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慢性萎缩性胃炎中医证型与胃镜、胃黏膜病理及幽门螺旋杆菌感染的相关性研究(PDF)

《云南中医学院学报》[ISSN:1000-2723/CN:53-1048/R]

期数:
2016年05期
页码:
57-61
栏目:
临床研究
出版日期:
2016-10-10

文章信息/Info

Title:
The Research of the Relevance of TCM Syndromes of CAG Patients with Gastroscopy, Gastric Mucosal Pathology and H. pylori Infection
作者:
艾春花1黄铭涵2
1. 福建省宁化县中医院,福建 宁化 365400;2. 福建中医药大学附属第二人民医院,福建 福州 350003
Author(s):
AI Chunhua1 HUANG Minghan2
1. Ninghua Hospital of Traditional Chinese Medicine of Fujian Province, Ninghua 365400, China;2. The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou 350003, China
关键词:
慢性萎缩性胃炎 中医证型 胃镜 胃黏膜病理 幽门螺旋杆菌感染 相关 临床研究
Keywords:
CAG TCM syndromes gastroscopy gastric mucosal pathology H. pylori infection correlation clinical research
分类号:
R259
DOI:
10.19288/j.cnki.issn.1000-2723.2016.05.015
文献标识码:
A
摘要:
目的〓探讨慢性萎缩性胃炎(CAG)患者中医证型与胃镜、胃黏膜病理及幽门螺旋杆菌(H.pylori)感染的相关性。方法〓随机抽取138例诊断为CAG的患者作为研究对象,进行中医证型调查,研究各证型分布特点及与性别、年龄、胃镜、胃黏膜病理、H.pylori感染之间的关系。结果〓(1)中医证型分布以脾胃虚弱证最高,脾胃湿热证次之;性别脾胃湿热证男性居多,余证型以女性居多;平均年龄分布以胃络瘀血证最高。(2)各证型胃镜下表现,单纯性萎缩形态以脾胃虚弱证比例最高,伴糜烂及胆汁返流均以脾胃湿热证比例最高,伴黏膜内出血以胃络瘀血证比例最高。(3)各证型胃黏膜病理表现,经秩和检验比较,脾胃虚弱证总体萎缩情况最低,与肝胃不和证、脾胃湿热证、胃络瘀血证比较均差异显著(P<0.05或P<0.01),而以胃络瘀血证萎缩比例最高,伴肠化和异型增生比例也最为严重。(4)H.pylori总感染率为47.8%,各证型中以脾胃湿热证感染率最高达69.4%,与胃阴不足证、脾胃虚弱证差异显著(P<0.05或P<0.01)。结论〓CAG患者中医各证型分布规律,与性别、年龄、电子胃镜及胃黏膜病理特点,以及H.pylori感染等因素存在一定相关性,该研究对临床辨证论治及预防CAG进展有积极意义。
Abstract:
Objective To explore the relevance of TCM syndromes of CAG patien 216842ts with gastroscopy, gastric mucosal pathology and H. pylori infection. Methods One hundred and thirty-eight diagnosed CAG patients were randomly selected as the research subjects so as to investigate their TCM syndromes as well as study the relationship of the distribution characteristics each syndrome with gender, age, gastroscopy, gastric mucosal pathology and H. pylori infection. Results 1. The highest distribution percentage of TCM syndrome was reported in deficiency of the spleen and stomach, followed by spleen-stomach damp-heat syndrome;most cases of spleen-stomach damp-heat syndrome were males, while females were mainly affected by the rest syndromes;the highest average age was distributed in stagnated blood of stomach meridian syndrome. 2. Subject to the endoscopic manifestations of various syndromes, the highest percentage of simple atrophy morphology was reported in deficiency of the spleen and stomach syndrome, the highest percentage of accompanied erosion and bile reflux in spleen-stomach damp-heat syndrome, and the highest percentage of accompanied mucosal entorrhagia in stagnated blood of stomach meridian syndrome. 3. According to the gastric mucosal pathological manifestations of various syndromes, rank sum test showed that deficiency of the spleen and stomach syndrome was associated with the least overall atrophy, which was significantly different compared with syndrome of disharmony between liver and stomach, spleen-stomach damp-heat syndrome and stagnated blood of stomach meridian syndrome(P<0.05 or P<0.01); of them, the highest percentage of atrophy was found in stagnated blood of stomach meridian syndrome, which was also associated with the highest percentage of intestinal metaplasia and dysplasia. 4. The overall infection rate of H. pylori was 47. 8%, where the highest infection rate(69. 4%) was found in spleen-stomach damp-heat syndrome, which was significantly different compared with stomach yin deficiency syndrome and deficiency of the spleen and stomach syndrome(P<0.05 or P<0.01). Conclusion The distribution law of TCM syndromes of CAG patients is correlated to a certain extent with gender, age, electronic gastroscopy, gastric mucosal gathological features, H. pylori infection and other factors. This study has positive significance both for the clinical diagnosis and treatment as well as the progress in CAG prevention.

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备注/Memo

备注/Memo:
* 基金项目: 福建省自然基金面上项目(2015J01403);福建省教育厅科研项目(JA15247);福建省卫计委青年基金项目 (2013-1-40) 收稿日期: 2016 - 07 - 16 作者简介: 艾春花(1966-),女,福建宁化人,副主任医师,主要从事中医内科临床与科研工作。△通信作者:黄铭涵,E-mail:huangminghan2010@163.com
更新日期/Last Update: 2016-10-10