目的：观察慢性萎缩性胃炎(简称CAG)中医常见辨证分型中胃黏膜组织p53蛋白的表达水平，探讨中医各证型之间在细胞生物学水平上有无差异，探索其是否可以作为CAG中医辨证分型的客观指标之一。方法：将CAG患者90例按照中医辨证分型标准进行分型，选择其中病例数较多的3个证型共71例分为3组，胃镜下采集3组患者病变胃黏膜组织，并记录Hp感染情况，同时检测胃黏膜组织p53蛋白的表达情况。结果：CAG 3个中医证型组Hp阳性与Hp阴性组比较p53阳性表达情况均无显著性差异(P＞0.05)；p53阳性表达率3个证型组间比较有显著性差异(P＜0.05)，且阳性表达率在脾胃湿热型、脾虚气滞型、胃阴不足型3个证型中逐渐递增。结论：检测p 53的表达可作为中医辨证分型的参考指标，并能协助指导临床诊断及治疗。%Objective: To observe the expression level of gastric mucosa p53 of different TCM patterns com-monly seen from chronic atrophic gastritis (CAG) patients in clinic to investigate whether there were differences in the patterns from the perspective of cytobiology and whether the differences could be one of the objective indexes for classifying the CAG patterns. Methods: According to the classification standard, 90 CAG patients were classified into different TCM patterns, among which 3 types of patterns with more cases (overall 71 cases) were selected to be randomly divided into 3 groups. Gastric mucosa tissues with pathological changes were collected under gastroscope, Hp infectious conditions were recorded and at the same time the expression levels of gastric mucosa p53 were de-tected. Results: Among the three groups, the positive expression level of p53 in the comparison of Hp positive group and Hp negative group had no significant difference(P>0.05); the positive expression rates of p53 in three groups with three types of patterns had significant difference (P<0.05) and the rates orderly increased in the pattern of dampness-heat accumulation in spleen and stomach, the spleen-deficiency andQi-stagnation pattern as well as the pattern of spleen-Yindeficiency. Results: The expression levels of p53 detected can be used as the indexes for the classification of CAG in TCM to assist the clinical diagnosis and treatment.
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