| Objective Chronic gastritis includes chronic non-atrophic gastritis and atrophic gastritis,and some non-atrophic gastritis gradually turns to atrophic gastritis.Chronic atrophic gastritis(cag)has a long course and no characteristic clinical manifestations.It often occurs with epigastric distension,epigastric pain,loss of appetite and emaciation,which are difficult diseases of the digestive system and also a kind of precancerous lesions of the stomach.Spleen and stomach in the damp heat syndrome is the clinical type of chronic atrophic gastritis,often witness,so this research using the metabonomics technology attempts to find the spleen and stomach syndrome of chronic atrophic gastritis,atrophic gastritis the change of the biological markers,interpretation of its metabolic pathway may change,from taste syndrome of chronic atrophic gastritis to atrophic gastritis syndrome with evolution of further analysis of chronic non atrophic gastritis to gastric cancer pathogenesis transformation law of precancerous lesions,evidence-based medicine of traditional Chinese medicine for prevention or truncation of chronic atrophic gastritis to atrophic gastritis to cancer and to provide evidence for the conversion of gastric cancer.Methods1.Theoretical research: consult ancient books,search knowledge network,wanfang,weipu and other databases,sort out the historical development of etiology and pathogenesis of heat and dampness,and sort out related contents of etiology,syndrome type distribution and pathogenesis transformation rules of chronic atrophic gastritis.2.Experimental study: from May 2018 to January 2019,120 cases of chronic atrophic gastritis were collected from the department of spleen and stomach,department of complicated diseases and other related departments of hubei provincial hospital of traditional Chinese medicine and wuhan hospital of integrated traditional Chinese and western medicine,and the informed consent was signed.About 10 ML of midmorning urine of patients with chronic atrophic gastritis who met the inclusion criteria were collected by urinary catheter,and the NMR spectra were collected.The data were analyzed by PCA(principal component analysis)and pls-da(partial least squares discriminant analysis).In addition,20 patients with chronic gastritis of damp-heat type of spleen and stomach(group A),20 patients with gastric cancer of damp-heat type of spleen and stomach(group C)and 20 patients in the healthy control group(group D)collected by Dr.Yina sun from the research group were used for comparison.Results1.Theoretical research results1.1 the internal cause of dampness-heat disease is deficiency of vital energy and wetness,and the external cause is hot and humid climate,low humidity in the region,raw,cold,fat and sweet diet.Of damp heat evil invasion medium,therefore,clinical rare taste hot and damp card,decided to damp and hot of pathogenic constitution violation,namely "gas in disease in Yang Ming,the deficiency of the disease in the lunar",wetlands for yinxu,painless,lingering damage sun be the spirit of hot for Yang,tianjin gas consumption,appear more hot and humid in delay day long qi and Yin deficiency,qi deficiency Jiao Yang,or into the collaterals blood poison.1.2 the main causes of chronic gastritis include eating disorders,internal transmission of external pathogenic factors,direct infection of pathogenic toxin(Hp infection),internal injury of emotions,chronic deficiency of the diseased body,etc.The pathogenesis of chronic gastritis mainly belongs to intrinsic deficiency and standard syndrome,deficiency is mostly weakness of spleen and stomach and deficiency of stomach Yin,while deficiency is mostly qi stagnation,dampness and heat,phlegm and dampness,food accumulation,blood stasis,turbid toxin,etc.Clinical common chronic atrophic gastritis in TCM syndrome type with spleen and stomach,liver with gastric collaterals syndrome,spleen and stomach syndrome,blood stasis resistance such as hot and humid,stomach Yin deficiency syndrome,chronic,atrophic gastritis overall development to the stage of atrophic gastritis syndromes exist from real to virtual evolution law,atrophic gastritis disease early more than liver stomach with certificate;The middle stage of the disease mostly belongs to the syndrome of damp-heat of spleen and stomach.In the later stage,it mostly belongs to gastric collaterosis and blood stasis syndrome.In addition,gastric collaterosis and blood stasis syndrome is more serious in intestinal metaplasia and dysplasia than other syndromes.2.Results of metabolomics study:2.1 General information: in terms of gender,there was no significant difference between the two groups after chi-square test,P>0.05.In terms of age distribution,one-way anova was used,P>0.05,and there was no significant difference between the two groups.BMI(body mass index)was analyzed by one-way anova,P>0.05,and no significant difference was found between the two groups.2.2 Results of metabolomics analysis Eight different metabolites were found in the comparison between the normal group and the chronic atrophic gastritis group with damp-heat type of spleen and stomach,among which the chronic atrophic gastritis group with damp-heat type of spleen and stomach:Carnitine(Carnitine)and Trimethylamine oxide(Trimethylamine N-oxide),Taurine(Taurine)content increased,glycerin(Glycerol),Trigonelline(Trigonelline),hippuric acid(Hippurate),acetyl(Acetoacetate),3-amino isobutyl acetate(3-Aminoisobutyrate)levels drop.The results of the comparison between the spleen and stomach damp-heat gastric cancer group and the chronic atrophic gastritis with intestinal metaplasia group,the spleen and stomach damp-heat gastric cancer group and the stomach collature-stasis chronic atrophic gastritis group showed that the different metabolites of the two groups were similar.A total of 12 identical differential metabolites were detected in the two comparison groups.Among them, Citrate,Glucuronate,Lysine,Histidine,Asparagine,N,n-nitrodimethylglycine and their contents were all increased in the gastric cancer group.Glycerin(Glycerol)and Fucose(Fucose),N-nitrosamines(N-Nitrosodimet),N-phenylacetyl glycine(N-Phenylacetylglycine),amino butyl 3-(3-Aminoisobutyrate),3-indole phenol sulfate(3-Indoxylsulfate)content in gastric cancer group decreased.Conclusions1.The pathogenesis of chronic atrophic gastritis with damp-heat syndrome of spleen and stomach generally exists the transformation from dampness to deficiency and from dampness to stasis.2.The difference between the metabolomics test results of the spleen and stomach damp-heat syndrome in chronic atrophic gastritis and the normal control group suggests that the spleen and stomach damp-heat syndrome has an objective material basis.3.The middle stage of chronic atrophic gastritis mostly belongs to damp-heat syndrome of spleen and stomach.Late onset multiple gastric collaterals blood stasis syndrome,gastric collaterals blood stasis syndrome in severe atrophy and intestinal metaplasia frequency is significantly higher than other syndromes,gastric cancer group and chronic atrophic gastritis with intestinal metaplasia and gastric cancer group and gastric collaterals blood stasis type of chronic atrophic gastritis metabonomics difference similarities also hint: chronic atrophic gastritis taste hot and humid,gastric collaterals blood stasis syndrome of transformation to a great extent in chronic atrophic gastritis moderate,severe contraction im(or with),the process of tip been promoting blood circulation to remove blood stasis therapy in the prevention and control of or truncation of chronic atrophic gastritis to atrophic gastritis and precancerous lesions to the process of the development of cancer of the stomach is of great significance. |
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