慢性萎缩性胃炎证候证素分布及用药规律研究

Retrospective Study on the Distribution of Syndrome Type and Syndrome Elements and Medication Rules of Chronic Atrophic Gastritis

目的:分析慢性萎缩性胃炎的证候证素分布特点及用药规律,为中医药改善甚至逆转胃黏膜萎缩提供参考依据。方法:收集整理慢性萎缩性胃炎有效门诊病例,通过建立数据库对纳入病例的性别、年龄、中医证型、证素和常用药物进行统计分析。结果:(1)共纳入病例286例,其中男性119例(41.61%),女性167例(58.39%),女性多于男性,年龄18~85岁,以50~59年龄段患者最多(79例)。(2)中医证型7种,频次最高的3种证型依次为脾胃气虚证、胃络瘀血证和肝胃气滞证。(3)病位证素3个,包括胃、脾、肝;病性证素7个,出现频次前3位为气虚、血瘀、气滞。(4)涉及中药137味,中药使用频数前5位为白术、党参、半夏、陈皮、肉桂。结论:脾胃气虚为慢性萎缩性胃炎发展过程中的核心病机,气虚、血瘀和气滞是其重要病理因素,治疗上以顾护脾胃正气为主,兼以通降气机。

Objective:To analyze the distribution of syndrome type,syndrome elements and medication rules of chronic atrophic gastritis,so as to provide reference for improving or even reversing gastric mucosa atrophy with traditional Chinese medicine.Methods:Effective outpatients with chronic atrophic gastritis were collected,and the gender,age,syndrome type,syndrome element and drugs of the patients were statistically analyzed by establishing a database.Results:(1)A total of 286 cases were included,including 119 males(41.61%)and 167 females(58.39%).Females were more than males,aged 18-85 years,with the most patients aged 50-59(79 cases).(2)There were seven syndrome types,and the three syndrome types with the highest frequency were spleen-stomach Qi deficiency syndrome,gastric collateral-blood stasis syndrome and liver-stomach Qi stagnation syndrome.(3)There were three disease-location syndrome elements,including stomach,spleen and liver;There were seven disease-nature syndrome elements,and the top three were Qi deficiency,blood stasis and Qi stagnation.(4)137 TCM herbs were involved,and the herbs with high frequency were Atractylodes atractylodes,Codonopsis pilosula,Pinellia,Tangerine peel and cinnamon.Conclusion:Qi deficiency of spleen and stomach is the core pathogenesis in the development of CAG.Qi deficiency,blood stasis and qi stagnation are the important pathological factors of CAG.The treatment is mainly to care for the spleen and stomach qi,and to reduce qi machine.