| ObjectiveThe development of H.pylori gastritis had a path of pathology progression : Chronic non-atrophic gastritis;Chronic atrophic gastritis;Intestinal metaplasia;Atypical hyperplasia;Cancerization.At present,most Traditional Chinese Medicine practitioners believed that H.pylori was closely related to dampness-heat in the spleen and stomach.Based on theory of TCM pathogenic factors,H.pylori should be a kind of evil qi of dampness-heat.H.pylori gastritis was closely related to dampness-warm disease.Ye Tianshi proposed that an incipient disease with damp-heat in meridians and collaterals.After a long time,there was syndrome of stagnant-heat invading collaterals(in the A Guide to Clinical Practice with Medical Record). You Zaijing proposed that " Every evil qi has noxious,heat would become poisoning.The poisons caused changes that were the pathogenesis of blood stasis(The Essence of Synopsis of the Golden Chamber)".Dampness-heat pathogenesis prolonged the onset period.The condition gradually changed.Dampness-heat infringed human body.Early onset was not serious,but the syndrome of Dampness-heat was a refractory case.After a long time stasis and poisoning was gradually eliminated.There were both symptom of stasis and poisoning.The condition deteriorated into the meridian so that the disease became increasingly serious.Both syndromes of Dampness-heat and H.pylori gastritis were seemed to have some kind of coincidence on pathological evolution.Traditional Chinese Medicine respected that Treat the diseases which haven't occured.How to explore the pathogenesis of H.pylori gastritis from theory of Traditional Chinese Medicine? Was the development from gastritis to gastric cancer accompanied by syndrome of dampness-heat? Was there an objective material basis involved in this transformation? Based on the analysis of the theory of Traditional Chinese Medicine and the study of modern Chinese medicine,this paper explored the transformation of H.pylori gastritis.The related material basis of Dampness-heat in the spleen and stomach and syndrome transformation of dampness-heat was found by metabonomics research method.Methods1.Theoretical research: After syndrome of dampness-heat was demarcated against the development and origin of Traditional Chinese Medicine.We compiled the relevant theories of the specialist on Epidemic febrile disease in the Ming and Qing Dynasties and the related research on H.pylori gastritis in modern Chinese medicine was summarized.2.Metabolic research: 100 cases of patients(the diagnosis of chronic gastritis,gastric cancer)were collected in January 2015 to January 2016 in Wuhan from five hospitals patients.14 C urea breath test to test H.pylori and stomachoscopy were performed.The dialectical classification of Traditional Chinese Medicine was carried out.Twenty chronic gastritis patients(dampness-heat in the spleen and stomach type)were enrolled in the study group.Twenty gastric cancer patients(dampness-heat in the spleen and stomach type)were enrolled in this study.Twenty healthy people in Wuhan Hospital of Traditional Chinese Medicine were selected as healthy control group.The patients meeting the inclusion criteria and health volunteers were selected,whose middle urine 10 ml was collected with EP tube in the morning.The urine nuclear magnetic resonance was collected.All data were analyzed and verified by PCA and PLS-DA.Results2.Theoretical results1.1 The main transformation of Dampness-heat in the spleen and stomachFrom the perspective of differentiation according to principles of wei,qi,ying and xue system,dampness-heat in the spleen and stomach was distributed to the Ying blood.Due to be treated properly,the condition was finally healed.From the Differenation of disease of the triple jiao theory,dampness-heat in the spleen and stomach syndrome occurred in the spleen and stomach,which was extended to liver,kidney,the large intestine,small intestine and bladder.It could also upload to lung,pericardium and brain.From the meridian point of view,dampness-heat in the spleen and stomach deteriorated for a long time,there would be a chronic disease,which was combined with blood stasis."The excessive syndrome located in Yangming,deficiency syndrome located in Taiyin ".Whether the strong yang-qi of spleen and stomach would affect the transformation of the dampness-heat in the spleen and stomach.Moreover,the physical type affected the outcome of the dampness-heat in the spleen and stomach.Yin deficiency of spleen and stomach appeared dampness-heat with more loss Yin liquid.The final occurrence of Yin deficiency of the dampness-heat in the spleen and stomach syndrome eventually led to the deficiency of kidney yang.Physical condition had a crucial effect on the occurrence,transformation and outcome of Dampness-heat in the spleen and stomach syndrome.1.2.Study on Pathogenesis of H.pylori-associated Chronic Gastritis to Gastric CancerH.pylori infection led to chronic active gastritis through different mechanisms.For disease consequences and severity,it played an important role in addition to bacterial factors.The host immune response was also H.pylori-related disease,which was the important determinant of gastric cancer.H.pylori in the gastric mucosa after colonization,the process of multiply,breeding and enshrouding spread to the body by secretion of toxins.The yin and yang blood was consumed with the destruction of human balance.H.pylori caused by the incidence of gastropathy in line with the characteristics of temperature disease in the temperature.There was the incidence of dampness-heat poisoning in the pathogenesis.2.Metabonomics research results2.1 The general situation60 cases were randomly divided into three groups: A,C and D.There was 20 cases in each group.The patients were divided into three groups: A,C and D.Group A was dampness-heat in the spleen and stomach type chronic gastritis group.Group C was dampness-heat in the spleen and stomach type gastric cancer group.Group D was healthy control group.There was no statistically significant difference in sex,age and body mass index among the three groups.2.2 Metabonomics analysis resultsIn this experiment,the 1H-NMR spectra of the samples were analyzed,the species of which were classified and were qualitative and quantitative.Amino acids and their derivatives(20 species);?.Amino compounds and mixed amines(9 species);?.Carbohydrates(5);?.Organic acids(15);? other types(10).By the analysis of urine metabonomics of the three groups,there was a trend between the healthy control group and the gastritis group.but the gastritis group and the gastric cancer group could not be separated,And the trend of gastritis group and gastric cancer group was further analyzed by PLS-DA analysis.The samples of gastric cancer group and healthy control group had separate trend.The gastritis group was separated from the healthy control group.And the difference of metabolites in urine was found by VIP map.Finally,the differences of eight metabolites were significant: Fucose?Creatine phosphate?Hippurate?Glycerol?Trigonelline?Taurine?Trimethylamine N-oxide?N-Phenylacetylglycine.The urine metabonomics of the dampness-heat in the spleen and stomach syndrome group(A + C group)and the healthy control group(group D)were analyzed by urine metabonomics.It was found that the samples of the dampness-heat in the spleen and stomach syndrome group and the healthy control group were different in the PCA score.In the PLS-DA score,the samples of both spleen and stomach model and healthy control group were significantly separated,indicating that the metabolic profile is different.And two kinds of different metabolites in the urine were found by VIP map.Finally,eight kinds of metabolites were identified as potential biomarkers of dampness-heat in the spleen and stomach syndrome: Hippurate?Taurine?Fucose?Glycerol?Trigonelline?Trimethylamine N-oxide?Creatine phosphate?Glucose.Compared with the healthy control group,the differential metabolites up-regulated in the dampness-heat in the spleen and stomach syndrome group were Taurine ? Fucose ?Glycerol?Trimethylamine N-oxide?Glucose.Downgraded metabolites: Hippurate?Trigonelline?Creatine phosphate.Conclusions1.From the classic study of Epidemic febrile disease and modern Chinese medicine,the overall trend of H.pylori gastritis dampness pathogenesis: retention of damp heat in the interior,physically declined and deteriorated,blood stasis formed gradually.2 H.pylori was the causative factor,which attributed to damp heat.H.pylori gastritis was more likely leading to dampness-heat in the spleen and stomach syndrome.H.pylori attack and its toxins gene type also closely related with the host's constitution,yang deficiency,qi deficiency,and phlegm-retention so that patients were more susceptible to the disease.H.pylori gastritis with syndrome of damp-heat and toxin and blood stasis,patients physically declined and deteriorated.3.The difference of metabonomics between dampness-heat in the spleen and stomach syndrome group and healthy control group suggested that there was an objective material basis for dampness-heat in the spleen and stomach syndrome.Chronic gastritis with dampness-heat in the spleen and stomach syndrome and gastric cancer with dampness-heat in the spleen and stomach syndrome metabolic had differences between two pathogenesis,but there was the pathogenesis of the disease.Pathogenesis was often earlier than the disease characterized.4 The advantage of Traditional Chinese Medicine was the development of the disease as a whole.There were constant illness cognition and individual patients selecting in different treatment.Revealing the disease pathogenesis of Traditional Chinese Medicine,especially for the disease transformation,the key treatment of the node had important clinical value. |
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