不同病因胆汁反流性胃炎中医证型横断面调查

Different Causes of Bile Reflux Gastritis Cross-Sectional Survey of TCM Syndrome Type

[目的]调查不同病因胆汁反流性胃炎中医证型。[方法]使用横断面调查方法,调查2011年3月至2012年3月福建省晋江市安海医院确诊为胆汁反流性胃炎患者。参照《证素辨证学》证素诊断标准,结合《中药新药临床研究指导原则》对症状轻、中、重程度定义,制定规范的四诊资料采集量表。患者入院确诊后即进行中医四诊资料规范化采集。规范数据采集环节,培训资料采集人员。设计统一调查表,建立调查档案。集观察对象症状、体征,在辨证四诊基础上,采用证素辨证方法辨证。[结果]符合初步纳入164例,排除14例,剩余150例;胆囊疾病50例,胃大部切除术后50例,不明原因50例。胆汁反流性胃炎病位证素主要为胃、脾、肝,病性证素积分从高到低依次为气滞、阳虚、气虚、湿、食积、血瘀、阴虚、血寒、血寒、热、寒、痰,频数分从高到低依次为气滞、湿、阳虚、气虚、食积、寒、热、血瘀、阴虚、痰、血寒、血虚。本病表现为虚中夹实,主以气虚、阳虚为本,并见气滞、湿困、食积实邪,可兼夹血瘀、寒邪、热邪、痰、血虚、血寒。[结论]病位证素:不明原因主要为脾、胃;胆囊疾病主要为脾、胃、肝、胆;胃大部切除术后主要为脾、胃、肝、胆。病性证素:不明原因主要为气滞、气虚、阳虚、食积、湿;胆囊疾病主要为气滞、湿、阳虚、热、寒、气虚;胃大部切除术后主要为气滞、湿、阳虚、气虚、血瘀、热、寒;三组间均主要为气滞、气虚、阳虚、湿,胃大部切除术后与胆囊疾病还同见寒、热证素,胃大部切除术后同时还存在血瘀证素。

[ Objective ] Investigate different causes of bile reflux gastritis, TCM syndrome type. [ Method ] Using cross-sectional survey method, in 2011 Marchto 2012 March in Fujian province Jinjiang city Anhai Hospital Department of internal medicine patient diagnosed with bile reflux gastritis patients were investigated. Refer to “learn” the syndrome differentiation of syndrome element diagnosis standard, combined with the “guiding principles of clinical research on new drugs of TCM symptoms of” light, heavy degree, definition, formulation standardized diagnostic data collection scale. Standard acquisitionnamely TCM diagnostic data of patients admitted to hospital after diagnosis.Specification for data acquisition link, through the training of clinical datacollection personnel to ensure the scientific and normative research data collection. Design of unified research questionnaire, establish files for each of the 1 cases of the observation object. Requires the collection object of observation of symptoms and signs, the four diagnostic methods in TCM basis, using the method of differentiation of syndrome element differentiation. [ Results ] The 164 patients met the inclusion criteria, 14 cases were excluded, the remaining 150 cases ; among the 50 cases of gallbladder disease, subtotal gastrectomy in 50 cases, 50 cases ef unknown reason. Bile reflux gastritissyndrome elements of disease location for the stomach, spleen, liver mainly, symptom factors of disease nature syndrome elements integral from high to low is stagnation of Qi, Yang and Qi, yin deficiency, blood stasis, wet, indigestion, cold blood, blood cold, heat, cold, phlegm, frequency respectively from high to low qi stagnation, dampness, Yang deficiency, Qi deficiency, indigestion, cold, heat, blood stasis, yin deficiency, blood deficiency, phlegm, blood cold. Show that the disease manifested as deficiency complicated with excess, the main deficiency of Qi, Yang deficiency,qi stagnation, dampnessand see the real evil, dyspeptic, can be accompanied with blood stasis, cold pathogen, pathogenic heat, phlegm, blood deficiency, blood cold. [ Conclusion ] The syndrome elements of disease location： unknown reasons mainly forspleen, stomach; gallbladder disease mainly spleen stomach, liver, gallbladder, ; subtotal gastrectomy for stomach, spleen, mainly liver, bile.Disease of syndrome elements： unexplained is Qi stagnation, Qi deficiency, Yang deficiency mainly, dyspeptic, wet; gallbladder disease is mainly qi stagnation, deficiency of Yang, cold, wet, heat, Qi deficiency; subtotal gastrectomy is mainly qi stagnation, dampness, deficiency of Yang, Qi deficiency, blood stasis, heat, cold ; three groups were mainly for thestagnation of qi deficiency of Qi, deficiency of Yang, wet, subtotal gastrectomyand gallbladder disease also with cold, heat syndrome element, after subtotal gastrectomy and also there is blood stasis.