门脉高压性胃病肝郁脾虚证与一氧化氮及内皮素水平关系研究

Relationship between portal hypertensive gastropathy with SLDS and NO,ET

目的:从血清一氧化氮(NO)及血浆内皮素(ET)水平探讨门脉高压性胃病(PHG)肝郁脾虚证的病理生理基础,为PHG肝郁脾虚证的中医辨病辨证提供理论依据。方法:入选对象120例,分为:PHG组(P组)、慢性乙型肝炎组(H组)、慢性胃炎组(G组)、正常对照组(C组),每组30例。详细询问每例患者的病史、临床症状,进行肝郁脾虚证的评分,填写资料卡片。在早晨空腹状态下采肘前静脉血,然后作电子胃镜检查。检测4组人员血浆ET和血清NO水平。结果:①P组患者NO和ET水平同步升高,明显高于H组、G组和C组,且P组>H组>G组>C组,差异有显著性意义(P<0.01);②P组患者McCormick分度重度患者NO、ET水平高于轻度组,差异有显著性意义(P<0.01);③P组患者肝郁脾虚证积分与血ET、NO水平存在正相关(P<0.01);④P组患者肝功能Child-Pugh分级,C级患者NO、ET水平均明显高于B级和A级,B级亦高于A级,各级之间相比差异有非常显著性意义(P<0.01)。结论:①NO、ET参与PHG的形成,促进其发展,在PHG的形成与发展中起重要作用;②症状越重,肝郁脾虚证积分越高,NO、ET水平升高越明显,肝功能损害越明显,NO、ET水平越高,③NO、ET可作为PHG肝郁脾虚证的检测指标,但不能指导辨证分型。

Objective： To investigate the syndromatic essentiality of portal hypertensive gastropathy （PHG） with stagnation of liver Qi and deficiency of spleen （SLDS） from endothelin （ET） and nitric oxide （NO）, and to supply theoretical evidence for clinical syndrome differentiation. Methods： All subjects were divided into four groups with P, H, G and C, 30 eath other. The history of disease and clinical symptoms of patients were imguired in detail and were filled in the data cards. Collected each sub- jectg blood specimens under empty stomach state in the morning and then made electronic gastrocopies. Radioimmunoassay was used to detect NO, ET in plasma. Results： ① The content of NO, ET in P group obviously increased as compared with those in H, G and C groups （P 〈0. 01 ） . ② In P group, the content of NO, ET of the heavy group by McCormickg grade were higher than those of the slight group （P 〈 0. 01 ） . ③ There existed relevance between scores of SLDS and the content of NO, ET （P 〈 0. 01 ） . ④In P group, the content of NO, ET of C grade of Child-Pugh classification were higher than those of grade A and B （P 〈0. 01 ） . Conclusion： ⑤ NO, ET participate in forming of PHG, brings about an advance in it and plays a leading role in the forming and development of PHG. ⑥ More high the scores and the degree of the liver functiona is, more high the content of NO, ET; ⑦ NO, ET can be used to detect PHG with SLDS and are not helpful to guiding the clinical syndrome differentiatioin.