应用内镜荧光强度分析法研究溃疡性结肠炎中医证型特征

The Chinese Medicine Syndrome Features of Ulcerative Colitis by Using Fluorescence Intensity of Auto Fluorescence Imaging

目的研究溃疡性结肠炎(ulcerative colitis,UC)不同中医证型自发荧光成像(auto fluorescence imaging,AFI)内镜下荧光强度[绿/红(the ratio of green to red,G/R比值)]的特征,为UC中医辨证提供客观依据。方法收集UC患者49例,根据白光内镜(white light endoscopy,WLE)黏膜形态和G/R比值对大肠湿热组(19例)、脾胃气虚组(30例)和健康对照组(21名)进行统计分析。结果脾胃气虚组和大肠湿热组G/R比值分别为(1.147±0.137)和(0.915±0.114),较健康对照组(1.227±0.137)降低,差异均有统计学意义(P<0.05,P<0.01),其中大肠湿热组G/R比值较脾胃气虚组更低(P<0.01)。大肠湿热组活动期内镜活动指数(endoscopic index,EI)以中度(11例)和重度(5例)为主;脾胃气虚组以缓解期(17例)和活动期EI轻度(7例)为主。活动期G/R比值小于缓解期(0.963vs1.220,P<0.01),且活动期EI轻、中、重度的G/R比值依次降低,分别为1.044、0.967和0.830(P<0.01)。结论 UC大肠湿热证的炎症程度高于脾胃气虚证。AFI能较好地反映UC的炎症程度。

Objective To study the Chinese medicine （CM） syndrome features of ulcerative colitis （UC） by using fluorescence intensity （the ratio of green to red, G/R ratio） of auto fluorescence imaging, thus providing objective evidences for the CM syndrome typing of UC. Methods Totally 49 patients were recruited. They were typed as Dachang damp-heat syndrome （19 cases）, Pi-Wei qi deficiency syndrome （30 cases）, and the healthy control group （21 cases） on the bases of mucosal morphology of white light endoscopy （WLE） and the G/R rati- o of AFI. Results Compared with the healthy control group （ 1. 227 ~0. 137）, the G/R ratio in Dachang damp- heat syndrome （0. 915 -＊0. 114） and Pi-Wei qi deficiency syndrome （1. 147 ~0. 137） decreased with statistical difference （ P〈0.05,P〈0. 01 ）. Of them, it was lower in Dachang damp-heat syndrome group （ P〈0.01 ）. The case number was mainly dominated in moderate endoscopic index （El） （11 cases） and severe El （5 cases） in Dachang damp-heat syndrome group. The case number was mainly dominated in the remission phase （17 ca- ses） and mild El （7 cases） in Pi-Wei qi deficiency syndrome group. The G/R ratio of the remission phase was higher than that of the active phase （1. 220 vs 0. 963, P 〈0.01 ）. There was statistical difference in the G/R ratio of the mild El （1. 044）, the moderate El （0. 967）, and the severe El （0. 830） （P〈O. 01 ）. Conclusions The in- flammation degree of Dachang damp-heat syndrome was more severe than that of Pi-Wei qi deficiency syn- drome. AFI could better reflect the inflammation degree of UC.