| Aim: To investigate the relationship of "dysfunction of the spleen in transport" with gastrointestinal movement, electrogastrography, gastric acid secretion, brain-gut peptide and their enteroendocrine cells-, Search for an objective index with high specificity and sensitivity to provide new clinic evidence for elucidating the essence of spleen-asthenia syndrome.Methods: The patients of Spleen-Asthenia syndrome(SA), Stomach-Heat (SH) , Flaming-Up of Liver-Fire (FULF) were selected in department of Gastroenterology from Mar. 2000 to Feb. 2001, having examined their breath hydrogen test(BHT)r Electrogastrography and analyse the results; The concentrations of somatostatin(SS), motilin(Mot), Cholecystokinin (cck) in tissue and plasma were measured by radioimmunoassay(RIA); Moreover immunohistochemical SABC method was employed to stain the D cell and I cell of gastric antrum. The variation of appearance and quantity of endocrine cells was observed by light microscope.Results (D In the group of SA, compared with groups of SH and FULF, the H2/excess during oral magnesium BHT reduced at 15Min,30Min,45Min (13.16?.51ppm VS 34.21?.86ppm,22.35?.17ppm;14.33?.18ppm VS 37.25 ?8.27ppm,31.36 ?4.84ppm ; 15.57 ?4.89ppm VS 39.24 ?6.17ppm,34.67?.92ppm) (PO.01), the result indicated that the function of gastric acid secretion reduced markedly in patients with SA; (2) The results of small bowel transit test(SBTT) after oral lactose BHT, compared with the groupof FULF: the time in groups of SA was increased (125.6 + 21.3Min VS 60.4 ?34.5Min) (PO.01), the times are not difference between SA and SH (125.6 ?1.3MinVS 143.2 + 29.8 Min) (P>0.05) , this indicated the gastrointestinal movement reduced and the SBTT increased. ã•he electrogastrography amplitude reduced and frequency increased in group of SA compared with groups of SH and FULF (amplitude: gastric antrum: 60.4 + 23.8uv VS 327.3 ?9.1uv, 246.4?6.2uv, gastric body.- 67.3?7.2uv VS 286.4?9.2uv, 217.5 + 60.4uv; frenquency: gastric antrum: 3.4?.3 VS 2.6 + 0.5, 3.1+0.4, gastric body: 3.7 + 0.5 VS 2.5 + 0.3, 3.1 ?.3) (P<0.01).this indicated EGG reduced in patients of SA. ?The radioimmunoassay results: compared with groups of SH and FULF, a. In the group of SA, the levels of Mot in gastric antrum mucosa and plasma reduced^O.Ol) (gastric antrum: 109.4+ 18.9ng/g VS 219.8 + 25.3ng/g,183.0 + 23.9ng/g; plasma: 61.7+10.6ng/L VS 171.4?30.8ng/L,126.3?4.6ng/L; b. In the group of SA, the levels of SS in gastric antrum and plasma increased(P<0.01) (gastric antrum: 224.3 + 67.9ng/g VS 80.2 + 25.6ng/g, 114.2 + 34.5ng/g; plasma: 74.5 + 17.2ng/L VS 30.3 ?11.8ng/L,38.1 + 12.7ng/L); C. In the group of SA, compared with groups of SH, the levels of CCK in gastric antrum and plasma mcreased(P<0.01) (gastric antrum: 34.1?.2ng/g VS 21.6+4.7ng/g; plasma: 5.8+0.4ng/L VS 3.7?0.6ng/g); In plasma, the level of CCK in group of SA is lower than group of FULF (5.8 + 0.4ng/LVS7.9?.8ng/L) (P<0.01) . The changes of brain-gut peptide in tissue and plasma could explain the serial of symptom about dysfunction of the spleen in transport. ã•he results of immunohistochemial SABC: a. In the group of SA, compared with groups of SH and FULF, the number of D cell and the percentage of strong positive cells increased markedly in gastric antrum (P<0.01)(the quantity of positive cells: 70.4?0.1 VS 38.1 + 6.4, 45.4+8.6, percentage of strong positive cells: 43.2?.7VS 17.9 + 6.6, 21.8?.5); b.Inthe group of S A, compared with groups of SH and FULF, thequantity of I cell and the percentage of strong positive cells markedly reduced in gastric antrum(P<0.01) (the quantity of positive cell: 44.7+4.2 VS 83.9 + 13.1, 78.4 + 7.7, percentage of strong positive cells: 19.4 + 3.5 VS 31.5 + 5.7, 20.5?.3)(P<0.01-P<0.05)), the quantity of I cell in group of FULF was more than that in group of SH(P<0.01), these indicated the change of D and I cell in gastric antrum were the direct reasons that brain-gut peptide changed in tissue and plasma.Conclusions:e researched firstly the relationship between D,... |
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