基于证素辨证的慢性胃炎胃黏膜糜烂证素特征研究

Characteristic research on syndrome factors of chronic gastric mucosal erosion based on syndrome factor differentiation

目的:通过证素辨证的方法,探讨慢性胃炎胃黏膜糜烂的主要证素分布特点,为慢性胃炎胃黏膜糜烂的中医病理变化特点提供参考依据。方法:将符合研究标准的914例患者按照内镜检查及病理活检结果分为糜烂组和非糜烂组,各262、652例,采用证素辨证法统计两组的证素积分,再通过统计学分析对两组证素积分进行对比,以探讨其差异性,并对存在差异的证素进一步分析。结果:两组痰、热证素比较,差异有显著(P<0.01);慢性胃炎胃黏膜糜烂痰热证的主要病位分布于胃、肝、脾,主要的兼杂病性为湿、阴虚、气滞、阳虚、气虚、血瘀。经证素因子分析,得出3个元件因子特征值>1,累积贡献率为71.219%。结论:脾胃痰热蕴结是胃黏膜糜烂的基本病理因素,而同时可存在脾胃阳气亏虚、肝胆蕴热,甚则阴虚内热、气滞血瘀等病理变化,互为因果,相互影响。

Objective: To explore the distribution characteristics of the main syndrome factors of chronic gastric mucosal erosion based on syndrome factor differentiation, and to provide reference for the TCM pathologic change characteristics of chronic gastric mucosal erosion. Methods: Nine hundreds and fourteen patients who met the study criteria were divided into erosion group(262 cases) and non-erosion group(652 cases) according to endoscopy and pathologic biopsy. The syndrome factors of the two groups were calculated according to the syndrome factor differentiation, statistical analysis was used to explore the differences, and the syndrome factors which existed differences were further analyzed. Results: The syndrome factors of phlegm and heat in two groups were statistically different(P<0.01). The main disease locations of chronic gastric mucosal erosion of phlegm heat syndrome were stomach, liver, spleen, and the main miscellaneous disease natures were wet, yin deficiency, qi stagnation, yang deficiency, qi deficiency and blood stasis. By factor analysis, 3 component factor eigenvalue>1, cumulative contribution rate was 71.219%. Conclusion: The phlegm-heat amassment in spleen and stomach is the basic pathology of gastric mucosa erosion. At the same time, there may be pathological changes such as yang deficiency of spleen and stomach, excessive heat of liver and gallbladder, endogenous heat due to yin deficiency and stagnation of qi and blood stasis, which are interdependent and interact with each other.