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[目的]探讨隆起糜烂性胃炎(Raised Erosive Gastritis,REG)中医证型与幽门螺杆菌(Hp)感染和病理组织学及热休克蛋白60(HSP60)、热休克蛋白70(HSP70)表达的关系,以期指导中西医结合防治REG。[方法]选择131例REG患者按中医辨证分为脾胃湿热证32例(Hp阳性19例,阴性13例),脾胃气虚证52例(Hp阳性者34例,阴性18例),脾虚湿热证47例(Hp阳性者33例,阴性14例)。所有受试者均行胃镜检查,取胃窦部活检标本行快速尿素酶试验及组织染色法检测Hp;病理组织学检查及免疫组织化学检测HSP60,其中63例免疫组织化学检测HSP70。并设正常对照(正常)组18例。[结果]REG脾虚湿热证组的萎缩、肠化生(IM)程度均高于脾胃湿热证及脾胃气虚证组(P<0.05),而后2组之间比较以及3组中Hp阳性者与阴性者比较差异均无统计学意义(P>0.05)。3组HSP60表达均较正常组增加(P<0.01),而3组之间比较均P>0.05;脾胃湿热证及脾虚湿热证组中Hp阳性者的HSP60表达均高于Hp阴性者(P<0.05),而脾胃气虚组中的Hp阳性与Hp阴性者比较P>0.05。3组的HSP70表达均较正常组增加(P<0.01);而3组的HSP70阳性表达情况分别比较均P>0.05;脾胃湿热证组中Hp阴性的HSP70表达高于Hp阳性者(P<0.05),而脾胃气虚证组与脾虚湿热证组中Hp阳性者与阴性者HSP70表达比较均P>0.05。REG Hp阳性者胃黏膜HSP60的表达明显高于Hp阴性(P<0.01);REG Hp阳性者胃黏膜HSP70的表达与Hp阴性者比较P>0.05。[结论]REG脾虚湿热证患者胃黏膜萎缩、IM程度均高于脾胃气虚证及脾胃湿热证。REG3组胃黏膜HSP60及HSP70的表达均较正常组增强。Hp感染可诱导胃黏膜HSP60的高表达。HSP60表达既与Hp感染有关,又与湿热之邪有关。
[Objective] To explore the relationship between TCM syndromes of Helicobacter pylori (REG) and Helicobacter pylori (Hp) infection, pathological histology and heat shock protein 60 (HSP60) and heat shock protein 70 (HSP70) In order to guide the combination of traditional Chinese and Western medicine prevention and control REG. [Methods] Thirty-one cases of REG patients were divided into 32 cases of spleen-stomach damp-heat syndrome (Hp positive in 19 cases, negative in 13 cases), spleen and stomach Qi deficiency in 52 cases (Hp positive in 34 cases, negative in 18 cases) Cases (Hp positive in 33 cases, negative in 14 cases). All subjects underwent gastroscopy. The specimens of gastric antrum were examined by rapid urease test and histological staining for Hp. Histopathology and immunohistochemistry were used to detect HSP60. 63 of them were immunohistochemically detected HSP70. And set the normal control (normal) group of 18 cases. [Result] The atrophy and intestinal metaplasia (IM) in the spleen damp-heat syndrome group were all higher than those in the spleen-stomach damp-heat syndrome and the spleen-stomach qi deficiency syndrome group (P <0.05), and then between the two groups and in the Hp positive and negative There was no significant difference between the two groups (P> 0.05). The expression of HSP60 in three groups were significantly higher than those in normal group (P <0.01), while those in three groups were all P> 0.05. The expression of HSP60 in Hp positive group was higher than that in Hp negative group (P < 0.05). However, HSP70 expression in spleen-qi-deficiency group was significantly higher than that in normal group (P <0.01), while P <0.05.3 group was significantly higher than that in Hp-negative group ; Hp-negative HSP70 expression in spleen-stomach damp-heat syndrome group was higher than that in Hp-positive group (P <0.05), while HSP70 expression in spleen-qi deficiency syndrome group and spleen deficiency-damp-heat syndrome group were higher than those in Hp- The expression of HSP60 in REG Hp positive group was significantly higher than that in Hp negative group (P <0.01). The expression of HSP70 in REG Hp positive group was significantly lower than that in Hp negative group (P 0.05). [Conclusion] Gastric mucosa atrophy and IM in patients with REG spleen-damp-heat syndrome were all higher than those with qi deficiency syndrome and damp-heat syndrome. The expression of HSP60 and HSP70 in REG3 group was higher than that in normal group. Hp infection can induce high expression of HSP60 in gastric mucosa. HSP60 expression is associated with Hp infection, but also with the heat of evil.