200例胆汁反流性胃炎患者中医证候分布特点研究

The study of Chinese medicine syndrome distribution characteristics of bile reflux gastritis in 200 cases

目的 探讨胆汁反流性胃炎的中医临床证候分布情况.方法 运用临床流行病学的方法,收集200例符合研究条件的胆汁反流性胃炎患者的临床资料,并对其进行统计学因子分析.结果 ①本组胆汁反流性胃炎患者女性居多,年龄在40～49岁和50～59岁者居多,病程分布以1～5年比例最高.②发病与患者的饮食习惯、情志因素及既往患有肝胆疾病有一定的关系.③有寒热错杂并脾胃虚弱、脾胃湿热、肝胃郁热、肝胃气滞、胆热犯胃、肝胃郁热并胆热犯胃、肝胃郁热并气郁痰阻共7个证候因子.结论 胆汁反流性胃炎的病位在胃胆,与肝脾关系密切.病性为虚实夹杂,虚证为脾胃虚弱、运化无力;实证为肝失疏泄、胆胃不和、胃气上逆,或邪热湿浊、蕴阻中焦、胃腑滞满、胃挟胆逆.

Objective To discuss the Chinese medicine syndrome distribution of bile reflux gastritis （BRG）. Methods According to clinical epidemiology, 200 cases of BRG patients were involved in this study and the clinical data were analysed with factor analysis. Results ① Women were easier to develop BRG, especially the women aged 40~49 and 50-59, who has developed BRG for 1-5 years. ② The mobidity had correlation with dietary habits, emotional condition and history of liver or gall disease. ③ There were seven syndromes in this study, including cold-heat complex combined weakness of spleen and stomach, dampness and heat of spleen and stomach, heat inthe liver and stomach, qi stagnation of the liver and stomach, gall heat invading the stomach, depression-heat in liver and stomach combined gall heat affected the stomach, heat in the liver and stomach combined phlegm obstruction caused by qi stagnation. Conclusion The stomach and gall are the disease location of BRG, which has a correlation with the liver and spleen. Deficiency complicated with excessiveness is the nature of BRG, deficiency refers to the weakness of spleen and stomach, and unable to transportation and transformation; while the excessiveness means adverse rising of stomach qi induced by liver dysfunction and imbalance between gall and stomach, or accumulate resistence of pathogenic heat and dampness which causes the stomach retardant.