岭南地区慢性萎缩性胃炎证候、证素分布规律的文献研究

Literature Study on Distribution of Traditional Chinese Medicine Syndromes and Syndrome Elements of Chronic Atrophic Gastritis in Lingnan Area

【目的】探讨岭南地区慢性萎缩性胃炎(CAG)的证候及证素分布,为岭南地区该病的规范化辨证和治疗提供依据。【方法】检索中国生物医学数据库(CBM)、中国知网数据库(CNKI)、万方数据库和维普数据库(VIP),纳入有关CAG证候的临床研究。收集文献的研究单位所在地、病例数、辨证分型,比较分析全国文献(除岭南地区外)和岭南地区文献(指文献的研究单位在岭南)CAG的证候类型与证素的频次、病例数及构成比。【结果】共纳入文献177篇,共计病例数24 780例;岭南地区文献有31篇。CAG常见证型为肝胃不和证、胃阴亏虚证、脾胃气虚证、脾胃湿热证、脾虚气滞证、脾胃阳虚证、瘀阻胃络证;CAG病位在胃与脾,与肝密切相关,常见病性类证素为气虚、热、阴虚、湿、气滞、瘀、阳虚。证候类型分布方面,全国文献以实证居多,岭南地区文献以虚证居多;全国文献比岭南地区文献更多见肝胃不和证、胃阴亏虚证、脾胃湿热证、脾虚气滞证,岭南地区文献比全国文献更多见脾胃气虚证、脾胃阳虚证。病位证素分布方面,全国文献比岭南地区文献更多见胃、肝病位,岭南地区文献比全国文献更多见脾病位证素。病性证素分布方面,全国文献比岭南地区文献更多见阴虚、气滞证素,岭南地区文献比全国文献更多见气虚、湿。【结论】脾虚湿蕴为岭南地区CAG病机特点,治疗时需以益气健脾、温阳化湿为纲。

Objective To investigate the distribution of traditional Chinese medicine(TCM) syndromes and syndrome elements of chronic atrophic gastritis(CAG) in Lingnan area, so as to provide evidence for the standardized syndrome differentiation and treatment of CAG in Lingnan area. Methods By searching Chinese Biomedical database(CBM),CNKI,Wanfang and VIP databases,the clinical trials of TCM syndromes of CAG were enrolled to the analysis. The institutions of the trials,the number of CAG cases and the syndrome types of the included literature were collected for the comparison of the frequency of syndrome types and syndrome elements,the number of CAG cases and their constituent ratio in the domestic literatures(except for the Lingnan area)and Lingnan area literatures(referring to the research institutions of the article being in Lingnan area). Results A total of 177 articles involving 24 780 patients were enrolled, and 31 articles were from Lingnan area. The frequent syndromes of CAG are disharmony of liver and stomach, stomach yin deficiency, spleen and stomach Qi deficiency,damp-heat in spleen and stomach,spleen deficiency with Qi stagnation,spleen and stomach yang deficiency,and blood-stasis obstructing the stomach collateral. CAG mainly affects the stomach and spleen,and is also related with the liver. The frequent syndrome elements of CAG are Qi deficiency,heat,yin deficiency,dampness,Qi stagnation,blood stasis and yang deficiency. The TCM syndromes in the domestic literatures are characterized by excess types and those in Lingnan area literatures are characterized by deficiency types. The syndrome types of disharmony of liver and stomach,stomach yin deficiency,damp-heat in spleen and stomach,and spleen deficiency with Qi stagnation are more frequently seen in the domestic literatures;while syndrome types of spleen and stomach Qi deficiency and spleen and stomach yang deficiency are more frequently seen in Lingnan area literatures. The syndrome elements of stomach,liver as well yin deficiency,and Qi stagnation are more frequently seen in the domestic literatures;while syndrome elements of spleen as well as Qi deficiency,and dampness are more frequenctly seen in Lingnan area literatures. Conclusion The literature analysis revealed that the characteristic pathogenesis of CAG in Lingnan area is spleen deficiency with dampness retention, and the therapies for CAG should be replenishing Qi and invigorating spleen,and warming yang to resolve dampness.