内镜成像技术在溃疡性结肠炎中医辨证中的应用研究

Application of endoscopic imaging technique to syndrome differentiation of ulcerative colitis

目的研究溃疡性结肠炎(UC)影像检测结果与中医证型的相关性。方法采用内镜成像技术和计算机图像软件定量分析UC患者结肠黏膜变化。159例UC患者分为EUS组、NBI内镜组和AFI内镜组。EUS组评估炎症深度分UC-M、UC-SM、UC-SMdeep、UC-MP和UC-SE;NBI内镜组分析炎症程度的黏膜表面微血管类型(CP)改变分UC-CPI、UC-CPII、UC-CPIII和UC-CP0;AFI内镜组获取的RGB值进行荧光强度(G/R比值)分析。结果EUS组湿热证患者肠壁UC-M、UC-SM和UC-SMdeep厚于脾虚证患者;脾虚证患者肠壁UC-MP和UC-SE厚于湿热证患者(P<0.05)。NBI内镜组湿热证患者多见UC-CPII和UC-CPIII,脾虚证多见UC-CPI和UC-CP0(P<0.05)。AFI内镜组患者脾虚证R成分明显低于湿热证,脾虚证G成分明显高于湿热证;湿热证G/R比值明显低于脾虚证(P<0.05)。结论溃疡性结肠炎脾虚证与活动期(轻度)和缓解期之间及湿热证与活动期之间存在一定的相关性。

Objective To study the correlafivity between endoscopic imaging results and Chinese medical syndromes in ulcerative colitis（UC） patients. Methods Endoscopic imaging technique and computer image analysis software were used to detect the colonic mucosa of UC patients. Total 159 subjects were divided into EUS group（ endoscopic ultrasonography group）, NBI group （narrow band imaging group） and AFI group （autofluorescence imaging group）. We measured the thickness of intestinal wall of EUS group to assess the inflammation depth（ UC-M, UC-SM, UC-Smdeep, UC-MP and UC-SE ） ; classified NBI group as UC-CPI , UC-CPu, UC-CPm and UC-CP0 according to the degree of inflammation of the mucosal surface of CP changes; analyzed the RGB value of AFI group. Results In EUS group, the inflammation depth of UC-MP and UC-SE, and the intestinal wall thickness were higher in spleen deficiency syndrome than in damp-heat syndrome （P 〈0.05 ）. In NBI group, UC-CPn and UC-CPm happened more frequently in the spleen damp-heat syndrome, while UC-CPI and UC-CP0 happened more frequently in the spleen deficiency syndrome（ P 〈0.05 ）. In AFI group, the component R in spleen deficiency syndrome was lower than that in damp-heat syndrome, while the component G in spleen deficiency syndrome was higher than that in spleen damp-heat syndrome; the ratio G/R in damp-heat syndrome was lower than that in spleen deficiency syndrome（ P 〈0.05 ）. Conclusion There is a certain correlativity between the spleen deficiency syndrome and active phase UC and the remission period, as well as damp-heat syndrome and active phase UC.