The Clinical And Endoscopic Distribution Characteristics Of Crohn’s Disease TCM Syndrome Type And The Diagnostic Value Of Multi-slice CT Enterography In Crohn’s Disease

Objective:1)By Summarizing and analyzing clinical and small intestine image distribution characteristics of different syndromes of the Crohn’s disease,to provide the basis for the TCM syndrome of the disease.2)By evaluating the diagnostic value of Multislice CT Enterography for the Crohn’s disease,to provide reference for early diagnosis of the disease.Method:1)The clinical data of 40 outpatients or inpatients who received single balloon enteroscopy and were eventually clinically diagnosed with the Crohn’s disease of the digestive department,General Hospital of Lanzhou Military Region from September of 2014 to January of 2017 was collected.The enteroscopy reports and the TCM syndrome differentiation were recorded,and the distribution characteristics of gender,age,disease activity,scope of lesions and small intestine images of different TCM syndromes were analyzed.2)The general data of 28 outpatients or inpatients who received single balloon enteroscopy,were eventually clinically diagnosed with the Crohn’s disease and agreed to receive Multislice CT Enterography within a week of the digestive department,General Hospital of Lanzhou Military Region from September of 2014 to January of2017 was collected.The results of Single Balloon Enteroscopy were acted as gold standard when evaluating the diagnostic value of multiple spiral CT small intestinal imaging for the Crohn’s disease and the consistency of these two medical examinations.Result:1)Abdominal pain was a common symptom of Crohn’s disease.TCM syndrome types of Crohn’s disease distribution rule is:syndrome of damp and hot accumulate knot>syndrome of qi stagnation and blood rcsistance>syndrome of cold and dampness retention spleen>syndrome of liver-stagnation andspleen-deficiency>syndrome of spleen deficiency and qi collapse.Ill age and disease activity: syndrome of damp and hot accumulate knot,syndrome of qi stagnation and blood rcsistance,syndrome of cold and dampness retention spleen were good in elderly patients,and the majority in remission stage.Disease sites:syndrome of qi stagnation and blood rcsistance,syndrome of liver-stagnation and spleen-deficiency,syndrome of spleen deficiency and qi collapse deficiency’s favotite site was ileocolon syndrome,syndrome of damp and hot accumulate knot,syndrome of cold and dampness retention spleen’s favotite site was colon.Lesion range:syndrome of liver-stagnation and spleen-deficiency was commom in single lesio,and the other four syndrome were commom in multiple lesio.The intestinal mucosa: syndrome of damp and hot accumulate knot,syndrome of qi stagnation and blood rcsistance,syndrome of liver-stagnation and spleen-deficiency’s intestinal mucosa were commen in irregular ulcer,syndrome of cold and dampness retention spleen,syndrome of spleen deficiency and qi collapse’s intestinal mucosa were most of erythematous,edema and erosion.2)In 28 cases of Crohn’s disease patients,single balloon enteroscopy positive diagnostic rate was 85.71%(24/28),the Multislice CT Enterography positive diagnostic rate was 75%(21/28),CT imaging with bowel wall thickening reinforcement most see(50.00%,12/24).The Multislice CT Enterography in the diagnosis of crohn’s disease sensitivity was 83.33%(20/24),and the specificity was75%(3/4),false positive rate was 25%(1/4),the false negative rate was 16.67%(4/24),Kappa value was 0.444(P<0.05).Conclusion:1)TCM syndrome of Crohn’s disease mainly included five types: syndrome of damp and hot accumulate knot,syndrome of qi stagnation and blood resistance,syndrome of cold and dampness retention spleen,syndrome of liver-stagnation and spleen-deficiency,syndrome of spleen deficiency and qi collapse,the most common syndrome was damp and hot accumulate knot.The patient’s gender,disease activity,and the lesion site scope can provide guidance for Crohn’s disease of TCM syndromedifferentiation;Single Balloon Enteroscopy can be used as one of objective indicator for TCM syndrome differentiation to guide clinic differentiate syndrome and treat Crohn’s disease.2)The multislice CT enteroscopy could assesse Crohn’s disease patients’ bowel wall thickening and intensive degree,accurately locate the narrow position of the small bowel lumen,timely discover the mesenteric vascular parenteral lesions,partially evaluate the activity of the disease.The diagnosis had moderate consistency with single balloon enteroscopy diagnosis and could be used as an effective method to diagnose Crohn’s disease.The filling degree of intestinal check is the key to successful multislice CT enteroscopy.