肝郁证各亚型与窄带成像内镜下Barrett食管相关性研究

Research on the Correlations between Narrow-band Imaging Endoscopy in the diagnosis of BE Differentiation and Each Subtype of Liver Depression Syndromes

目的:在窄带成像内镜(NBI)技术下观察Barrett食管(BE)肝郁证各亚型的分布,及其与NBI技术下分型的关系。方法:将经过内镜及病理确诊入组,并符合临床诊断和纳入标准的230例BE患者进行中医辨证分型,观察Barrett食管(BE)肝郁证各亚型的分布,采用对应相关分析方法,分析其与NBI技术下分型的关系。结果:NBI普通模式及放大模式分型中,岛型及pit-1、pit-2型多分布于肝郁证亚型中的肝胃不和、肝胃郁热、肝郁脾虚等亚型;而舌型、全周型及pit-3、pit-4、pit-5多分布于肝郁证亚型中的肝郁痰凝、肝郁血瘀、肝郁阴伤三个亚型。NBI普通模式及放大模式分型的分布规律与BE肝郁证及其各亚型症状轻重程度的排序相一致。结论:NBI内镜下BE分型与肝郁证及各亚型的关系:肝郁证以pit-1、pit-2型腺管开口为主,pit-1、pit-2型中以肝胃不和、肝胃郁热、肝郁脾虚三个亚型为主。

Objective：Liver depression in the patients with Barretfs esophagus （BE） and the distributions of each subtype were ob- served under the narrow band imaging （NBI） endoscopy, and the relationship with types of NBI endoscopy. Methods：The syndrome differentiation-typing in traditional Chinese medicine was performed on 230 BE patients receiving treatments. These patients which were diagnosed by endoscopy and pathology, and in accordance with inclusion criteria and diagnostic criteria. The purpose was to observe the liver depression in the BE patients and the distribution characteristics of each subtype under the narrow band imaging （NBI） endoscopy,to use corresponding related analytical method analyzing the relationship with types of NBI endoscopy. Results： Using NBI endoscopy to analyze the data. In the differentiation by the common and amplification modes of NBI, the island-type, pit-1 and pit-2 patterns were mostly distributed in the subtypes of liver depression such as liver-stomach disharmony, liver-stomach gloomy heat and liver-depression and spleen-deficiency; the tongue-type, circumferential-type distribution, pit-3, pit-4 and pit-5 were mostly distributed in other three subtypes of liver-depression, namely, phlegm-coagulation, liver-depression and blood-stasis, and liver-depression and YIN-deficiency. The distribution of subtypes by the common and amplification modes of NBI was consistent with the degree of each subtype of liver depression in the BE patients. Conclusion： The relationship between the BE differentiation and each subtype of liver depression under the NBI endoscopy： The pit-1 and pit-2 patterns were dominant in the liver depression,mainly including liverstomach disharmony,liver-stomach gloomy heat and liver-depression and spleen-deficiency.