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慢性萎缩性胃炎中医证型与胃粘膜象相关性研究*(PDF)

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

期数:
2018年03期
页码:
61-64
栏目:
临床研究
出版日期:
2018-12-15

文章信息/Info

Title:
Clinical Study on TCM Syndromes and Gastric Mucosa in Chronic Atrophic Gastritis
作者:
施文杰王艳袁成业干晓花
(南京中医药大学附属泰州市中医院,江苏 泰州 225300)
Author(s):
SHI Wenjie YUAN Chengye WANG Yan GAN Xiaohua
(Taizhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Taizhou 225300, China)
关键词:
慢性萎缩性胃炎 胃粘膜象 胆汁反流 脾胃湿热 Hp感染
Keywords:
chronic atrophic gastritis gastric mucosal image bile reflux dampness and heat of the spleen and stomachHp infection
分类号:
R259
DOI:
10.19288/j.cnki.issn.1000-2723.2018.03.014
文献标识码:
A
摘要:
目的通过结合胃镜粘膜象的微观特点,探讨慢性萎缩性胃炎的证型分布规律以及CAG中医辨证分型与组织病理改变 的关系,为临床治疗提供依据。方法选择诊断符合慢性萎缩性胃炎患者86例,对比观察5种证型患者萎缩部位、萎缩程度, 有无Hp感染,有无糜烂、出血点、胆汁反流,病理组织学检查是否有肠上皮化生改变。通过胃镜粘膜象与病理特点的表现 ,探讨两者之间的关系。结果各证型的萎缩程度分布有统计学意义(P<0.05)。各证型的萎缩部位分布无统计学意义 (P>0.05)。各证型的伴随病变分布有统计学意义(P<0.05)。两两比较得知,肝胃不和伴胆汁反流比例较其他证型有显 著性差异(P<0.01),脾胃湿热伴糜烂比例较其他证型有显著性差异(P<0.01)。各证型的肠上皮化生率无统计学意义 (P>0.05)。各证型的异型增生组间差异有统计学意义(P<0.05)。5种中医证型的Hp感染都有检出率,且无统计学意义。 结论该病的演变过程可能是肝胃不和、脾胃湿热、脾胃虚弱、胃阴不足、胃络瘀血,且病情逐渐恶化。肝胃不和证胆汁反 流的检出率为41.94%,明显高于其余4种证型。脾胃湿热证伴糜烂者检出率为60%,较其它4种证型明显升高。
Abstract:
Objective To investigate the distribution pattern of chronic atrophic gastritis and the relationship between CAG TCM syndrome differentiation and histopathological changes by combining the microscopic features of gastroscopic mucosa, provide further evidence for clinical treatment. Methods Eighty-six patients with chronic atrophic gastritis were selected for diagnosis. The atrophy sites, degree of atrophy, presence or absence of Hp infection, presence or absence of erosion, bleeding point, bile reflux, and pathological histology were observed. Epithelial metaplasia changes. The relationship between the two is discussed by the appearance of the mucosa and the pathological features of the gastroscope. Results There was a statistically significant difference in the degree of atrophy of each syndrome(P<0.05 ). There was no statistically significant difference in the distribution of atrophy sites of each syndrome (P>0.05). There was a statistically significant difference in the distribution of concomitant lesions of each syndrome(P<0.05). The comparison between the two groups showed that the ratio of liver and stomach discomfort with bile reflux was significantly different from other syndromes(P<0.01), and the proportion of spleen and stomach dampness with erosion was significantly different from other syndromes(P<0.01). There was no significant difference in the intestinal metaplasia rate of each syndrome type(P>0.05). The differences between the dysplasia groups of each syndrome type were statistically significant(P<0.05). There was a certain detection rate for Hp infection of five syndrome types, and there was no significant difference. Conclusion The evolution of the disease may be Liver and stomach disharmony, dampness and heat of the spleen and stomach, weakness of the spleen and stomach, deficiency of stomach yin and blood stasis of stomach, and the condition is gradually aggravated. The detection rate of bile reflux in liver-gastric disharmony was 41.94%, which was significantly higher than that in the other four syndromes. The detection rate of dampness and heat of the spleen and stomach was 60%, which was significantly higher than the other four syndromes.

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备注/Memo

备注/Memo:
收稿日期: 2018 - 05- 25 *
基金项目: 江苏省中医药科技基金项目(YB2015163)
第一作者简介: 施文杰(1982-),男,硕士,副主任中医师,研究方向:脾胃病的中医药治疗。E-mail:webshiwenjie@126.com
更新日期/Last Update: 2018-12-30