细胞核DNA含量在慢性萎缩性胃炎伴异型增生中医证型中的比较及其意义

Study the Nuclear DNA Content in the Syndromes of Traditional Chinese Medicine for Chronic Atrophic Gastritis with Dysplasia

目的:观察细胞核DNA含量在慢性萎缩性胃炎伴异型增生的中医各证型中的变化,探索中医辨证分型的客观指标,以更好地协助指导中医药防治慢性萎缩性胃炎伴异型增生。方法:选取146例慢性萎缩性胃炎伴异型增生患者进行中医辨证分型;采用Feulgen染色、病理图像定量分析细胞核DNA含量。结果:(1)DNA含量随异型增生程度的加重逐渐增加,且轻、中、重度异型增生之间存在非常显著性差异(P<0.01)。(2)DNA含量在各证型间存在非常显著性差异(P<0.01),且胃络瘀血型>胃阴不足型>脾胃虚弱型>脾胃湿热型>肝胃不和型。结论:(1)慢性萎缩性胃炎伴异型增生的中医辨证分型有其一定的分子生物学基础。(2)轻、中、重度异型增生均有癌变的可能,且随着异型增生程度的加重癌变的可能性逐渐增大。(3)慢性萎缩性胃炎伴异型增生的中医证型在病情上存在一定的轻重递进关系,具体表现为胃络瘀血型>胃阴不足型>脾胃虚弱型>脾胃湿热型>肝胃不和型。(4)检测DNA含量可作为活检慢性萎缩性胃炎伴异型增生的诊断、分级和中医辨证分型的参考指标,并能协助指导临床诊治。

Objective：Observing the nuclear DNA conte nt in the syndromes of traditional chinese medicine（TCM）of chronic atrophic gastritis with dysplasia,studying the difference of the syndromes of TCM in the molecule biology level.Exploring objective indicators of syndromes of TCM as a guidance for preventing and treating the chronic atrophic gastritis with dysplasia in TCM.Methods：146 Cases with chronic atrophic gastritis with dysplasia were divided into five types according to the Syndrome differentiation of TCM.The nuclear DNA content was quantitatively determined by Feulgen dying method and pathological image analysis.Results：（1）The nuclear DNA content increased with the increment of the severity of dysplasia in gastric mucosa,and there was very significant difference among Mild,moderate and severe types of dysplasia（P〈0.01）.（2）Significant difference of the nuclear DNA content was found in all types of the syndromes of TCM,and the regular sequence was Disharmony between the Liver and Stomach,Damp Heat in the Spleen and Stomach,Deficiency of the Spleen and Stomach,Deficiency of Stomach Yin,Blood Stagnation of the Stomach.Conclusions：（1）The syndromes of TCM of chronic atrophic gastritis with dysplasia were on the basis of molecule biology reliably,and it might play partly a good guidance in treating this disease.（2）Mild,moderate and severe dysplasia had the possibility of carcinogenesis,and this kind of possibility increased with the increment of the severity of dysplasia in gastric mucosa.（3）The worse of the syndromes of TCM of chronic atrophic gastritis with dysplasia increased by degrees,and the regular sequence was Disharmony between the Liver and Stomach,Damp Heat in the Spleen and Stomach,Deficiency of the Spleen and Stomach,Deficiency of Stomach Yin,Blood Stagnation of the Stomach.（4）It had been approved that the nuclear DNA content could be used as some important indexes for diagnosis and classification of chronic atrophic gastritis with dysplasia,and the guidance of treatment,too.