慢性萎缩性胃炎中医证候的胃镜及病理特征分析研究

Study on the endoscopic and pathological characteristics of Traditional Chinese Medicine syndromes of chronic atrophic gastritis

目的:对慢性萎缩性胃炎(CAG)中医证型的胃镜及病理特征进行分析,探讨与中医证型的相关性。方法:收集2020年4月—8月经胃镜及病理检查诊断为CAG的347例患者,利用胃镜对黏膜萎缩范围和黏膜形态特征以及活检病理结果进行分析研究,以明确CAG中医各证型胃镜及病理结果的差异性,探讨与中医各证型的相关性。结果:CAG各中医证型萎缩范围比较差异无统计学意义(P>0.05),均以闭合型萎缩为主。CAG中医证型在单纯萎缩、胆汁反流、平坦糜烂及隆起糜烂等黏膜形态特征上差异有统计学意义(P<0.05),但在出血、肠化生发生率方面差异无统计学意义(P>0.05)。CAG中医证型在萎缩程度、Hp感染率和异型增生发生率方面差异有统计学意义(P<0.05)。结论:CAG中医证型与内镜及病理特征存在一定的相关性。微观辨证可以为中医辨证论治提供有力的客观依据,以此提高CAG的中医辨证论治水平。

Objective:To analyze the gastroscopy and pathological characteristics of Traditional Chinese Medicine(TCM)syndromes of chronic atrophic gastritis to explore the correlation with TCM syndromes.Methods:A collection of 347 patients diagnosed as CAG by gastroscopy and pathology in our hospital from April 2020 to August 2020.The scope of mucosal atrophy,mucosal morphology and biopsy pathological results were analyzed and studied by gastroscopy and pathology to clarify the differences of endoscopic and pathological characteristics of various syndromes of TCM.Results:There was no significant difference in the atrophy range of various TCM syndromes of CAG(P>0.05),and closed atrophy was the main type.TCM syndromes of CAG have statistically significant differences in mucosal morphological characteristics such as single atrophy,bile reflux,flat erosion,and protuberant erosion(P<0.05),but there is no statistically significant difference in bleeding(P>0.05).There were statistically significant differences in the degree of atrophy,Hp infection rate,and the incidence of dysplasia in the various types of CAG TCM syndromes(P<0.05),but there was no significant difference in the incidence of intestinal metaplasia(P>0.05).Conclusion:There is a certain correlation between TCM syndromes of CAG and endoscopic and pathological characteristics.Microscopic syndrome differentiation can provide a powerful objective basis for TCM syndrome differentiation and treatment,thereby improving the level of TCM syndrome differentiation and treatment of CAG.