The Study Of The Correlation Between Syndrome Types Of Traditional Chinese Medicine Of Liver Cirrhosis And Its Manifest Under Gastroscope

ObjectiveTo study the correlation between syndrome types of Traditional Chinese Medicine(TCM)of liver cirrhosis and its manifest under gastroscope,mainly the correlation of esophageal varix and damage degree of gastric mucosa by the method of survey.MethodUsing the method of clinical investigation and designing questionaires, which covered general information,liver cirrhosis etiology,four diagnostic methods of TCM,and the manifest of liver cirrhosis,such as the degree of esophageal varix and portal hypertensive gastric disease,the incidence rate of combined ulcer and etc.TCM syndromes of liver cirrhosis were divided into 6 types:stagnation of liver-QI,internal resistance of dampness,internal accumulation of dampness-heat,liver kidney yin insufficiency,spleen-kidney yang defficiency and obstruction of collaterals by blood stasis.The questionaires were filled in by the specialists,and the syndrome types of TCM were finally approved by 2 experts with senior-medium professional titles according to differentiation standards.The clinical observation was carried out after the specialists amending the questionaires.Statistical method:Data was collected and a database was setup,which was imported into a statistical package of SPSS13.0 for data analysis.The purpose was to study the correlation between syndrome types of TCM of liver cirrhosis and its manifest under gastroscope.The rate comparison was used by X~2(chi-square)test,and the average comparison was used by analysis of variance or T-test,or rank test in the condition of variance heterogeneity.Test level was designated as a =0.05.Furthermore,the thesis covered the study of 180 liver cirrhosis patients,who underwent Zheng differentiation-classification and routine gastroscopy according to the methods mentioned above.Record of the condition of esophageal varix,portal hypertensive gastric disease and the ulcer were taken,and 3 pieces of biopsy specimens from stomach lining were examined in order to study the degree of endogastritis and investigate the distribution law of TCM syndrome types of liver cirrhosis and the relationship between different syndrome types of TCM and the manifest of liver cirrhosis under under gastroscope,such as the degree of esophageal varix and portal hypertensive gastric disease,the incidence rate of ulcer and the degree of endogastritis.ResultsAccording to the proportion of distribution,syndrome types ranked in order:internal accumulation of dampness-heat＞obstruction of collaterals by blood stasis＞stagnation of liver-QI＞internal resistance of dampness＞spleen-kidney yang defficiency=liver kidney yin insufficiency.Internal accumulation of dampness-heat accounted for 51.1%of all cases.Patients with liver function of grade A usually manifested as stagnation of liver-QI, internal resistance of dampness and spleen-kidney yang defficiency.Patients with liver function of grade B and C usually manifested as internal accumulation of dampness-heat,liver kidney yin insufficiency and obstruction of collaterals by blood stasis.The comparison of these 3 syndromes and the other 3 ones had statistical significance(P＜0.05).The stomach lining of liver cirrhosis patients with stagnation of liver-QI,internal resistance of dampness,liver kidney yin insufficiency,spleen-kidney yang defficiency was mainly congested,but seldom anabrotic or edematous.The stomach lining of liver cirrhosis patients with internal accumulation of dampness-heat and obstruction of collaterals by blood stasis usually manifesed as being anabrotic,congested and edematous,even autogenous hemorrhage.Liver cirrhosis patients with liver kidney yin insufficiency and internal accumulation of dampness-heat usually had mild portal hypertensive gastric disease,which was lower compared with the other syndromes(P＜0.05).Liver cirrhosis patients with obstruction of collaterals by blood stasis usually had serious portal hypertensive gastric disease,which had statistical significance when compared with the other syndromes(P＜0.05).Liver cirrhosis patients with stagnation of liver-QI usually had a low degree of esophageal varix,which had an obvious difference when compared with the other syndromes (P＜0.05).Liver cirrhosis patients with internal accumulation of dampness-heat usually had a moderate degree of esophageal varix,which had statistical significance when compared with the other syndromes(P＜0.05). Liver cirrhosis patients with liver kidney yin insufficiency and obstruction of collaterals by blood stasis usually had high degree of esophageal varix, which had an obvious difference when compared with the other syndromes(P＜0.05). The comparison of ulcer's incidence rate among the 6 syndromes of TCM had no statistical significance(P＜0.05).Most patients with stomach lining inflammation had moderate or even severe inflammation.The comparison between the mild inflammation syndromes and the moderate ones had no statistical significance(P＞0.05).However,patients with severe inflammation usually manifested as internal accumulation of dampness-heat and obstruction of collaterals by blood stasis,and it had an obvious difference when compared with the other syndromes(P＜0.05).ConclusionsSyndrome types of TCM of liver cirrhosis ware related to the degree of portal hypertensive gastric disease and stomach lining inflammation. Clinically,it might be helpful to the liver cirrhosis patients with obstruction of collaterals by blood stasis and internal accumulation of dampness-heat if they took adequate medicine which helped restrain gastric acid or protect stomach lining.