中医“有证无病”“有证有病”和“无证有病”的病理学与病理生理学基础的现代研究

Study on modern pathophysiologic basis of symptoms without disease,disease without symptoms and disease with symptoms in TCM

目的:探索中医"有证无病""有证有病"和"无证有病"的现代病理生理学基础。方法:取188例脾虚证患者胃黏膜和42例平素无临床症状的志愿献血者的胃黏膜,在应用光学显微镜、扫描电镜、透射电镜和组织化学染色,进行组织病理学、胃黏膜超微结构、细胞核和线粒体超微结构分析的基础上,同步采用能量色散X射线分析仪、图象分析系统、放射免疫法和化学发光法测定生物活性物质。结果:胃粘膜cAMP、SOD、Zn、Cu和线粒体Zn、Cu的量,以及线粒体及嵴的数目减少,随健康对照组、有证无病组(脾气虚证F组、脾阳虚证F组)、有病无证组、有证有病组(脾气虚证G组、脾阳虚证G组、脾阴虚证G组和脾虚气滞证G组)的顺序递减,(P<0.05或P<0.01);细胞核DNA、Zn和Cu随上述顺序递增,(P<0.05或P<0.01)。结论:胃粘膜cAMP、SOD、Zn、Cu,线粒体Zn、Cu和细胞核DNA、Zn、Cu的量变,以及线粒体及嵴的数目减少,既是胃黏膜组织结构产生病变的物质基础,也是决定有证无病、有病无证和有病有证的物质基础。

Objective： Explore the modern pathophysiologic basis of symptoms without disease, disease without symptoms and disease with symptoms in TCM. Method： By means of optical microscope, TEM and histochemical staining, we conducted histopathological, subcellular ultrastructural analysis and nuclei and mitochondrial ultrastrnctural analysis of gastric mucosa of 188 Spleen deficiency patients, of 42 voluntary blood donors usually devoid of clinical symptoms. Synchronously, bin- active substances were measured by means of EDAX, image analysis system, radio-immuno assay method and chemiluminescence method. Result： The content of cAMP, SOD, Zn, Cu in gastric mucosa, and the content of Zn Cu in mitochondria decrease and decrease in the number of mitochondria and their cristae progressively in order of HC group, symptoms without disease group （SQD -Fgroup, SyangD -F group）, disease without symptoms group, disease with symptoms group （SQD - Ggroup, SyangD -G group, SyinD-G group and SDQS-G group）; While the content of DNA, Zn, Cu in nuclei increased progressively in above mentioned orders, P〈0.05-0.01.Conclusiou： The quantitative changes of gastric mucosa cAMP, SOD, Zn, Cu, of mitochondrial Zn, Cu and of nuclei DNA, Zn, Cu and decrease in ＇the number of mitochondria and their cristae are not only the substance base on which lhe lesion of gastric mucosa tissue structure occurs, but also the substance base on which symptoms without disease, disease without symptoms and disease with symptoms is classified.