慢性浅表性胃炎中医证型分布与幽门螺杆菌感染、胃镜像及病理表现相关性分析

Association of the Distribution of Traditional Chinese Medicine Syndrome Types of Chronic Superficial Gastritis with Helicobacter pylori Infection,Gastroscopic Findings,and Pathological Manifestations

目的探讨慢性浅表性胃炎(chronic superficial gastritis,CSG)中医证型分布与幽门螺杆菌(helicobacter pylori,Hp)感染、胃镜像及病理表现的相关性。方法选取150例经胃镜和病理检查确诊为CSG的患者,根据中医辨证分型将其分为肝胃不和型(n=38)、脾胃湿热型(n=22)、脾胃虚弱型(n=46)、胃阴不足型(n=29)、胃络瘀阻型(n=15)。用快速尿素酶试验和Warrthin-Starry银染色法检测患者Hp感染情况,并收集患者的胃镜像及病理表现的相关资料,探讨CSG中医证型分布与Hp感染、胃镜像及病理表现之间的相关性。结果CSG患者Hp阳性率以脾胃湿热型和脾胃虚弱型最高,且与其余各组比较差异有统计学意义(P<0.05)。黏膜白相多见于脾胃虚弱型,血管透见多见于胃阴不足型,黏膜粗糙和颗粒增生多见于胃络瘀阻型,且各证型分布差异有统计学意义(P<0.05)。不同证型患者炎症程度比较,差异有统计学意义(P<0.05),轻度炎症多见于肝胃不和型,中度炎症多见于脾胃虚弱型,重度炎症多见于脾胃湿热型。结论CSG中医证型分布与Hp感染、胃镜像及病理表现均存在一定的相关性。

Objective To investigate the association of the distribution of traditional Chinese medicine(TCM)syndrome types of chronic superficial gastritis(CSG)with Helicobacter pylori(Hp)infection,gastroscopic findings,and pathological manifestations.Methods A total of 150 patients who were diagnosed with CSG based on gastroscopy and pathological examination were enrolled,and according to their TCM syndrome type,they were divided into liver-stomach incoordination group with 38 patients,spleen-stomach damp-heat group with 22 patients,spleen-stomach deficiency group with 46 patients,stomach-Yin deficiency group with 29 patients,and gastric collateral stasis group with 15 patients.Rapid urease test and Warthin-Starry staining were used to detect Hp infection in patients,and related gastroscopic findings and pathological manifestations were collected to investigate the association of the distribution of TCM syndrome types of CSG with Hp infection,gastroscopic findings,and pathological manifestations.Results For the patients with CSG,the highest positive rate of Hp was observed in the spleen-stomach damp-heat group and the spleen-stomach deficiency group,and there was a significant difference in positive rate between these two groups and the other groups(P<0.05).White mucosa was commonly observed in patients with deficiency of spleen and stomach,clear vessel was commonly observed in patients with stomach-Yin deficiency,and mucosal roughness and granular hyperplasia were commonly observed in patients with gastric collateral stasis,with a significant difference in the distribution of TCM syndrome types(P<0.05).There was a significant difference in the degree of inflammation between the patients with different TCM syndrome types(P<0.05);mild inflammation was commonly observed in patients with incoordination between liver and stomach,moderate inflammation was commonly observed in patients with deficiency of spleen and stomach,and severe inflammation was commonly observed in patients with spleen-stomach damp-heat syndrome.Conclusion The distribution of TCM syndrome types of CSG is associated with Hp infection,gastroscopic findings,and pathological manifestations.