胃镜下慢性胃炎与中医辨证分型的相关性研究

Clinical study of the correlation between the mucosa changes of chronicgastritis in gastroscopy and typing of Traditional Chinese Medicine

[目的]研究胃镜下慢性胃炎(CG)与中医辨证分型的相关性。[方法]对476例门诊CG患者进行常规胃镜检查,辨证分型记录,均行幽门螺杆菌(Hp)检测及胃黏膜活检作出病理诊断。[结果]CG患者性别与辨证分型无关;患者年龄与辨证分型相关(P<0.05),年长者多见脾胃虚弱型;患者Hp感染与辨证分型无关;患者中慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、肠上皮化生(IM)、不典型增生(ATP)与辨证分型有关(P<0.05),坐标图显示CAG、ATP表现脾胃虚弱型,胃络瘀血型在坐标右上象限,IM表现胃阴不足型在坐标左上象限,CSG表现脾胃湿热型、肝胃不和型均在坐标左下象限。[结论]CG的微观变化与中医辨证结合使其诊断更臻完善,拓展了中西医结合诊治CG的新思路。

[Objective]To evaluate the correlation between the mucosa changes of chronic gastritis in gastroscopy and typing of traditional Chinese medicine. [Methods]Four hundred and seventy-six out-patients of chronic gastritis were taken gastroscopy and the different typing of traditional Chinese medicine according to ＂criterion＂ was recorded. All the patients were taken helicobacter pylori （Hp） test and gastric mucosa pathological diagnosis. [Results] The different sex of chronic gastritis was irrelevant with its types in TCM （P〉0. 05） ; there existed statistical difference between the young and elder patients （P〈0.05）, and in elders the insufficiency of both the spleen and stomach was common; chronic gastritis caused by Hp was irrelevant with its types in TCM （P〉0. 05）; chronic superficial gastric （CSG）, Chronic atrophic gastritis （CAG）, intestinal metaplasia （IM） and atypical delirium（ATP）of the chronic gastritis patients were relevant with its typing of TCM （P〈0.05. Coordinate frame showed. CAG and ATP which showed insufficiency of both the spleen and stomach, blood stasis in stomach-collaterals were in the top right corner of the coordinate frame; IM which showed insufficiency of stomach yin was in the top left corner; CSG which showed the type of damp-heat in the spleen and the stomach and the type of incoordination between the liver and the spleen were in the low left corner. [Conclusion ]The combination of the mucosa changes of chronic gastritis in gastroscopy and typing of traditional Chinese medicine makes the diagnosis of CG much more complete, and benefits to the diagnosis and therapy approach in CG in integrated traditional and western medicine area.