Chronic Atrophic Gastritis Syndrome Distribution And Evolution Research

ObjectiveTo investigate the characteristic of chronic atrophic gastritis(CAG)traditional Chinese medicine(TCM) syndromes distribution and the law of evolution.MethodsWith chronic non-atrophic gastritis(CNAG) and chronic atrophic gastritis as the research objects, the researchers inspected the objects four kinds of diagnosis and main projects, collected clinical information, and determined clinical TCM syndromes with the method of face-to-face interview. Then analyzing the characteristics of syndromes distribution, the correlation between the TCM syndromes distribution and gender, age, pathological types, inflammation, Helicobacter pylori(Hp) infection, and the evolution of TCM syndromes, pathological character, pathological location, syndrome factors with the severity of pathological types of CAG.Results1 Clinical data:307 chronic gastritis(CG)patients was collected, concluding CNAG patients 126 cases, CAG patients 181 cases, and 114 male patients,193 female patients. The oldest patient is 79 years old, the youngest is 23.The average age was 56.77±1.34.The shortest disease duration was 3 months, longest was 50 years.2 The characteristics of TCM syndrome distribution2.1 the distribution of CG:The 372 CG syndromes were collected. The frequency of occurrence of different syndromes were found to be:spleen-stomach damp-heat type (19.6%)> spleen-stomach deficiency cold type (17.5%)> liver-stomach muggy type(17.2%)> liver-stomach qi stagnation type(16.4%)> heat-cold complex type(11.5%)> blood stasis in stomach collaterals type(9.7%)> stomach-yin deficiency(8.1%).2.2 the distribution of CNAG、CAG:The CANG patients were 126 cases, and the TCM syndromes were 147 cases. The frequency of occurrence of different syndromes were found to be:spleen-stomach damp-heat type (23.8%)> liver-stomach muggy type(21.1%)> liver-stomach qi stagnation type(19.0%)> spleen-stomach deficiency cold type (18.4%)> heat-cold complex type(10.9%)> blood stasis in stomach collaterals type(5.4%)> stomach-yin deficiency(1.4%). The CAG patients were 181 cases, the CAG syndromes were 225 cases. The frequency of occurrence of different syndromes were found to be:spleen-stomach damp-heat type (16.9%)=spleen-stomach deficiency cold type (16.9%)> liver-stomach muggy type(14.7%)=liver-stomach qi stagnation type(14.7%)> stomach-yin deficiency(12.4%)= blood stasis in stomach collaterals type(12.4%)> heat-cold complex type(12.0%).By chi-square test,stomach-yin deficiency type and blood stasis in stomach collateral type in CAG occurred more frequently than CNAG, the difference was statistically significant(P< 0.01).2.3 The relationship between gender and TCM syndrome types:spleen-stomach damp-heat type in male patients occurred more frequently than female patients. By chi-square test, the difference was statistically significant(P=0.029); Liver-stomach qi stagnation type in female patients occurred more frequently than male patients(P=0.049).2.4 The relationship between Hp infection and CG, TCM syndrome types:liver-stomach qi stagnation type,spleen-stomach deficiency cold type, heat-cold complex type often occurred when Hp was negative(P< 0.05). Spleen-stomach damp-heat type often occurred when Hp was positive(P< 0.05). The relationship between Hp infection and CAG syndrome types:Spleen-stomach damp-heat type,liver-stomach muggy type often occurred when Hp was positive(P< 0.05).spleen-stomach deficiency cold type often occurred when Hp was negative(P< 0.05).2.5 The distribution characteristic of TCM syndrome types in CG endoscopic findings:by logistic regression analysis,liver-stomach qi stagnation type was positively correlated with red gastric mucosa(B=0.706,P=0.017,OR=2.026),liver-stomach muggy type was positively correlated with bile reflux(B=0.839,P=0.047,OR=2.315),spleen-stomach deficiency cold type was negatively correlated with bile reflux(B=-2.084,P=0.043,OR=0.124),stomach-yin deficiency type was positively correlated with gastric mucosa hyperplasia(B=1.188, P=0.007,OR=3.281), blood stasis in stomach collateral type was positively correlated with gastric mucosa hyperplasia(B=1.091,P=0.009, OR=2.978).3 TCM syndrome evolution:CNAG→mild atrophy→moderate atrophy→severe atrophy,the degree of atrophy was negatively correlated with liver-stomach qi stagnation (P=0.000), was positively correlated with stomach-yin deficiency type (P=0.000), was positively correlated with blood stasis in stomach collateral type (P=0.000).The degree of intestinal metaplasia was negatively correlated with liver-stomach qi stagnation (P=0.017), was positively correlated with stomach-yin deficiency type (P=0.000), was positively correlated with s blood stasis in stomach collateral type (P=0.000).The active inflammation was positively correlated with spleen-stomach damp-heat type(P=0.034), was negatively correlated with spleen-stomach deficiency cold type(P=0.004).Dysplasia had no relationship with syndrome types due to the number of cases was less.The chronic inflammation had no relationship with TCM syndromes(P> 0.05).4 The evolution of character, location and syndrome factors of CAG4.1 The evolution of character:the efficiency occurred in CNAG,mild atrophy more often than moderate atrophy,severe atrophy, but had no relationship with the degree of atrophy(P=0.504).The deficiency was positively correlated with the degree of atrophy(P=0.001). The efficiency-deficiency syndrome had no relationship with the degree of atrophy(P=0.468).The efficiency syndrome often occurred in mild intestinal metaplasia;deficiency syndrome often occurred in severe intestinal metaplasia;The efficiency-deficiency syndrome often occurred in mild intestinal metaplasia. The degree of intestinal metaplasia had no relationship with the efficiency syndrome,deficiency syndrome and efficiency-deficiency syndrome(P> 0.05).4.2 The evolution of location:with the evolution of CNAG to severe atrophy, the damaged organ located in liver became decreasing(P=0.004). severe atrophy often located in stomach. The difference had no statistically significance(P=0.711).The damaged organ located in spleen had no relationship with atrophy(P=0.220).The intestinal metaplasia often located in liver. With the aggravation of intestinal metaplasia,the damaged organ located in liver became decreasing(P=0.011). The damaged organ located in spleen and stomach had no relationship with intestinal metaplasia(P> 0.05).4.3 The evolution of syndrome factors:the degree of atrophy was negatively correlated with qi stagnation(P=0.004), positively correlated with yin deficiency(P=0.000), positively correlated with blood stasis in stomach collateral(P=0.000). Other syndrome factors had no relationship with the degree of atrophy(P> 0.05). The degree of intestinal metaplasia was negatively correlated with qi stagnation(P=0.011),positively correlated with blood stasis in stomach collateral(P=0.000).as the degree of intestinal metaplasia evolving, yin deficiency became aggravated. The difference had no statistically significance(P=0.055). Other syndrome factors had no relationship with the degree of intestinal metaplasia(P> 0.05).ConclusionsThe distribution of CAG syndrome types was spleen-stomach damp-heat type,spleen-stomach deficiency cold type most, liver-stomach qi stagnation type,liver-stomach muggy type second,stomach-yin deficiency type,blood stasis in stomach collateral type, heat-cold complex type least. Stomach-yin deficiency type and blood stasis in stomach collateral type occurred in CAG more.frequently than CNAG;CG syndrome types and gender, age,Hp infection,active inflammation and endoscopy results were closely related. With the development of CNAG→mild atrophy→moderate atrophy→severe atrophy,mild intestinal metaplasia→moderate intestinal metaplasia→severe metaplasia, the TCM syndrome types, disease character,location, syndrome factors had corresponding evolution.