消化性溃疡活动期中医辨证分型与舌象、胃镜像的关系研究

The correlation among traditional Chinese medicine syndrome type and tongue images and gastroscope images

目的探究消化性溃疡活动期中医证型与舌象、胃镜像表现及Hp感染的关系。方法收集160例消化性溃疡活动期患者的舌象、胃镜像、Hp感染资料,运用χ~2检验对数据进行统计学分析。结果脾胃湿热型占46.25%(74/160),脾胃虚弱型占36.25%(58/160),胃络瘀阻型占17.50%(28/160);各舌色、舌苔,胃镜像和Hp阳性率在不同消化性溃疡中医证型之间的差异均具有统计学意义(P <0.01);红、淡白、绛紫分别为脾胃湿热证、脾胃虚弱证、胃络瘀阻证的主要舌色,黄腻为脾胃湿热证和胃络瘀阻证的主要舌苔,薄白为脾胃虚弱证的主要舌苔;脾胃湿热证患者胃镜像显示黏膜以糜烂为主,其次为充血,脾胃虚弱证和胃络瘀阻证的患者分别以苍白和充血所占比重最高;消化性溃疡活动期各中医证型的Hp感染率从高到低为脾胃湿热证>脾胃虚弱证>胃络瘀阻证。结论消化性溃疡活动期中医证型与舌色、舌苔、胃镜像、Hp感染有一定的关系。

Objective To explore the correlation among traditional Chinese medicine(TCM)syndrome type and TCM tongue images and gastroscope images and Helicobacter pylori(Hp)infection in active peptic ulcer. Methods Tongue images,gastroscope images and Hp infection data of 160 patients with active peptic ulcer were collected and statistically analyzed by chi-square test. Results The spleen-stomach damp-heat type accounted for 46.25%(74/160)and the spleen-stomach weakness type accounted for 36.25%(58/160),and gastro-collateral stasis type accounted for 17.50%(28/160).Comparison of tongue color images,tongue coating images,gastroscope images and Hp-positive rate among different TCM syndrome types of active peptic ulcer showed statistically significant differences(P<0.01).Red,light white,and dark reddish purple were the main tongue colors of patients with spleen-stomach damp-heat syndrome,spleen-stomach weakness syndrome and gastro-collateral stasis,respectively.The yellowish greasy tongue was the main tongue coating of patients with spleen-stomach damp-heat syndrome and gastric collaterals stasis syndrome.The thin white was the main tongue coating of patients with spleen-stomach weakness syndrome.The mucous membranes of patients with spleen-stomach damp-heat syndrome mainly presented with erosion under the gastroscope,followed by hyperemia;the patients with spleen-stomach weakness syndrome and gastric collaterals stasis syndrome had the highest proportions of paleness and congestion.The Hp infection rate of all TCM syndromes ranged from high to low as the following:spleen-stomach damp-heat syndrome>spleen-stomach weakness syndrome>gastric collaterals stasis. Conclusion There is a certain correlation between the TCM syndrome of active peptic ulcer and tongue color,tongue coating,gastroscope images and Hp infection.