The Improvement Of "Salivary Amylase Load Test" Determination And Application For Micro-differentiation Of Spleen Deficiency Syndrome

[Objective]The significance of "salivary amylase load test" in the modern research for spleen deficiency syndrome has been recognized by the academic community. This article attempts to test the traditional method of testing some improvements to improve its clinical feasibility in order to better diagnosis and treatment for the spleen of research services; the same time through the trial basis in the basic state and non-synchronous condition compared spleen deficiency in patients initially confirmed that non-basic state can also show the ratio of salivary amylase activity decreased spleen nature.[Method]1,Study of Guangzhou University of Traditional Chinese Medicine Department of Gastroenterology, First Affiliated Hospital, outpatient and ward treatment of chronic gastritis, peptic ulcer patients with spleen deficiency by the TCM group and non-spleen-deficiency were divided into groups and set up the control group;2, These three groups were simultaneously detected in the basal state (no activity after the early morning wake up, quiet and fasting) and non-basal (morning quiet and fasting, can have normal activity) under the acid stimulation of salivary amylase activity before and after, and calculate the activity ratio (acid stimulated activity/acid stimulation activity), respectively in each group statistical comparisons between the data, while four diagnostic information fill out the registration form;3, All the data application SPSS 13.0 for Windows statistical software to analyze the data, including t test was used to compare measurement data, count data were compared with chi-square test, using rank correlation analysis, the symptoms and indicators, correlation analysis. [Results]1, Qi Deficiency group basal state and non-basic acid stimulation than salivary amylase activity was significantly decreased acid stimulation, activity of acid before and after stimulation were significantly different (P<0.05), non-spleen-deficiency group and the healthy control group foundation in the basic state of the state and non-acid stimulation of salivary amylase activity before stimulation were higher than the trend of acid, but the enzyme activity before and after acid stimulation was no significant difference.2, These three groups based on both the baseline state or acid stimulation of salivary amylase activity was no statistically significant difference (P> 0.05); spleen spleen group and non-state groups or between the base non-basic state activity after acid stimulation were significantly different than (P <0.05); above baseline between the three groups based on state or non-acid ratio of activity before and after stimulation were significantly different (P<0.05).3, Three groups based on the basis of state and non-state activity ratios compared with methods from the diagnostic test to see up to 96.55% sensitivity and specificity was 87.10%,91.67% accuracy, positive predictive value of 0.875 the negative predictive value 0.8710, and positive likelihood ratio was 7.483, and negative likelihood ratio was 0.0396; The results show that the activity of non-basic state, a high sensitivity to changes in the ratio.4, Qi Deficiency group and the occurrence rate of some of the major symptoms: tongue pale, while there are teeth marks (90.0%), epigastric pain, thermophilic hi press (70.0%), abdominal distention (50.0%), physical weary (45.0%) and body weight sleepiness (45.0%), thin veins (45.0%), anorexia (40.0%). Some of the major symptoms of spleen qi deficiency and experimental group Correlative analysis showed that patients with spleen-deficiency "epigastric pain, thermophilic hi press the" probability of onset of symptoms at baseline and non-basic state are related to the ratio of salivary amylase activity was positively correlated.[Conclusion]1, Based on state, group of patients with spleen acid stimulation significantly decreased salivary amylase activity, indicating that the spleen in patients with baseline parasympathetic stress under low capacity, the nature of the phenomenon of reduced digestive function, consistent with previous findings. In the non-basic state, the spleen in patients after acid stimulation of salivary amylase activity also decreased significantly, the trend of activity with the baseline results are basically consistent with the determination of the initial spleen deficiency in patients with confirmed non-basic state as digestive dysfunction, parasympathetic hyperfunction and stress capacity is low.2, Spleen-deficiency group, non-spleen-deficiency group and the healthy control group in the basic state and non-basic state before and after acid stimulation of salivary amylase ratio analysis shows differences between the groups, "salivary amylase load test" on the basis of the above non-state can also reflect changes in characteristics of spleen.3, Three groups based on the state of non-diagnostic gold standard test, compared with the baseline state, highly sensitive diagnostic test, suggesting that non-basal salivary amylase activity was measured as the ratio can be used as indicators of spleen deficiency syndrome diagnosis4, Spleen-deficiency patients, "epigastric pain, thermophilic hi by" The incidence of symptoms of Basic and non-basic state are related to the ratio of salivary amylase activity was positively correlated, suggesting that the higher the ratio of salivary amylase activity (in the ratio<1.0 cases), epigastric pain symptoms appear higher probability.