幽门螺杆菌感染与慢性胃炎中医证候研究

The study of the correlation between helicobacter pylori infection and TCM syndrome of chronic gastritis in Yongwai district of Beijing

目的 探讨H.pylori感染与慢性胃炎的中医证候特征,为临床科研、证候规范化及指导临床用药提供参考.方法 收集2013年5月-2014年6月北京永外地区有慢性胃炎病史并有上消化道症状的202例慢性胃炎患者,入组前2周内未服用过H2受体拮抗剂、铬剂及硫糖铝者,经胃镜诊断为慢性胃炎.采用13C尿素呼气试验检测患者H.pylori感染情况,根据胃镜结果 对受检者进行病情分级及中医辨证分型,分析H.pylori感染的分布特点及相关规律.结果 北京永外地区202例慢性胃炎患者中,萎缩性胃炎H.pylori阳性率为81.2%;其中胃窦部位H.pylori阳性率为80.7%;慢性胃炎兼H.pylori阳性时多见脾胃湿热证和胃络瘀阻证,H.pylori阳性率分别为83.6%（46/55）和86.9%（53/61）;脾胃湿热和胃络瘀阻证型的肠化生及不典型增生检出率也高于其他证型.结论 H.pylori感染为慢性胃炎最为常见和主要病因,H.pylori感染患者以胃络瘀阻证和脾胃湿热证为多.

Objective To explore the correlation between Helicobacter pylori infection and TCM syndrome of chronic gastritis in Yongwai of Beijing.Methods A total of 202 patients with chronic gastritis in the Yongwai district of Beijing were detected with H.pylori infection and tested by the13C-urea breath test. The patients were classified by the disease severity according to the results of gastroscope, and diagonsed with TCM Syndromee. The distribution characteristics and correlation of H.pylori infection and the TCM syndromes were analyzed.Results The chronic gastritis patients with atrophic gastritis showed the higher infection rate of 81.2%, among which the gastric antrum was most inflammatory areas with 80.7%. The patients with chronic gastritis with positive H.pylori always correlated with the TCM syndromes such as the blood stasis of stomach Luo and the dampness-heat of spleen and stomach. And among these two TCM syndromes, the frequency of the intestinal metaplasia and atypical hyperplasia were higher than other syndromes.Conclusions The H.pylori infection is the common cause of chronic gastritis, and it was always correlated with the TCM syndromes blood stasis of stomach Luo and the dampness-heat of spleen and stomach.