更年期女性慢性萎缩性胃炎中医证候分布规律研究

Study on the Distribution Regularity of TCM Syndromes of Chronic Atrophic Gastritis in Menopausal Women

目的:探讨更年期女性慢性萎缩性胃炎的中医证型分布规律,以加深对本病的认识,为中医临证诊治提供理论参考。方法:选取2016年1月至2017年12月在南京中医药大学附属江苏省中医院就诊符合更年期综合征诊断的经胃镜病理确诊为慢性萎缩性胃炎女性患者100例,填写《更年期女性慢性萎缩性胃炎中医临床观察表》以及库珀曼指数(kupperman index,KI)量表。纪录患者的一般情况、症状体征、镜下黏膜情况、病理、幽门螺杆菌(Helicobacter pylori,Hp)检测结果等,后期采用统计学软件进行统计分析,得出结论。结果:随着年龄的增加,更年期女性慢性萎缩性胃炎的发病率逐渐升高,中医证型以肝郁气滞证最为常见。肝胃郁热证胆汁反流发生率最高,脾胃湿热证HP的感染率最高,精神及情绪因素在诱发肝郁气滞证中比率最高,气候因素在诱发脾胃虚寒证中比率最高。证型分布受KI量表、HP感染、胆汁反流影响,与进食习惯、肠上皮化生、异型增生无关。结论:建立统一的中医病名、证型分类标准及评价体系,有助于更好地认识疾病,开展临床研究,比较、评价疗效。

Objective: To explore the distribution regularity of TCM syndromes of menopausal women with chronic atrophic gastritis,deepen the understanding of this disease,and provide theoretical reference for the diagnosis and treatment of TCM. Methods: From January 2016 to December 2017,100 women with chronic atrophic gastritis diagnosed by gastroscopy and pathology were selected from Jiangsu Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine. The ' Clinical Observation Form of Chinese Medicine for Menopausal Women with Chronic Atrophic Gastritis' and Kupperman Index( KI) scales were filled in. The general condition,symptoms and signs,microscopic mucosal condition,pathology,Helicobacter pylori( Hp) test results of the patients were recorded. Statistical software was used for statistical analysis in the later period to draw conclusions. Results: With the increase of age,the incidence of chronic atrophic gastritis in menopausal women was gradually increasing,and syndrome of liver depression and qi stagnation was the most common syndromes in Chinese medicine. The incidence of bile reflux was the highest in the stagnated heat of liver and stomach syndrome. The HP infection rate of the dampness-heat of spleen and stomach syndrome was the highest. The mental and emotional factors were the highest in the liver qi stagnation syndrome. The climatic factors were the highest in the syndrome of deficient cold of spleen and stomach. The distribution of syndrome type was affected by KI scale,HP infection,and bile reflux,and was not related to eating habits,intestinal metaplasia,and dysplasia. Conclusion: Establishing a unified TCM disease name,syndrome classification criteria and associated evaluation system will help to better understand the disease,carry out clinical research,compare and evaluate the curative effect.