Zhang Z L, Bu J K, Zhao J X
Zi-Li Zhang, Ji-Kang Bu, Department of TCM, the First Hospital of Lanzhou Medical College, Lanzhou 730000, Gansu Province, China.
World J Gastroenterol. 1997 Sep 15;3(3):185-8. doi: 10.3748/wjg.v3.i3.185.
To demonstrate the relationship between the ultrastructural changes of the gastric mucosa and the syndrome differentiation in chronic gastritis.
Sixteen chronic gastritis patients with Piweixuhan (PXG, the cold of insufficiency syndrome of the spleen and the stomach) and fifteen chronic gastritis patients with Ganweibuhe (GBG, incoordination syndrome of the liver and the stomach) were treated with Jianpiwenwei decoction (JWD, invigorating the spleen and warming the stomach) or Shuganhewei decoction (SHD, dispersing the stagnated Liver Qi and regulating the stomach), respectively for three months. Before and after treatment, a gastroscopy was performed and the gastric mucosa was collected from the lesser curvature of the antrum of each patient. The ultrasections were observed and photographed under the JEM-100C X electron microscope.
The common ultrastructural anomalies of the two types of chronic gastritis were the plasmacyte infiltration and the lesions of the mucosal epithelial cells, chief cells and antral mucous cells. There were obvious differences between the two types. In PXG, the predominant lesion of the chief cells was swelling of the mitochondria, while in GBG the rough endoplasmic reticulum was enlarged in the chief cells and the plasmacytes. After treatment, most cases of the ultrastructural lesions reverted to normal or improved.
There was a close relationship between the ultrastructural changes of gastric mucosa and the syndrome differentiation of chronic gastritis. JWD and SHD could significantly improve the ultrastructural lesions of the gastric mucosa.
探讨慢性胃炎胃黏膜超微结构变化与中医辨证的关系。
将16例脾胃虚寒型慢性胃炎患者和15例肝胃不和型慢性胃炎患者,分别用健脾温胃汤或疏肝和胃汤治疗3个月。治疗前后进行胃镜检查,从每位患者胃窦小弯处取胃黏膜。将超薄切片在JEM - 100C X电子显微镜下观察并拍照。
两种类型慢性胃炎共同的超微结构异常是浆细胞浸润以及黏膜上皮细胞、主细胞和胃窦黏液细胞的病变。两种类型之间存在明显差异。在脾胃虚寒型中,主细胞的主要病变是线粒体肿胀,而在肝胃不和型中,主细胞和浆细胞中的粗面内质网扩大。治疗后,大多数超微结构病变病例恢复正常或有所改善。
胃黏膜超微结构变化与慢性胃炎的中医辨证密切相关。健脾温胃汤和疏肝和胃汤可显著改善胃黏膜的超微结构病变。