Clinical Study On Relationship Between Plasma Endothelin,nitric Oxide And Tcm Differentiation Syndromes Of Peptic Ulcer

Clinical Study on Relationship between Plasma Endothelin, Nitric Oxide and TCM Differentiation Syndromes of Peptic UlcerMajor: Internal Medicine of TCMPostgraduate: Man WeiInstructor: Chief Physician Wang XuezhangAbstractBackground: Endothelin and nitric oxide play an important role in gastric mucosal damage and protection.Objectives: To investigate the effect of endothelin and nitric oxide on the pathogenesis of peptic ulcer and relationship with TCM differentiation syndromes.Subjects and Methods: With the criteria of diagnosis and TCM differentiation syndromes of peptic ulcer in the guide on clinical study of new Chinese fte/ts(issued by the national health department) 72 cases of peptic ulcer were chosen (58 male, 14 female) with an average age of 38.25+ 7.12(19?3 years old).Among them 29 cases were gastric ulcer,38 cases duodenal ulcer and 5 cases complex ulcer;46 cases active stage, 26 cases healing stage;24 cases with complication of haemorrhage;42 cases Hp*30 cases H';17 cases qi stasis,22 cases heat stasis.9 cases cold of insufficiency syndrome,24 cases blood stasis sy.ndrome.2Q cases of chronic gastritis were chosen(15 male,5 female) with a average age of 36.31+9.20(20?0 years old).Among them 17 cases were chronic superficial gastritis, 3 cases chronic/atrophic gastritise;16 cases Hp*4 cases Hp". 30 cases were chosen (22 male, 8 female)as contra) group, with an average age of 40.11 ?10.31(21?1 years old). The plasma endothelin levels were measured with radioimmunoassay, the plasma nitric oxide with colorimeric method, Hp with rapid urease test and the inflammation scores were assessed with sections under microscope. Results:1. ET levels were significantly higher in PU than in control(P<0.01).CU>DU>GU, but without statistical difference. The levels of acute stage were higher than that of healing stage, but without a statistical difference. There was no difference between healing stage and control and CG.. The levels in 4 >1cm group were higher than that in d> <1cm group(P<0.01). In Hp* group higher than in Hp'group ,but without a statistical difference.2. There was no difference between the levels of NO in PU .control and CG. NO levels in CU were higher than that in GU(P<0.05). and in control group(P<0.01) and in CG(P<0.05). ln <1cm group and control group(P<0.05). In HP* group higher than in control group(P<0.05).3. ET/NO in PU were higher than in control and CG group(P<0,01). There was no difference among GU.DU and CU. In acute stage higher than in healing stage(P<0.01). In 4> >1cm group higherthan <1cm group(P<0.01). There was no difference between in HP* and HP group.4. Inflammation scores were positively correlated with the levels of ET,r=0.392,P<0.01, and with the levels of NO, r=0.399,P<0.01.5. The ET levels increased significantly in PU group with complication of hemorrhage. In bleeding higher than in the bleeding stopping(P<0.01). The levels decreased as the loss of blood, but without a statistical difference. The NO level increased compared with control (PO.01) and according to the loss of blood but without a statistical difference. ET/NO when bleeding increased compared with when stopping(P<0.01), but no relationship with loss of blood.6. Compared; with control and CG group, the ET levels in blood stasis group increased significantly(P<0.01) and there was no change in other groups. The ET level, in blood stasis group were higher than in qi stasis group(P<0.01).The NO levels in blood stasis group were higher than in control(P<0.01) and in CG(P<0.05). There was no change of NO levels between other TCM groups and CG or control group. The NO levels in blood stasis group were higher than in qi stasis and heat stasis group(P<0.01) and cold of insufficiency group(P<6.05).Compared with control and CG, ET/NO increased in every group of TCM syndromes, especially in heat stasis and blood stasis(P<0.01), and in qi stasis group lower than in blood stasis group(P<0.05).Conclusion: the levels of plasma ET and NO have a close r...