Study On The Levels Of Serum Pepsinogen And Gastrin 17 In Patients With Chronic Atrophic Gastritis With Different Syndromes

Objecive:As one of the most common malignant tumors in the world,gastric cancer is the second leading cause of tumor-related death in the world.The incidence and mortality of gastric cancer in China are both higher than the world average level,and its public health burden is significant.Chronic atrophic gastritis(CAG)is the common precancerous lesion of stomach,Its early detection and treatment are crucial.In recent years,the detection of serum pepsinogen(PG)and gastrin-17(G-17)levels has been increasingly used in the screening of CAG CAG is one of the dominant disease in TCM treatment,and syndrome differentiation is the key to TCM treatment.In this study,by detecting the levels of serum PG and G-17,the characteristics of serum PG and G-17 in different TCM syndromes of CAG were studied to provide more evidence for clinical diagnosis and treatment.Methods:1.Cross-sectional study:clinical questionnaire was made to collect general information of patients、information of four diagnoses and gastroscopy results.TCM syndrome types were determined according to the"consensus opinions on TCM diagnosis and treatment of chronic gastritis".2.The serum PG and G-17 levels of CAG patients were detected by ELISA method.Combined with the results of clinical studies,the differences in the expression of PG Ⅰ、PGⅡ、PGR(PG I/PGⅡ)and G-17 in CAG patients with different syndromes were compared.Results:1.A total of 127 CAG patients with serum PG and G-17 were included in this study,including 72 females and 55 males.The age is mainly from 50 to 70 years old,with an average age of 58.2.Among the 127 patients,41 of them were accompanied by mucosal erosion,about 32%;14 patients had bile reflux,about 11%;20 patients had gastric polyps,about 16%;29 patients had reflux esophagitis or Barrett’s esophagus,about 23%.3.There were 7 syndrome types,including 35 cases of damp-heat syndrome of spleen and stomach,29 cases of spleen-stomach qi deficiency,27 cases of liver-stomach qi stagnation,18 cases of spleen-stomach cold deficiency,12 cases of liver-stomach heat retention,5 cases of stomach collaterals stasis,and 1 case of stomach Yin deficiency.Seven syndromes were classified into two types:deficiency syndrome and empirical syndrome,of which 79 cases were empirical syndrome,accounting for 62:2%,and 48 cases were deficiency syndrome,accounting for 37.8%.4.According to the statistical results,Compared with the mild atrophy group,the level of PG I in severe atrophy group decreased,Compared with the moderate atrop hy group,the level of PG I in severe atrophy group decreased,the difference was st atistically significant(P<0.05),Compared with the mild atrophy group,the level of P GR in moderate and severe atrophy group decreased,the difference was statistically significant(P<0.05);Compared with mild IM group,the PG I level of moderate IM gr oup decreased,the PG I and PGR level of severe IM group decreased,compared wit h the moderate IM group,PGR decreased in the severe IM group,and the differenc e was statistically significant(P<0.05).Compared with the atrophy group,the level of PG I and PGR in atrophy with IM group decreased,and the difference was statistic ally significant(P<0.05),compared with the atrophy group,the level of PG I in atrop hy with dysplasia group decreased(P>0.05).5.Different TCM syndrome had different serum PG Ⅰ、PG Ⅱ、PGR and G-17 level.Compared to the liver-stomach stagnation group,the PG I level of spleen-stomach cold group decreased.Compared to the spleen-stomach damp-heat group,the serum PG Ⅰ、PGR level of spleen-stomach qi deficiency group and spleen-stomach cold deficiency group decreased,the differences were statistically significant(P<0.05);Compared the empirical group with the deficiency syndrome group,it can be seen that there are differences in the expression levels of PG Ⅰ、PG Ⅱ、PGR and G-17.,Compared with the empirical group,the level of PGR in the deficiency syndrome group decreased,and the difference was statistically significant(P<0.05).6.Compared to mild inflammation group,serum PG Ⅰ、PGⅡ and G-17 levels in moderate-severe inflammation group increased,while PGR level decreased.,The differences of G-17 and PGR levels were statistically significant(P<0.05).Compared to the chronic inflammation group,the levels of PG Ⅰ、PGⅡ and G-17 in the active inflammation group increased,while the levels of PGR decreased.,The difference of G-17 was statistically significant(P<0.05).Compared with non-erosive group,the level of PG I and PGR in erosive group decreased,and the difference of PGR was statistically significant(P<0.05).7.According to statistical analysis,It was found that serum PG I and PGR levels of females were lower than that of males,and the difference was statistically significant(P<0.05).Conclusion:1.Different TCM syndromes of patients with chronic atrophic gastritis have different serum pepsinogen and gastrin-17 levels,compared with the empirical group,the decrease of PGR was more obvious in the deficiency syndrome group.2.CAG patients with different degree of atrophy and intestinal have different levels of serum PG Ⅰ、PGⅡ、PGR and G-17,and the levels of serum PG Ⅰ、PGⅡ、PGR、G-17 are different in different degree of gastric mucosal inflammation.