慢性萎缩性胃炎浊毒内蕴证与胃镜像-胃黏膜病理改变相关性探讨

Research on the Correlation Between Gastroscope Image and Pathological Performance with Turbidity-Toxin Brewing Internally Syndrome of Chronic Atrophic Gastritis

目的:观察慢性萎缩性胃炎浊毒内蕴证患者胃镜像及其病理学表现,探讨浊毒证胃镜像与病理的相关性。方法:入选的慢性萎缩性胃炎浊毒证患者99例,由专职医师进行胃镜检查和组织活检,记录其内镜下形态学表现,比较其胃镜像与病理学表现。结果胃镜下的各种表现对应病理诊断的各种比较,在统计学方面没有意义(P>0.05),因此胃镜下的所有表现对应的病理学诊断的阳性率我们不认为有区别。本研究发现对病理学诊断有萎缩的,胃镜像正确率最高的是结节状,为60.50%;对病理学诊断有肠上皮化生的,胃镜像正确率最高的是黏膜粗糙,为89.43%;对病理学诊断有异型增生的,胃镜像正确率最高的是结节状为64.31%。结论:胃镜和病理检查是目前诊断CAG的最好方法,CAG浊毒证在胃镜下有多样的表现,胃镜下的任何一种表现都不能肯定或否定CAG浊毒证在病理学诊断中的任何一项,病理检查的微观辨病、胃镜表现与中医宏观辨证相结合才能得到正确的诊断。当出现异型增生、萎缩、肠化的诊断中的一项,或兼而有之时,可决定CAG的诊断,所以当发现结节状改变在胃镜下出现时和(或者)黏膜粗糙时,对诊断CAG浊毒证有着重大意义,当引起高度重视。

Objective： To observe Chronic atrophic gastritis（ CAG） turbidity-toxin brewing internally syndrome patients gastroscopy image and pathological performance,and disscuss the correlation of CAG turbidity toxin syndrome gastroscopy image and pathological performance. Methods： Select 95 cases of patients with CAG turbidity toxin syndrome,gastroscopy and biopsy by full-time physicians,record its endoscopic morphology,compare the gastroscopy and pathology manifestations. Results： All sorts of corresponding pathologic diagnosis under gastroscope,not in terms of statistical significance（ P〉0. 05）,Therefore all performance under gastroscope corresponding pathology diagnosis positive rate had no difference. This study found that shrinking to the pathology diagnosis,gastroscope highest accuracy was nodular,60. 50%. For pathological diagnosis of intestinal metaplasia,gastroscope highest accuracy was rough mucosa,89. 43%. For pathological diagnosis of hyperplasia,gastroscope highest accuracy was nodular64. 31%. Conclusion： Gastroscopy and pathological examination are the best way to diagnose the CAG. The CAG turbidity toxin syndrome under gastroscope performance diversity,any kind of gastroscope performance can not conclude or exclude the CAG turbidity toxin,correct diagnosis depended on the macroscopic syndrome differentiation of traditional Chinese medicine combined with endoscopy and microscopic disease pathologic examination,When pathological diagnosis atrophy with hyperplasia or both,to diagnose the CAG is decided to significance,so when the gastroscope performance nodular changes and（ or） mucosa is rough which is of great significance to the CAG turbidity toxin syndrome diagnosis,should be taken into consideration seriously.