180例慢性胃炎患者中医证型与内镜视野下微环境相关性研究

Study on the Relationship between Traditional Chinese Medicine Syndromes and Endoscopic Microenvironment in Chronic Gastritis for 180 Cases

目的通过观察108例慢性胃炎患者5个中医证型与内镜视野下微环境的相关性,以期为其中医辨证及治疗提供依据。方法选取180例慢性胃炎患者进行中医辨证分型,搜集患者一般资料、镜下黏膜表现、幽门螺杆菌(Hp)感染情况、病理结果、胃液pH值并进一步分析与中医证型的相关性。结果胃镜下黏膜白相在脾胃虚寒证患者中检出率最高,红相在痰热郁结证患者中检出率最高,不同证型间镜下黏膜表现差异有统计学意义(P<0.01)。不同证型间Hp感染率比较,痰热郁结证>气滞痰阻证>胃阴不足证>瘀血内停证>脾胃虚寒证,差异有统计学意义(P<0.01)。在病理诊断方面,萎缩性胃炎中胃阴不足证多见,非萎缩性胃炎中痰热郁结证多见,慢性胃炎病理分型在中医各证型差异有统计学意义(P<0.01)。各证型肠化生阳性率、不典型增生、胃液pH值比较,差异无统计学意义(P>0.05)。结论通过此项研究考虑慢性胃炎中医证型与镜下微环境、病理分型存在一定的相关性。

Objective To observe the correlation between five TCM syndrome types and endoscopic microenvironment in patients with chronic gastritis,and to provide a basis for TCM syndrome differentiation and treatment of chronic gastritis.Methods One hundred and eighty patients with chronic gastritis were selected for TCM syndrome differentiation,and the general data,microscopic mucosal manifestations,Hp infection,pathological results and pH value of gastric juice were collected,and the correlation between TCM syn-drome type and microscopic mucosal manifestation,Hp infection,pathological results and gastric juice pH value was further analyzed.Results The detection rate of white phase of mucosa under gastroscopy was the highest in patients with spleen-stomach deficiencycold syndrome,and the detection rate of red phase was the highest in patients with phlegm-heat stagnation syndrome.There were sig-nificant differences in mucosal manifestations among different syndrome types(P<0.01).There was significant difference in Hp infec-tion rate among different syndrome types(P<0.01).Phlegm heat stagnation syndrome>qi stagnation phlegm stagnation syndrome>stomach yin deficiency syndrome>internal stagnation of blood stasis syndrome>spleen and stomach deficiency cold syndrome.In pathological diagnosis,stomach yin deficiency syndrome was common in atrophic gastritis,phlegm-heat stagnation syndrome was com-mon in non-atrophic gastritis,and there was significant difference in pathological classification of chronic gastritis among TCM syn-drome types(P<0.01).There was no significant difference in positive rate of intestinal metaplasia,atypical hyperplasia and pH value of gastric juice among different syndrome types(P>0.05).Conclusion There is some correlation between TCM syndrome types of chronic gastritis and microscopic microenvironment and pathological types.