反流性食管炎胃镜分级与中医证型的关联性研究

Relevance Research on Gastroscopic Grades of Reflux Esophagitis and Syndrome Types of Traditional Chinese Medicine

目的：探讨反流性食管炎（RE）食管黏膜在胃镜下的分级与中医辨证分型的关联性。方法：对151例符合观察条件RE患者根据临床症状及体征进行中医辨证分型,分为4组,并对其食管黏膜根据洛杉矶标准进行分级。结果：151例RE患者中医证型分布为肝胃不和占35.10%（53/151,95%CI=27.49%～42.71%）,肝胃郁热占40.40%（61/151,95%CI=32.57%～48.22%）,痰瘀交阻占11.26%（17/151,95%CI=6.22%～16.30%）,脾胃虚弱占13.25%（20/151,95%CI=7.84%～18.65%）;其中肝胃不和与肝胃郁热分别与痰瘀交阻及脾胃虚弱进行比较（95%CI不重叠,P〈0.05）,差异有显著性意义。151例RE患者中医证型与胃镜分级比较（χ^2=18.552 0,f=3,P〈0.01）,差异有显著性意义;组间比较,肝胃不和与肝胃郁热的胃镜分级低于脾胃虚弱组（P〈0.05）。结论：反流性食管炎的中医证型分布之间存在差异;反流性食管炎中医证型与胃镜分级之间存在差异。

Objective： To investigate the relevance between gastroscopic grades of reflux esophagitis（ RE） and syndrome differentiation classification of traditional Chinese medicine. Methods： 151 cases of RE patients who met viewing conditions were divided into 4 groups on the basis of syndrome differentiation classification of traditional Chinese medicine according to their clinical symptoms and signs,and graded their mucous membrane of esophagus according to Los Angeles criterion. Results： The distribution of syndrome types of traditional Chinese medicine in151 cases of RE patients ： liver-stomach disharmony was 35. 10%（ 53 /151,95% CI = 27. 49% ～ 42. 71%）,intense heat of liver and stomach was 40. 40%（ 61 /151,95% CI = 32. 57% ～ 48. 22%）,intermingled phlegm and blood-stasis was 11. 26%（ 17 /151,95% CI = 6. 22% ～ 16. 30%）,spleen-stomach weakness was 13. 25%（ 20 /151,95% CI = 7. 84% ～ 18. 65%）; compared intense heat of liver and stomach,liver-stomach disharmony with intermingled phlegm and blood-stasis and spleen-stomach weakness separately,95% CI values did not overlap（ P〈0. 05）,the difference was significant. Compared syndrome types of traditional Chinese medicine in 151 cases of RE patients with gastroscopic grade（ χ^2= 18. 552 0,f = 3,P〈0. 01）,the difference was significant; compared between groups,the gastroscopic grades of intense heat of liver and stomach and liver-stomach disharmony were lower than of spleen-stomach weakness（ P〈0. 05）. Conclusion： The distribution of syndrome types of traditional Chinese medicine in RE patients revealed a significant difference; The distribution of syndrome types of traditional Chinese medicine in RE patients was different from gastroscopic grades.