慢性萎缩性胃炎患者中医证候分型与癌变风险的相关性

Correlation between Traditional Chinese Medicine Syndromes and Cancer Risk of Patients with Chronic Atrophic Gastritis

目的探讨与慢性萎缩性胃炎癌变风险相关的影响因素。方法收集经胃镜、病理确诊的慢性萎缩性胃炎患者180例,通过中医四诊收集患者的一般资料、中医症状、中医辨证分型及可操作的与胃癌风险相关的萎缩/肠上皮化生评估(OLGA/OLGIM)癌变风险分期。先进行单因素相关分析探讨性别、年龄、幽门螺杆菌(Hp)感染史、学历、体重指数(BMI)、吸烟史、饮酒史、家族肿瘤史、中医症状、中医证型与OLGA、OLGIM风险分期的相关性,进一步采用二元Logistic回归法分析独立危险因素。结果单因素相关性分析显示,Hp感染史、家族肿瘤史、中医证型与OLGA分期相关(P=0.013,P=0.010,P=0.006);Hp感染史与OLGIM分期相关(P=0.01)。二元Logistic回归分析显示,Hp感染史(OR=2.365,95%CI:1.055~5.302,P=0.037)及胃络瘀血证(OR=9.972,95%CI:1.637~60.743,P=0.013)可影响OLGA分期;Hp感染史可影响OLGIM分期(OR=3.017,95%CI:1.541~5.909,P=0.001)。结论Hp感染史、中医证型与慢性萎缩性胃炎患者癌变风险增高具有相关性,其中胃络瘀血证癌变风险高。

Objective To explore the influencing factors related to the risk of carcinogenesis of chronic atrophic gastritis.Methods A total of 180 patients with chronic atrophic gastritis diagnosed by gastroscopy and pathology were collected,and the general information,traditional Chinese medicine(TCM)symptoms,staging of cancer risk of operative link for gastritis assessment(OLGA)/operative link gastritis intestinal metaplasia assessment(OLGIM)(OLGA/OLGIM)related to the risk of gastric cancer were collected through the four diagnosis of TCM.Firstly,univariate correlation analysis was carried out to explore the correlation between gender,age,history of helicobacter pylori(Hp)infection,education,body mass index(BMI),smoking history,drinking history,family cancer history,TCM symptoms,TCM syndrome types and OLGA,OLGIM risk stage.Further analysis of independent risk factors was performed by using binary logistic regression.Results Univariate correlation analysis showed that Hp infection history,family cancer history,and TCM syndrome types were related to OLGA stage(P=0.013,P=0.010,P=0.006);Hp infection history was related to OLGIM stage(P=0.01).Binary Logistic regression analysis showed that the history of Hp infection(OR=2.365,95%CI:1.055~5.302,P=0.037)and syndrome of blood stasis in the stomach(OR=9.972,95%CI:1.637~60.743,P=0.013)could affect OLGA stage;Hp infection history can affect OLGIM stage(OR=3.017,95%CI:1.541~5.909,P=0.001).Conclusion The history of Hp infection and TCM syndrome types are associated with an increased risk of canceration in patients with chronic atrophic gastritis.Among them,the risk of cancer of syndrome of blood stasis in the stomach is high.