Portal Hypertensive Gastropathy - Research And Treatment Of Liver Stagnation And Spleen Deficiency Syndrome Essence Discussion

Objection:This study aimed to investigate the syndromatic essentiality of portal hypertensive gastropathy (PHG) with Stagnation of Liver Qi and Deficiency of Spleen (SLDS) from Nitric oxide (NO), Endothelin (ET), Motilin(MTL) and plasma cyclonucleotide (cAMP, cGMP), and to supply theoretical evidence for clinical syndrome differentiation and at the same time priliminarily to investigate the result of treatment of the prescription of Smoothing Liver Qi , Acting Blood and strengthening Spleen to PHG with SLDS.Methods:l.All Subjects were divided into four groups, P group, including 30 patients of PHG with SLDS, H group, including 30 patients of chronic hepatitis B(CHB) with SLDS, G group, includingSO patients of chromic gastritis with SLDS and C group, 30 volunteers with good health.2.It inquired the history of disease and clinical symptoms of patients in detail and was filled in the data cards.3.Collected each subject's blood specimens under empty stomach state in the morning and then made electronic gastrocopies, wrote down mirror finding and last drawed stomach tissue for Helicobacter pylori (HP) measure.4.Radioimmunoassay was used to detect MTL, ET, cAMP and cGMP in plasma.5.the nitric acid reducing the enzyme law was used to detect No.6.P group were divided into two groups, A group, including 20 patients, was treated by the prescription of Smoothing Liver Qi , Acting Blood and strengthening Spleen. The other group, including 10 patients, was treated by Inderal7.Analysed synthetically each of meanings to SLDSResults:1 .The content of No, ET and MTL in P group obviously increased as compared with those in H, G and C groups (P<0.01), The content of cAMP in the lowest and those of cGMP is the highest.2.There was no obvious difference of positive rate of HP among the four groups, but the positive rate of HP of the heavy group in P groups by McCormick's grade was higher than those of slight group (P<0.01).3. Scores of SLDS in P group were significantly higher than those in H groups and G groups(p<0.01). the scores of SLDS of the heavy group in P group were higher than those of slight group(P<0.01)4.1n P group, the content of NO, ET and MTL of the heavy group by McCormick's grade were higher than those of the slight group (P<0.01).S.In P group, the content of cAMP was the highest and the content of cGMP was lowest in the SLDS I ;In the SLDS II, the content of CAMP and cGMP is contrary to the SLDS I. There were obvious difference among I, Hand HI of SLDS (PO.01)6.1n P group, the content of NO and ET were the highest in SLDS I and the content of MTL was the highest In SLDS II. There were no difference among I, II and III of SLDS7.1n P group, the content of No ,ET and MTL of C grade of Child-Pugh classification were higher than those of grade A and B .there were obvious difference among grade A, B and C (PO.01).8.There existed relevance between scores of SLDS and the content of No, ET.MTL, cAMP and cGMP(P<0.01).9. The prescription of Smoothing Liver Qi , Acting Blood and strengthening Spleen can have been obvious to reduce the levels of No, ET and MTL, and raise the radio of cAMP to cGMP and improve the clinical symptom.Conclusion:l.No, ET and MTL participate in forming of PHG, brings about an advance in it and plays a leading role in the forming and development of PHG.2.More high the scores is, more high the content of NO, ET and MTL and more heavy the damage the gastric mucous membrane becomes; more high the degree of the liver functional damage is, more bad the gastric mucous membrane becomes.3.No, ET and MTL can be used to detect PHG with SLDS and cAMP and cGMP are helpful to guiding the dialectical and dividing type.4.Hp infection is unlikely to be involved in the pathogenesis of PHG there are some relevance between HP and PHG.5. The prescription of Smoothing Liver Qi , Acting Blood and strengthening Spleen has obvious result of treatment to PHG with SLDS.