【摘要】 目的探究腹泻型肠易激综合征(D-IBS)重叠胃食管反流病(GERD)患者血浆中脑肠肽水平的变化以及与中医证型之间的关系。方法以80例D-IBS重叠GERD患者为研究对象,以30例单纯D-IBS、30例单纯GERD及20例健康人为对照组,检测其血浆中饥饿素(Ghrelin)、瘦素(Leptin)、降钙素基因相关肽(calcitonin gene-related peptide,CGRP)、神经肽Y(neuropeptide Y,NPY)的水平。结果与健康组相比,重叠证组患者血浆Leptin、NPY水平均显著降低(P <0. 05)、CGRP水平显著升高(P <0. 01);单纯D-IBS组患者血浆NPY、Leptin水平显著降低(P <0. 05、P <0. 01),CGRP水平显著升高(P <0. 01);单纯GERD组患者血浆Ghrelin水平下降(P <0. 05)、Leptin、CGRP水平显著升高(P <0. 05);与D-IBS重叠NERD组相比,D-IBS重叠RE组患者血浆CGRP水平显著降低(P <0. 05)。重叠证组患者中,肝气乘脾证组血浆Leptin水平显著高于中虚气逆证组(P <0. 05),肝郁脾虚证组血浆NPY、CGRP水平显著高于脾胃虚弱证组(P <0. 05)。结论血浆NPY、Leptin、CGRP水平的变化与重叠证的发生发展有关;血浆CGRP水平的降低与食管粘膜受损有关;血浆Leptin、NPY和CGRP水平差异与中医分型有关。更多还原

【Abstract】 Objective To study the changes of plasma levels of brain-gut peptide and the correlation between TCM syndromes and brain-gut peptide of diarrhea-predominant irritable bowel syndrome( D-IBS) overlap gastroesophageal reflux disease( GERD). Methods Eighty patients of D-IBS overlapping GERD as the research objects,thirty pure D-IBS patients,thirty GERD patients and twenty healthy people as control group. Results Compared with the healthy group,the level of Leptin and NPY in plasma were significantly lower( P < 0. 05) and the level of CGRP was significantly higher( P < 0. 01) in the overlap syndrome group; In the pure D-IBS group,the level of NPY and Leptin were significantly decreased( P < 0. 05,P < 0. 01),the level of CGRP was increased significantly( P < 0. 01); In the pure GERD group,the level of Ghrelin in plasma was decreased significantly( P < 0. 05),the level of Leptin and CGRP were increased significantly( P < 0. 05). Compared to the patients D-IBS overlap NERD,the level of CGRP was significantly lower in patients of D-IBS overlap RE( P < 0. 05). In the overlap syndrome group,the level of Leptin by liver and spleen deficiency syndrome was significantly higher than that in the inverse gas group( P < 0. 05),the level of NPY and CGRP by liver stagnation and spleen deficiency of serum were significantly higher than that of spleen and stomach group( P < 0. 05). Conclusion The changes of NPY,Leptin and CGRP were related to the occurrence and development of the overlap syndrome. The decrease of plasma CGRP level was related to the damage of esophageal mucosa. The level of Leptin,NPY and CGRP were related to the TCM syndrome types.更多还原