| Objective:To study the distribution of TCM syndromes of precancerous lesions of gastric cancer,and to explore the correlation between TCM syndromes of precancerous lesions of gastric cancer and serum PG,gastrin G-17,folic acid and CEA,so as to provide basis for clinical monitoring of the progress of precancerous lesions of gastric cancer and TCM guiding the treatment of precancerous lesions of gastric cancer.Methods:1.112 patients with chronic atrophic gastritis with intestinal metaplasia and/or intraepithelial neoplasia diagnosed by electronic gastroscopy in our hospital from February 2018 to February 2019 were selected as observation group and 30 healthy people as control group.2.Collect the four diagnostic information of the observation group and determine the TCM syndromes according to the TCM diagnostic criteria.3.The levels of serum PG,gastrin G-17,folic acid and CEA in the observation group and the control group were detected by ELISA and electrochemiluminescent immunoassay.The statistical database was established by SPSS24.0,and the difference was statistically significant with P<0.05.4.Combined with the clinical research results,the differences of serological indicators between the observation group and the control group were analyzed,and the differences of serological indicators between different syndrome types in the observation group were also analyzed.Results:1.112 cases of precancerous lesions of gastric cancer were 52 males(46.43%)and 60 females(53.57%).The ratio of males to females was 1:1.15.Thirty healthy controls were 13 males(43.33%)and 17 females(56.67%)with a male-to-female ratio of 1:1.31.In the precancerous lesion group,the youngest age was 28 years old and the oldest age was 74 years old.The youngest age in the control group was 32 years old and the oldest was 68 years old.There was no statistical difference in sex and age distribution between the two groups(P>0.05).2.The serum levels of PGI,PGR(PGI/PGII)and folic acid in precancerous lesions of gastric cancer were lower than those in control group(P<0.05),while the serum levels of PGII,gastrin G-17 and CEA were higher than those in control group(P<0.05).3.The duration of precancerous lesions of gastric cancer varies from 5 to 10 years.The most common risk factors are dietary factors(37.5%)and emotional factors(23.21%).Pathological results showed that 60 cases of chronic atrophic gastritis with intestinal metaplasia,accounting for 53.57%;21 cases of chronic atrophic gastritis with intraepithelial neoplasia,accounting for 18.75%;31 cases of chronic atrophic gastritis with intestinal metaplasia and intraepithelial neoplasia,accounting for 27.68%.4.Distribution of TCM syndromes of precancerous lesions of gastric cancer: 36 cases of Spleen-stomach damp-heat syndrome(32.14%),28 cases of Spleen-stomach weakness syndrome(25%),24 cases of liver-stomach disharmony syndrome(21.43%),15 cases of stomach collateral stasis syndrome(13.39%)and 9 cases of Stomach-yin deficiency syndrome(8.04%).The distribution of syndrome types from high to low is: spleen-stomach dampness-heat syndrome>spleen-stomach weakness syndrome>liverstomach disharmony syndrome>stomach collateral stasis syndrome>Stomach-yin deficiency syndrome.5.There was no significant difference in sex distribution among different syndromes of precancerous lesions of gastric cancer(P>0.05),but there was difference in age distribution(P<0.05).The damp-heat syndrome of spleen and stomach was more common in young group,and the weak syndrome of spleen and stomach was more common in middle-aged and old group.6.78 cases(69.64%)were positive for Hp and 34 cases(30.36%)were negative for Hp in precancerous lesions of gastric cancer.The infection rate of Hp was higher in spleen-stomach dampness-heat syndrome and spleen-stomach weakness syndrome(P<0.05).7.Spleen-stomach damp-heat syndrome and liver-stomach disharmony syndrome are mainly mild atrophy-mild intestinal epithelial metaplasia,spleen-stomach weakness syndrome and Stomach-yin deficiency syndrome are mainly moderate atrophymoderate intestinal epithelial metaplasia,while gastrointestinal stasis syndrome is mainly severe atrophy-severe intestinal epithelial metaplasia.8.The decrease of serum PGI level was found in spleen-stomach weakness syndrome,stomach collateral stasis syndrome and stomach yin deficiency syndrome(P<0.05);the increase of PGII level was found in spleen-stomach dampness-heat syndrome and spleen-stomach weakness syndrome(P<0.05);the decrease of PGR was found in spleen-stomach dampness-heat syndrome,spleen-stomach weakness syndrome and stomach collateral stasis syndrome(P<0.05);the increase of gastrin gastrin G-17 level was found in spleen-stomach dampness-heat syndrome(P<0.05);the decrease of folic acid Weakness syndrome and deficiency of stomach yin syndrome(P<0.05);elevated CEA level was found in stomach collateral stasis syndrome(P<0.05).Conclusions:1.Compared with the normal control group,the serum levels of PGI,PGR and folic acid in precancerous lesions of gastric cancer decreased,while the levels of PGII,gastrin G-17 and CEA increased.Combined detection of related indicators can monitor the progress of precancerous lesions of gastric cancer.2.The distribution of TCM syndromes of precancerous lesions of gastric cancer is in turn spleen-stomach dampness-heat syndrome,spleen-stomach weakness syndrome,liver-stomach disharmony syndrome,stomach collateral stasis syndrome and stomach yin deficiency syndrome.TCM syndromes are correlated with serum levels of PG,gastrin G-17,folic acid and CEA.Combining TCM syndromes with related indicators can better guide clinical diagnosis and treatment. |
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