慢性胃炎常见中医证候及证候要素的文献分析

The Study of Literatures on Common Syndromes and Syndrome Factors of Chronic Gastritis

目的探讨慢性胃炎(chronic gastritis,CG)常见中医证候和证候要素的分布特点。方法检索1979-2014年有关CG中医辨证的文献,建立数据库,进行统计分析。结果文献中共获取87个原貌证候类型,经过证候规范后归纳为41个证候类型。出现频率≥5%的证候依次为肝胃不和、脾虚气滞、脾胃湿热、脾胃虚寒、胃络瘀血、寒热错杂。对CG的3种常见类型(慢性浅表性胃炎、慢性糜烂性胃炎和慢性萎缩性胃炎)的证候进行二次统计发现,慢性浅表性胃炎与慢性糜烂性胃炎二者的常见证候类型基本一致,以实证(肝胃不和、脾胃湿热、寒热错杂、痰湿内结)为主;慢性萎缩性胃炎中,虚证(脾胃虚寒、胃阴不足)亦多见。提取CG证候要素16个,其中病位类证候要素4个[胃(络)、脾、肝、中焦];病性类证候要素12个,其中病性类证候要素出现频率≥5%分别是气滞、热(火)、湿、虚寒、血瘀、阴虚。慢性浅表性胃炎和慢性糜烂性胃炎证候要素中主要为湿、热、气滞,出现频率≥15%。慢性萎缩性胃炎以气滞、虚寒、热、湿、瘀血为主。结论 CG临床辨证分型复杂多样,而证候要素相对简约,从构成证候的要素入手对本病进行常见证候的研究,可起到执简驭繁的作用。

Objective To investigate the distribution characteristics of common TCM syndromes and syndrome factors of chronic gastritis （CG）. Methods The literatures were selected from 1979 to 2014 through retrieval and then a database was established and analyzed statistically. Results 87 original syndrome types were extracted from the literatures, and there were 41 syndrome types after the standardization of the syndromes. Symptom frequency I〉5% were liver and stomach disharmony, spleen defi ciency and qi stagnation, dampness - heat of spleen and stomach, spleen -stomach weakness, blood stasis of stomach meridian, cold-heat complicated. The syndromes in three types of chronic gastritis （chronic superficial gastritis, chronic erosive gastritis and chronic atrophic gastritis） were analyzed statistically for the second time and the results showed that the common syndrome types of chronic superficial gastritis and chronic erosive gastritis were basically consistent, they were mainly empirical （liver and stomach disharmony, dampness-heat of spleen and stomach, cold-heat complicated, Phlegm dampness）. Deficiency （deficiency cold of spleen-stomach, deficiency of stomach yin） in chronic atrophic gastritis is frequently. From the literatures we extracted 16 chronic gastritis syndrome elements, of which 4 were the syndrome elements of disease location （stomach （channel）, spleen, liver, middle-jiao）; the other 12 were the syndrome elements of disease nature frequency, which is equal to or more than 5% were qi stagnation, heat （fire）, dampness, deficiency-cold, blood stasis, deficiency of yirL The dampness, heal, qi stagnation were the main disease nature of chronic superficial gastritis and chronic erosive gastritis, and their frequency of occurrence were greater than or equal to 15%. But qi stagnation, deficiency-cold, heat, dampness, blood stasis were the main syndrome in CG. Conclusion The syndrome types of CG are complicated in clinic, and syndrome factors are relatively simple. The study on common syndromes of a disease based on syndrome factors plays the role from the simple to the complex.