远端胃切除术后胆汁反流性胃炎的中医证候分布规律分析

Analysis of Distribution of TCM Syndromes in Bile Reflux Gastritis after Distal Gastrectomy

目的:探索远端胃切除术后胆汁反流性胃炎的中医证候分布规律。方法:收集2020年1月—2021年1月纳入的90例远端胃切除术后反流性胃炎患者的临床资料,分析中医症状分布、证候分布,中医证候与胃镜表现、组织学表现的相关性。结果:远端胃切除术后反流性胃炎常见的临床症状为咽干口苦(56.7%)、胃脘胀满(45.6%)、嗳气泛苦(40.0%)、两胁胀满(35.6%)。肝脾失调型为最常见的证型(36.7%),其次为脾肾两虚型(27.8%)、脾胃失调型(23.3%)以及阴阳俱虚型(12.2%)。各证型间胃炎严重程度、胃炎范围、胆汁反流程度比较差异无统计学意义(P>0.05),食物潴留比较差异有统计学意义(P<0.05)。各证型间慢性炎症、活动性炎症、萎缩、Hp感染比较差异有统计学意义(P<0.05),肠化比较差异无统计学意义(P>0.05)。结论:远端胃切除术后胆汁反流性胃炎患者的胃镜和组织学表现与中医证候之间存在密切联系,运用中医证候分型有助于指导临床治疗。

Objective:To investigate the distribution of TCM syndromes in bile reflux gastritis after distal gastrectomy.Methods:The clinical data of 90 cases of bile reflux gastritis after distal gastrectomy were collected from January 2020 to January 2021.The distribution of TCM symptoms and syndromes,the relationship between TCM syndromes and endoscopic features,and histological manifestations were analyzed.Results:The common clinical symptoms was dry and bitter mouth(56.7%),stomach distension(45.6%),belching and bitter regurgitation(40.0%),distension of both sides of the chest(35.6%).disorder of liver and spleen was the most common syndrome(36.7%),followed by deficiency of spleen and kidney(27.8%),disorder of spleen and stomach(23.3%),and deficiency of Yin and Yang(12.2%).No statistical differences in extent and degree of gastritis,bile reflux were found among the four syndromes(P>0.05),while food retention were significantly different among them(P<0.05).There were statistical differences in chronic inflammation,active inflammation,atrophy and Hp infection among the four syndromes(P<0.05),while no statistical difference in intestinal metaplasia was found among them(P>0.05).Conclusion:There is close relation between endoscopic features,histological manifestations and TCM syndromes in patients with bile reflux gastritis after distal gastrectomy,and the application of TCM classification is helpful to clinical treatment.