Study On The Correlation Of Quality Of Ulcer Healing Of Spleen Deficiency Syndrome Of Peptic Ulcer And MC, EGFR

Peptic ulcer is a common disease worldwide, its incidence is closely related with genetics, region, race, living environment, psychological factors. It has long been considered to be due to imbalance of defensive factors and aggressive factors, and the gastric acid, pepsin are major aggressive factors. Acute peptic ulcer healing was 90%, but its easy to relapse is still the urgent problem. The quality of ulcer healing is the key reason for its recurrence. On the Hawaii International Conference at the end of 1990, Tarnawski first proposed the quality of ulcer healing concept (QOUH). Pointed out that the ulcer healing requires not only mucosal, but also submucosal tissue structures need repair and reconstruction. In the evaluation of the maturity of the local regeneration of mucosal structure, QOUH put more emphasis on its functionality, maturity, and linked the quality of QOUH with ulcer recurrence in the future.TCM(Traditional Chinese medicine) believes that this disease belongs to "stomachache", " hematemesis ", " hematochezia". The pathogenesis are related to endoretention of damp heat, transformation failure of spleen, cold-damp accumulating in the interior, stagnation of QI-blood, often due to weakness of the spleen and stomach, emotional disorders, internal injury caused by excess of seven emotions, unhygienic diet, hyperactive liver-QI attacking the stomach. Long-term repeated persistence of these factors often makes the recurrence of the disease. Weakness of the spleen and stomach is the basic pathology of this disease.1. Literature study and theoretical studyOn the diagnostic criteria spleen deficiency syndrome in traditional Chinese medicine, we analyzed the relevance of peptic ulcer of spleen deficiency and digestive, endocrine, immune, autonomic nervous system dysfunction, and gave the main points of the current diagnostic criteria of spleen deficiency. And we provided an analysis on the literature and theoretical views of the diagnosis of peptic ulcer of spleen deficiency, including clinical research, animal model and drug trials, focused on clinical research.2. Diagnostic criteria of Spleen Deficiency of Peptic ulcer disease.Modern study of the nature of spleen deficiency started since 20 years ago, during this period, people had done a lot of work, and made remarkable achievements. Spleen-qi deficiency syndrome served as the basic evidence and premise of other spleen deficiency types, therefore in most cases the nature of spleen deficiency is the real target of spleen deficiency syndrome. Spleen-qi deficiency syndrome is more clearly defined than spleen deficiency, but the diagnosis of spleen deficiency syndrome so far has no uniform standard diagnostic criteria. Diagnostic criteria on peptic ulcer of spleen deficiency syndrome have not been reported. In view of this, we introduced "clinical epidemiology" approach. We analyzed 190 cases of peptic ulcer patients by clinical epidemiological study investigated the statistical results, we found the diagnosis of peptic ulcer spleen deficiency should include etiology (positive evidence), symptom (the permits), relevant factors and quantitative indicators (evidence) and prescription treatment (evidence to the contrary), and combined with four aspects of endoscopic diagnosis.(1) Etiology (positive evidence)Multiple pathogenic factors in 45 cases (39.8%), fatigue in 15 cases (13.3%), exogenous cold in 21 cases (18.6%), mental factors in 2 cases (1.8%), inappropriate medication in 6 cases (5.3%), alcohol in 9 cases (8.0%), cold diet in 1cases (0.9%), oily food in 1cases (0.9%), spicy food in 2 cases (1.8%), improper treatment in 6 cases (5.3%), irregular diet in 2 cases (1.8% ).(2) Symptom (the permits)Main symptoms:stomach distention,pale tongue,pale tongue and whitecoating,teeth india on the tongue,pale chlorosis,tiredness,poor appetite.Minorsymptom: Dyspnea, eructation, Amid the hi by abdominal pain,abdominal pain, increased fatigue, Supine to reduce abdominal pain, Defecation weak, Pale lips, mouth saliva Pan Qing, glossarxesis, loose stools, hard bowel movements when the pond, small or weak pulse, chills.Diagnostic criteria of symptoms: stomach distention was essential to the disease, with four main symptoms can be diagnosed; with two main symptoms of the former five main symptoms plus any three minorsymptoms can be diagnosed; with three main symptoms plus any two minorsymptoms can be diagnosed.(3) Related factors (evidence)Location of disease: duodenal ampulla; gastric angle; composite ulcer; gastric body and Gastric Antrum; gastric multiple ulcer, gastric fundus. Small ulcers are more common in spleen deficiency syndrome. 46 to 60 age group and rural are more common in spleen deficiency syndrome, the incidence in autumn and spring was higher than in other seasons.(3) Recipes (disprove)TCM group is more efficient than western medicine group (P <0.05). Show that the invigorating the spleen treated effectively,and disprove the reasonableness of differentiation.3. Study on the correlation of quality of ulcer healing of spleen deficiency syndrome of peptic ulcer and MC, EGFR Most scholars now believe that spleen deficiency is the fundamental factor of the occurrence and recurrence of ulcer deficiency. Besides epidermal growth factor receptor and local infiltration of inflammatory cytokines are considered to be important aspects of quality of ulcer healing. However, the relevance of the quality of spleen deficiency with peptic ulcer healing mast cells and epidermal growth factor receptor is not reported. In our study, 86 patients with gastric ulcer diagnosed by endoscopy were randomly divided into spleen deficiency group and non-spleen deficiency group. The spleen deficiency group was divided into first-time diagnosed group, 22 cases and recurrence group, 16 cases. The non-deficiency group was divided into first-time diagnosed group, 22 cases and recurrence group,16 cases. Another 10 asymptomatic, healthy patients were chosen as control group. We use gastric mucosa specimens, combined with immunohistochemistry, the immunopathological image analysis, ulcer index, calculated ulcer recurrence within one year, to obtain the correlation between them. The results are as follows:(1) The gastric ulcer MC expression level and degranulation were significantly higher in gastric ulcer recurrence group than in the normal group, first-time diagnosed spleen deficiency group, non-SDS group .(2) Decreased EGFR expression level in gastric ulcer recurrence group than in the normal group and the other three groups.(3) GUI of non-ulcer spleen deficiency first-time diagnosed group is the lowest in all groups, while the GUI of spleen deficiency ulcer recurrence group is the highest.(4) In terms of symptom recurrence and gastric ulcer recurrence, the spleen deficiency group was significantly non-deficiency group. The gastric ulcer recurrence rate was significantly increased in both spleen deficiency group and non-deficiency group than in the first-time diagnosed group.(5) MC, EGFR level of gastric ulcer in each group was not significant correlated,and MC, GUI of gastric ulcer in each group had a significant positive correlation.