消化性溃疡中医辨证分型与胃酸、胃泌素、环核苷酸关系的探讨

作者	单位
牟德峻	解放军145医院
刘国荣	解放军145医院
于瑞珍	解放军145医院
徐世林	解放军145医院
邹积才	解放军145医院
温良玉	解放军145医院

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中文摘要:

对采用中医辨证分型治疗的64例消化性溃疡患者,测定了治疗前后胃酸、血清及组织的胃泌素、血浆及组织环核苷酸含量。结果:治疗前脾胃虚寒型血清及组织胃泌素、血浆 cGMP、组织 cAMP 均降低。寒热夹杂型胃酸、血清和组织胃泌素、血浆 cAMP增高。胃阴不足型基础胃酸及最大排酸量介于两型之间,最高排酸量降低;组织胃泌素及血浆、组织 cGMP 明显增高。治疗后各值趋向正常。

英文摘要:

64 peptic ulcer patients treated with Chinese herbal medicines were studied.The diagnosis of peptic ulcer was confirmed by fibro-gastroscopy.In these patients 10 suffered from gastric ulcer,49 duodenal ulcer and 5 compound ulcer.26 healthy subjects were used as control.Syndrome differentiation typing of traditional Chinese medicine:Stomach deficiency type,12 cases treated with Shashen(沙参)Maidong(麦冬)decoction(Adenophora tetraphylla,Ophiopogon japonicus etc.);Spleen deficiency type,31 cases treated with Huangqi Jianzhong(黄芪建中)decoetion(Astragalus mem- branaceus,Cinnamomum cassia etc.):cold type,21 cases treated with Zuojin pill(左金丸,Coptis chinensis.Euodia rutaecarpa).Before and after treatment gastric acid,gastrin,cAMP and cGMP were measured.Results:Clinical cure in 42 patients(65.63%),markedly effective in 20(31.25%),the total effective rate was 96.88%.Serum and tissue gastrin in Spleen deficiency type was lower than that in Stomach deficiency and cold types.The serum and tissue gastrin and gastric acid in cold type were higher than that in Spleen deficiency type.The above-mentioned parameters and pepsinogen levels in stomach deficiency type were between Spleen deficiency and cold types,but the maximal excretion of gastric acid decreased and the gastrin level in tissue increased.The plasma cGMP, cAMP and cAMP/cGMP ratio in tissue decreased in Spleen deficiency type.In cold type the plasma cAMP increased,cGMP decreased and cAMP/cGMP elevated.In Stomach deficiency type the plasma cAMP decreased,but cGMP in plasma and tissue significantly increased.There were significant difference in three types.After treatment,these indices in all three types normalized.The present study suggested that Zuojin pills could inhibit excretion of gastric acid,reduce plasma cAMP and increase plasma cGMP;Huangqi Jianzhong decoction could increase plasma cGMP level,and serum and tissue gastrin levei;Shashen Maidong decoction could decrease cGMP levels in plasma and tissue as well as gastrin levels in serum and tissue,the cAMP/cGMP ratio in plasma and tissue was similar to that in control.It is believed that traditional Chinese medicine therapy is an essential principle regulating balance of physiological function in human body.

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