慢性萎缩性胃炎中医证型与Hp感染及胃黏膜癌前病理变化的相关性研究

Study on the Correlation between TCM Syndromes of Chronic Atrophic Gastritis and HP Infection and Precancerous Pathological Changes of Gastric Mucosa

目的探讨慢性萎缩性胃炎的中医证型分布与幽门螺旋杆菌(Hp)感染及胃黏膜癌前病理变化之间的关系。方法统计170例慢性萎缩性胃炎患者的中医证型分布、Hp感染情况及胃黏膜病理表现,分析证型分布与Hp感染、腺体萎缩程度、肠上皮化生、异型增生之间的相关性。结果不同证型间HP感染阳性率差异有统计学意义(P<0.05),各证型Hp感染阳性率从高到低为:脾胃湿热证>肝胃不和证>胃阴不足证>脾胃虚弱证>胃络瘀血证;各证型间腺体萎缩程度差异有统计学意义(P<0.05),肝胃不和证轻度萎缩所占比例最高,胃络瘀血证的重度萎缩所占比例高于其他证型;各个证型间存在肠化生、异型增生的差异无统计学意义(P>0.05)。结论慢性萎缩性胃炎中医证型与Hp感染、胃黏膜萎缩程度存在一定的相关性。

Objective To analyze the relationship between the distribution of TCM syndromes of chronic atrophic gastritis and HP infection and precancerous pathological changes of gastric mucosa. Methods Through statistics of the distribution of TCM syndromes, HP infection and the pathological manifestation of gastric mucosa of 170 patients with CAG, we analyze the correlation between the distribution of TCM syndromes and HP infection, degree of gland atrophy, intestinal metaplasia and dysplasia. Results Different syndromes of CAG have statistically significant difference in positive rate of HP infection （P〈0.05）, the highest positive rate of Hp infection is dampness-heat of spleen, followed by incoordination between liver and stomach syndrome、deficiency of stomach yin syndrome, the spleen and stomach deficiency syndrome and static blood blocking stomach collaterals syndrome. Different syndromes of CAG also have statistically significant difference in degree of gland atrophy （P〈0.05）, the highest proportion of mild atrophy is incoordination between liver and stomach syndrome, the highest proportion of severe atrophy is static blood blocking stomach collaterals syndrome; there is no significant difference between TCM syndromes distribution and intestinal metaplasia and dysplasia （P〉0.05）. Conclusion The distribution of TCM syndromes is related to HP infection and degree of gland atrophy.