| Study of Apoptosis on Relationship Between Tongue Presentation & Gastric Mucosa for Syndrome of Damp Heat of Spleen & Stomach in CSGFor studying the characteristics and the forming mechanism of the TCM syndrome and the tongue manifestation of the damp heat syndrome of spleen and stomach, 76 cases with damp heat syndrome of spleen and stomach in chronic superficial gastritis (CSG) were observed, and 43 cases with Qi deficiency syndrome of spleen and stomach and 11 healthy cases as control. With the indexes such as, tongue picture, maturation index (MI) and maturation value ( MV ) of tongue printing slides, apoptosis index (AI) and correlative genetic protein of gastric mucous and tongue, and helicobacter pylori (HP), the study was carried out. The result showed that:l.The red tongue with yellow sticky coating was mainly presented in the damp heat syndrome of spleen and stomach., which embodied the common rule of the red tongue stands for heat syndrome and the yellow sticky coating stands for damp heat syndrome. However, the red tongue with yellow sticky coating was not the only tongue picture in the syndrome, which might relate to the constitution of the patient, the function of stomach, the nature of pathogen and the partiality of dampness or heat.2. The changes of MI and MV in red tongue, in yellow sticky coating and in the damp heat syndrome of spleen and stomach were the most obvious ones, respectively. Therefore, the changes of tongue exfoliated cytology correlated not only to the changes of tongue picture but also to the TCM syndromes.3. The AI of gastric mucous and tongue increased in both disease's groups. Moreover, those in the group of Qi deficiency of spleen and stomach was higher. It indicates that as the changes of gastric mucous from normal to excess and then to deficiency syndrome, the cell apoptosis increases, which confirms to the transformation rule of excess and deficiency syndrome.4. There were abnormal expression of correlative genetic proteins of gastric mucous and tongue, such as p53, Bcl-2 and Fas, in the damp heat syndrome of spleen and stomach, and in the Qi deficiency of spleen and stomach. The correlative genetic proteins took part in the regulation of cell apoptosis, whichmight relate to the complex nature of TCM syndrome.5. In different tongue color groups, the AI of both gastric mucous and tongue changed obviously, while in different tongue coating groups, only the AI of tongue changed obviously. The changes of AI in pale tongue and white thick coating were the most obvious ones respectively. It indicates that, in CGS, the forming of TCM tongue picture is closely related to cell apoptosis.6. The expression of p53, Bcl-2 and Fas changed correlatively, which was not only related to the tongue color but also to the color and the thickness of the coating. The expression of Fas played an important role in the formation of tongue picture, and probably be the genetic basis of yellow sticky coating and white thick coating.7.1n the group of damp heat syndrome of spleen and stomach , HP infection rate was the highest, while the correlationship between HP and AI and p53, Bcl-2 and Fas had not been proved. It may be due to the different location and nature of gastric mucous diseases, or due to the different strain of HP. The HP infection rate in the groups of red tongue and yellow sticky coating was the highest, while that in the groups of purple tongue, light red tongue and white thick coating was lower. The MI and MV changed correlatively. It gives the expression to the correspondence of changes of syndrome and tongue.Based on the result of the study, some intrinsic rule of the formation of the syndrome and the tongue, in damp heat syndrome of spleen and stomach, has been revealed. The characteristics of cell apoptosis in different syndrome, tongue picture and gastric mucous pathological changes are initially discovered.In this paper, the mechanism of 'same disease with different syndrome' and 'different diseases with same syndrome' is...
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