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慢性萎缩性胃炎伴糜烂中医治疗后胃粘膜的变化与证型的相关性研究*(PDF)

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

期数:
2018年05期
页码:
15-20
栏目:
临床研究
出版日期:
2019-06-24

文章信息/Info

Title:
Research on the Relationship between the Changes of Gastric Mucosa and Syndromes after TCM Treatment of Chronic Atrophic Gastritis with Erosion
文章编号:
1000-2723(2018)05-0015-06
作者:
杨晶璐1时昭红1△张 书1胡 峰2
(1. 武汉市中西医结合医院,湖北 武汉 430022;2. 湖北中医药大学第一临床学院,湖北 武汉 430061)
Author(s):
YANG Jinglu1 SHI Zhaohong1 ZHANG Shu1 HU Feng2
(1. Wuhan Hospitol of Traditional Chinese and Western Medicine, Wuhan 430022, China, 2. Hubei University of Chinese Medicine, Wuhan 430061, China)
关键词:
慢性萎缩性胃炎 糜烂 辨证论治 胃粘膜 中医证型
Keywords:
chronic atrophicgastritis erosion syndrome differentiation treatment gastric mucosa TCM syndrome type
分类号:
R259
DOI:
10.19288/j.cnki.issn.1000-2723.2018.05.004
文献标识码:
A
摘要:
目的 观察不同证型慢性萎缩性胃炎伴糜烂中医辨证论治前后的胃粘膜内镜及病理的变化,探讨该病中医证型与胃粘膜变化的相关性,为临床诊治不同证型该病患者提供一定试验依据。方法 将68例慢性萎缩性胃炎伴糜烂患者辨证分为6个证型,脾胃虚弱证18例、肝胃郁热证16例、脾胃湿热证12例、胃阴不足证9例、肝胃气滞证8例、胃络瘀血证5例,予中医辨证治疗3月,比较治疗前后胃粘膜变化程度,并分析其与各证型的关系。结果 证型例数从多到少依次为:脾胃虚弱证(26.5%),肝胃郁热证(23.5%),脾胃湿热证(17.6%),胃阴不足证(13.2%),肝胃气滞证(11.8%),胃络瘀血证(7.4%);胃粘膜轻度萎缩以脾胃虚弱证最常见(88.9%,P<0.001),胃粘膜轻度肠上皮化生以脾胃湿热证最常见(91.7%,P<0.01),重度萎缩和重度肠上皮化生均以胃络瘀血证(100%、80%,P<0.05)最常见,胃粘膜I级糜烂以脾胃虚弱证(77.8%,P<0.05)最常见,IV级糜烂以脾胃湿热证(75.0%,P<0.05)最常见;脾胃虚弱证在中医治疗后胃粘膜萎缩程度积分变化最大(△=0.94±0.42,P<0.05),胃络瘀血证在中医治疗后胃粘膜肠上皮化生程度变化最大(△=1.80±0.45,P<0.05),脾胃湿热证在中医治疗后胃粘膜糜烂程度变化最大(△=1.67±0.49,P<0.05)。结论 慢性萎缩性胃炎伴糜烂中医治疗前后证型与胃粘膜的变化存在一定的相关性,可为临床诊治不同证型患者提供部分试验依据。
Abstract:
Objective To observe the changes of endoscopy and pathology of gastric mucosa before and after treatment of chronic atrophic gastritis with erosion in different syndromes and to explore the relationship between TCM syndromes of chronic atrophic gastritis with erosion and the changes of gastric mucosa, which provides evidence for clinical diagnosis and treatment of chronic atrophic gastritis with erosion. Methods 68 cases of chronic atrophic gastritis with erosion was divided into 6 TCM syndrome type: deficiency of spleen and stomach in 18 cases, stagnation of heat in liver and stomach in 16 cases, dampness and heat of spleen and stomach in 12 cases, deficiency of stomach and yin in 9 cases, stagnation of qi in liver and stomach in 8 cases, and blood stasis of stomach in 5 cases. All patients were treated with TCM syndrome differentiation for 3 months. Then compared the changes of gastric mucosa before and after treatment, and analyzed the relationship between the changes of gastric mucosa and the types of syndromes. Results The number of syndrome types was as follows: deficiency of spleen and stomach(26.5%), stagnation of heat in liver and stomach(23.5%), dampness and heat of spleen and stomach(17.6%), deficiency of stomach yin(13.2%), stagnation of qi in liver and stomach(11.8%), and blood stasis of stomach(7.4%). The most common type of mild atrophy of gastric mucosa was deficiency of spleen and stomach(88.9% P<0.001). The most common type of mild intestinal metaplasia of the gastric mucosa was dampness and heat of spleen and stomach(91.7%, P<0.01). The most common type of severe atrophy and severe intestinal metaplasia was blood stasis of stomach(100%, 80%, P<0.05). The most common type of erosion in grade I of gastric mucosa was deficiency of spleen and stomach(77.8% P<0.05). The most common type of erosion of grade IV was dampness and heat of spleen and stomach(75.0%, P<0.05). Spleen and stomach deficiency syndrome had the biggest change in the degree of gastric mucosal atrophy after TCM treatment(△=0.94±0.42, P<0.05). Blood stasis of stomach had the biggest change in the degree of intestinal metaplasia of gastric mucous membrane after TCM treatment(△=1.80±0.45, P<0.05). Spleen and stomach damp-heat syndrome had the biggest change in the degree of gastric mucosal erosion after TCM treatment(△=1.67±0.49, P<0.05). Conclusion Chronic atrophic gastritis combined with erosion has a certain correlation with the changes of gastric mucosa before and after TCM treatment, which can provide some basis for clinical diagnosis and treatment of different types of chronic atrophic gastritis with erosion.

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备注/Memo

备注/Memo:
收稿日期: 2018 - 09- 18 * 基金项目: 2014年中医药行业科研专项(201407001-12)
第一作者简介: 杨晶璐(1993-),女,在读硕士研究生,研究方向:中西医结合治疗消化系统疾病。
△通信作者: 时昭红,E-mail:zhaohshi@126.com
更新日期/Last Update: 2019-06-25