慢性非萎缩性胃炎证候分类与幽门螺杆菌感染的相关性研究

Research on the Correlation Between the Classification of the Syndromes of Chronic Non-atrophic Gastritis and Helicobacter Pylori Infection

目的:探讨慢性非萎缩性胃炎证候、证素分布规律及其与幽门螺杆菌(Helicobacter pylori,Hp)感染的关系,为证候规范化研究提供参考。方法:制定统一的临床病例观察表,采集慢性非萎缩性胃炎患者的一般情况、四诊信息、C13呼气试验、胃镜检査等各方面资料,分析慢性非萎缩性胃炎的中医证候分类与证素特点及其与Hp感染的关系。结果:类肝胃不和证、类肝胃郁热证、类脾胃虛弱证、类胃热内蕴证为Hp阳性慢性非萎缩性胃炎临床常见4个证型,其分布特点为类肝胃不和证、类肝胃郁热证>类脾胃虛弱证>类胃热内蕴证;Hp阴性慢性非萎缩性胃炎中医常见3个证型,其分布特点为类脾胃虛弱证>类肝胃不和证>类肝郁脾虛证。结论:建立了Hp相关性慢性非萎缩性胃炎证候分布的因子分析及系统聚类模型,揭示了Hp相关性慢性非萎缩性胃炎的中医证候特点,为临床治疗和疗效评价提供了一定的依据和可行的研究思路。

Objective：To discuss the correlation between the syndromes of chronic non-atrophic gastritis,distrihution of syndrome element and the Helicobacter pylori （Hp） infection,and provide reference for the standardization research on syndromes. Methods ：Formulate unified observation schedule of clinical eases,collect the general condition of chronic non-atrophic gastritis, data of four diagnoses, C13 breath test and gastroscopy, and analyze the correlation between the classification of TCM syndromes of chronic non-atrophic gastritis ,features of the syndrome elements and Hp infection. Results： Classified syndrome of disharmony between the liver and stomach, classified stagnated heat syndrome of the liver and stomach, classified deficiency syndrome of the spleen and stomach ,and classified syndrome of internal accumulation of stomach heat are the four commonly seen syndromes of Hp positive chronic： non-atrophic gastritis;the feature of distribution was classified syndrome of disharmony between the liver and stomach, classified stagnated heat syndrome of the liver and stomach 〉 classified deficiency syndrome of the spleen and stomach 〉 classified syndrome of internal accumulation of stomach heat. There were 3 TCM syndromes commonly seen in Hp negative chronic non-atrophic gastritis;the feature of distribution was classified deficiency syndrome of the spleen and stomach 〉 classified syndrome of disharmony between the liver and stomach 〉 classified syndrome of liver depression and spleen deficiency. Conclusion ： The model of the factor analysis and hierarchical clustering for the syndrome distribution of chronic non-atrophic gastritis is established to reveal the features of the TCM syndromes of Hp-related chronic non-atrophic gastritis, which provides certain evidence and feasible research thought for clinical treatment and therapeutic evaluation.