【摘要】 目的:通过观察胃黏膜c-myc DNA甲基化水平在慢性萎缩性胃炎(CAG)不同中医证型间的差异,探讨中医证型与癌基因之间的关系,寻求这些差异产生的可能原因。方法:(1)根据纳入标准,选取180例内镜和病理组织学诊断为CAG患者进行中医辨证分型;(2)C-14幽门螺旋杆菌(helicobacter pylori Hp)检测;(3)采焦磷酸测序法检测72例患者胃黏膜中的c-myc DNA甲基化表达。(4)分析不同中医证型的c-myc DNA甲基化水平差异及其相关性,分析CAG不同中医证型及甲基化与Hp感染的相关性。结果:(1)c-myc基因甲基化率在CAG中医各证型间呈显著性差异(P<0.01),且各证型中c-myc基因甲基化率由高到低依次是胃热伤阴>瘀毒内阻>痰湿凝结>脾胃虚寒>气血双亏>肝胃不和。与肝胃不和组比较,痰湿凝结、胃热伤阴、瘀毒内阻组差异有统计学意义(P<0.05);与脾胃虚寒组比较,胃热伤阴、瘀毒内阻组差异有统计学意义(P<0.05);与气血双亏组比较,痰湿凝结、瘀毒内阻组,差异有统计学意义(P<0.05)。(2)CAG中医各证型c-myc基因甲基化与Hp感染比较差异无统计学意义(P>0.05),CAG中医各证型间Hp感染比较差异有统计学意义(P<0.05),各证型Hp感染由高到低依次是肝胃不和>痰湿凝结>瘀毒内阻>胃热伤阴>脾胃虚寒>气血双亏。结论:(1)c-myc DNA甲基化率与CAG中医各证型有一定相关性。(2)CAG不同中医证型Hp表达存在差异,且实证阳性感染率较虚证更高,中医各证型c-myc DNA甲基化与Hp感染无明显相关性。更多还原

【Abstract】 Objective: By observing the c- myc DNA levels of oncogenes genes in different TCM syndromes to find out the possible causes of the differences between them to provide theoretical basis for the early Chinese medical and herbal intervention to reverse DNA methylation and to prevent the worsening of diseases. Method:( 1) 180 patients diagnosed as chronic atrophic gastritis by endoscopy were chosen based on the inclusion and exclusion criteria for TCM syndrome differentiation.( 2) C- 14 Helicobacter pylori( Hp) test.( 3) Pyrophosphoric acid sequencing on 72 patients was used to detect the c- myc DNA methylation.( 4) Statistical analysis was done to determine the methylation levels of c- myc DNA to determine the correlation between different TCM syndromes of chronic atrophic gastritis and the Hp infection. Result:( 1) The c- myc DNA methylation rates in different TCM syndromes of chronic atrophic gastritis showed statistically significant differences( P < 0. 01) and the c- myc DNA methylation rates in the syndromes were stomach heat impairing yin> stasis toxin stagnation > phlegm- dampness coagulation > deficiency- cold in spleen and stomach > deficiency of qi and blood > liver- stomach disharmony. The differences between the phlegm- dampness coagulation group,the stomach heat impairing yin group,the stasis toxin stagnation group and the liver- stomach disharmony group and the differences between the stomach heat impairing yin group and the stasis toxin stagnation group and the deficiency- cold in spleen and stomach group and the differences between the phlegm- dampness coagulation group and the stasis toxin stagnation group and the deficiency of qi and blood group were statistically significant( P < 0. 05).( 2) Based on each TCM syndrome ofchronic atrophic gastritis,the difference between c- myc DNA methylation rates and Hp infection was of no statistical significance( P > 0. 05). The differences in Hp infection between the different TCM syndromes of chronic atrophic gastritis were statistically significant( P < 0. 05). The Hp infection severity in the syndromes was liver- stomach disharmony >phlegm- dampness coagulation > stasis toxin stagnation > stomach heat impairing yin > deficiency- cold in spleen and stomach > deficiency of qi and blood. Conclusion:( 1) C- myc DNA methylation shows statistically significant differences in different TCM syndromes of chronic atrophic gastritis.( 2) The differences in Hp infection between the different TCM syndromes of chronic atrophic gastritis are statistically significant. Based on each TCM syndrome of chronic atrophic gastritis,the differences between DNA methylation rates and Hp infection are of no statistical significance.更多还原