficacy of Huxiang-Yangwei powder combined with conventional western medicine on gastric motility and gastrointestinal hormones in patients with chronic atrophic gastritis[J].,2019,41(01):692.[doi:10.3760/cma.j.issn.1673-4246.2019.07.005]
备注/Memo
通信作者：韩冉，Email: 2205541523@qq.com 基金项目 北京中医药大学青年教师项目(2019-JYB-JS-120)
更新日期/Last Update:
2021-01-05