Study On Relationship Between TCM Type Of Chronic Atrophic Gastritis With PGⅠ And PGⅡ

Objective: chronic atrophic gastritis is a frequently-occurring diseasedigestive system, is listed as one of the precancerous lesions. So earlydetection, early diagnosis is of great significance. Serum pepsinogen is aninactive precursor of pepsin, can be divided into two subtypes: PG ⅠandPGⅡ, the change of serum pepsinogen can reflect the function of the gastricmucosa form. By detecting serum PGⅠ and PG Ⅱ, explore the TCMsyndrome type of chronic gastritis with pepsin, correlation, so as to providebasis for the clinical treatment based on syndrome differentiation.Methods:1The clinical differential gauge. was made based on professionalexperts and literature research.2Using epidemiological investigation method, the patients of chronicatrophic gastritis were treated in Hebei province Chinese medicine hospitalfrom September2012to January2013. Collect in patients with clinicalsymptoms, gastroscope, pathological diagnosis and other relevant information,fill in clinical questionnaire, and comprehensive quantization according to theunified standard.3There are chronic atrophic gastritis, chronic atrophic gastritis withintestinal metaplasia, chronic atrophic gastritis with atypical hyperplasiaaccording to gastroscopy and pathological diagnosis4Using descriptive statistics method to find out the relationships betweenthe incidence and age, sex, course of disease, predisposing factors, bad habitsand pepsinogen abnormality.5PGⅠ, PG II in61cases of chronic atrophic gastritis were measured,analyzed its expression level and the degree of atrophy.6Application of statistics to explore the distribution of patients with chronic atrophic gastritis of pepsin former, analysis of pepsinogen andgastroscope, pathological correlation, so as to explore the relationship withTCM syndromes.Result:1In the61patients with chronic atrophic gastritis (CAG),20patients areCAG,23patients are CAG with Intestinal metaplasia,18patients are CAGwith atypical hyperplasia. And males are30, females are31, the female is1.03times as same as male. The percentage of patients is40.98%, whose diseasecourse is5to10years,31.15%are patients with1to5years,18.03%of thepatients with10years and more，9.84%of the patients with less than1years.The age spreads43.25to66.47years old. The youngest is28years old. Theoldest is78years old，The largest proportion of patients is32.79%,whose agesis from51to60years old; The proportion of patients61to70years old is24.59%,and proportion in41to50years old is19.67%,31to40years old is13.11%. The Constituent ratio of male and female in the these age groups haveno significant difference (P>0.05).2The main symptoms of the chronic atrophic gastritis are bloating(63.39%),stomachache (60.66%),taste bitter, acid regurgitation(29.5%),lessfood to eat(27.87%),feeling dry of mouth(21.31%),heartburn(21.31%).Themanifestation of tongue: red tongue accounted for50.82%, dull-red accountedfor21.67%, ecchymosis accounted for8.2%,surface of the tongue is yellowwhich is the most(45.9%), greasy is the second(42.62%).The patient who havethe taut pulse accounted for29.5%,and slippery pulse was seen for44.26%.3These patients are compared with6kinds of symptom types accordingto dialectical methods the traditional Chinese medicine. The patients whobelong to liver-stomach disharmony are16cases, The patients with intrinsicturbidity toxin are15cases, The patients with wet and heat resistance ofbodies disharmony are13cases, The patients who with gastric stasis windingresistance are7cases, The patients who with spleen and stomach weak are5cases, The patients who with stomach Yin deficiency are5cases.4PGⅠ expression aspect:liver stomach poison intrinsic＞turbidity＞wet and heat resistance＞gastric stasis winding resistance＞spleen and stomachweak＞stomach Yin deficiency. Turbidity, liver stomach poison intrinsic andthe wet and heat resistance with three groups there was no statisticallysignificant difference: higher than gastric stasis winding resistance, stomachyin deficiency, spleen and stomach weak three groups was statisticallysignificant difference(P＜0.05).Gastric stasis winding resistance stomach yindeficiency spleen and three was no statistically significant difference(P＞0.05).5In PGⅡ expression: turbidity＞liver-stomach disharmony＞wet andheat resistance of bodies disharmony＞stomach Yin deficiency＞gastric stasiswinding resistance＞spleen and stomach weak. Liver stomach with wet andheat resistance there was no statistically significant difference(P＞0.05), therewas statistically significant difference with intrinsic turbidity toxin, spleen andstomach weak and gastric stasis winding resistance(P＜0.05). Intrinsicturbidity toxin with liver stomach, wet and heat resistance，gastric stasiswinding resistance，spleen and stomach weak and stomach Yin deficiency,there was statistically significant difference(P＜0.05). Wet and heat resistancewith the liver-stomach disharmony, there was no statistically significantdifference(P＞0.05), there was statistically significant difference withturbidity, spleen and stomach weak and stomach Yin deficiency(P＜0.05).Spleen and stomach weak with stomach Yin deficiency, gastric stasis windingresistance, there was no statistically significant difference(P＞0.05), there wasstatistically significant difference with liver-stomach disharmony, wet andheat resistance and intrinsic turbidity toxin(P＜0.05). Stomach Yindeficiency,there was no statistically significant difference with spleen andstomach weak and gastric stasis winding resistance(P＞0.05), there wasstatistically significant difference with liver-stomach disharmony, wet andheat resistance and intrinsic turbidity toxin(P＜0.05). Gastric stasis windingresistance with stomach yin deficiency and spleen and stomach weak, therewas no statistically significant difference(P＞0.05), there was statisticallysignificant difference with liver-stomach disharmony, wet and heat resistance and intrinsic turbidity toxin(P＜0.05).Conclusions:1In the early stage of TCM syndrome classification of chronic atrophicgastritis is disharmony between liver and stomach, due to damp-heatsyndrome, turbidity toxin intrinsic card. Late for stomach collateral stasis,spleen and stomach, stomach yin deficiency. The incoordination between theliver and stomach, phlegm and toxin intrinsic card, due to damp-heatsyndrome is the most common.2PGⅠ reduce belong to stagnation of stomach collateral, stomach yindeficiency, spleen and stomach weakness, PGⅡ increased belong to phlegmand toxin intrinsic card.3The decrease of PGⅠ in chronic atrophic gastritis is related to thegastric mucosa atrophy. PGⅡ increased is concerned with intestinalmetaplasia, pseudopyloric metaplasia and dysplasia.