脾虚证患者十二指肠的病理形态及组织化学研究

作者	单位
许长照	南京中医学院
张瑜瑶	南京中医学院
刘隆棣	南京中医学院
朱启锭	南京医学院
田启鹏	南京医学院
沙家豪	南京医学院

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中文摘要:

本文通过光镜、电镜和组织化学方法,对54例脾虚患者及29例非脾虚患者的十二指肠标本进行观察,并与正常者作对比。结果表明:脾虚组的十二指肠炎较多;碱性磷酸酶和酸性磷酸酶在十二指肠绒毛功能部增强,顶部减弱;微绒毛稀疏、缩短;绒毛上皮细胞间隙增宽,杯状细胞、内分泌细胞、隐窝处低分化细胞、上皮内淋巴细胞浸润及固有膜各种炎性细胞均增多;细胞器一般也增多等病理改变.与非脾虚组及正常对照比较,有显著差异(P<0.05～0.005)。提示脾虚组与非脾虚组及两组中慢性胃炎、溃疡病的十二指肠具有不同的病理形态基础。

英文摘要:

In this paper 54 Spleen deficiency(SD)and 29 non-SD patients′ duodenal specimens(including chronic gastritis and peptic ulcer of both groups)obtained during gastrectomy or fibrogastroscopical mucosal biopsy were observed with light-,electronmicroscope and histochemical assay.The finding were compared with the control group.The results obtained were as follows:(1)Under light microscope,the changes in intestinal villi and Lieberkühn’s glands,the necrosis,deformation and sloughing of the epithelium of villi-tip,the mitosis in Lieberkühn’s glands,the count of goblet cells, the migration of lymphocytes into the intestinal epithelial cells and inflammatory cells in the lamina propria as well as the aspect of duodenitis(superficial,diffuse,atrophic)in the group of SD cases were increased significantly,P<0.05～0.005.(2)Histochemically,the AKP and ACP activity in the functional region of intestinal villi were increased and their activity decreased in the villi-tip.It was significantly different from normal and non-SD group(P<0.05-0.005).(3)Under electronmicros- cope,less number of microviili at the cell apex could be seen,the organelles in the functional region of intestinal villi epithelium were increased,the intercellular space was wider,the base membrane thicker,and the endocrine cells and low-differentiated cells in mucus layer,the mast cells,plasma cells and acidophilic cells were all increased and significantly different from those of normal and non-SD group. In short,the pathological base of SD patients’ duodenum is due to various degree of mor- phological changes of inflammation and dysfunction.SD syndrome in this paper usually consists of two types:Spleen-stomach type and Qi(气)deficiency type;the former seems to be the primary pathological change of SD.Whenthe digestive and absorptive disturbance followed by malnutrition, pathological change in other systems of the body would occur,resulting in Qi deficiency syndrome. Therefore,this paper provides a modern pathological basis for"treating different diseases with the same method"in SD syndrome,

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