胃黏膜异型增生虚实关联证证候结构特征研究与思考

Study on the Structural Characteristics of Xu-Shi Correlation Syndrome of Gastric Dysplasia

用标本理论辨析胃黏膜异型增生(Dys)的临床证候,其具有本虚标实相关联的结构特征。为了研究Dys虚实关联证证候结构,探讨其演变规律,判断各类别的癌变趋向,课题组建立起虚实关联证证候辨识系统数据库,多中心协作,将首诊选择的186例Dys患者临床症状体征信息资料,输入数据库进行辨识,初步分析结果显示:首诊病例75.27%属虚实标本关联证,且以主兼关联证居多,在一月后复诊时点上的个体化证候演化统计,转入单实证24例,多有饮食、劳倦、受寒等诱发因素,多因病情加重而就诊;转入单虚证16例,其中脾胃气虚、胃阴不足、气阴两虚证病情轻。表明Dys的证候具有本虚标实的结构特点,治疗Dys不能陷入非实即虚、非虚即实的证候选择之中。

Apply the TCM Biao- Ben theory to discriminate the clinical Syndromes of gastric dysplasia （Dys）, which were characterized with Ben - Xu Biao - Shi correlated structure. In order to study on the Dys Xu - Sift correlation structure,lnvestigate the evolving law of the TCM syndrome, and judge all types of cancer trends, the database of the Dys Xu - Shi correlation structure differentiation system was constructed,by the multi -center collaboration,select 186 Dys patients and input their clinical symptoms and signs information into the system database for identification. The preliminary result showed that the 75.27% first diagnosed Dys patients were Xu - Shi correlation syndrome cases and most of them belonged to the correlation syndrome of the major syndromes plus minor syndromes. According to the evolution statistics of the individual syndrome with follow-up one month later,24 cases became positive syndrome ,most of them were accompanied with the predisposing factors such as diet,fatigue, catching a chill etc and saw a doctor due to the disease getting worse; 16 cases converted into single deficiency syndrome and the syndromes of the Spleen - Stomach - qi - Xu, Stomach - yin - Xu, Qi - yin - Xu became light. The statistical results demonstrated that the characteristics of Dys Syndrome is Ben- Xu and Biao - Shi, and indicated that when treating the Dys ,it can not be trapped into the choice of single-Shi or single - Xu.