| Objective:By observing the distribution characteristics of TCM syndrome types of chronic atrophic gastritis and the correlation with gastroscopy and pathology,the paper summarizes the law,which provides a certain theoretical reference and clinical reference for the combination of modern examination methods and TCM syndrome differentiation.Methods:In this study,120 patients with chronic atrophic gastritis,who were treated in Fengtai Hospital of traditional Chinese and Western medicine from January 2018 to June2018,were selected as the research objects.Using the self-made observation table in the hospital,the TCM syndrome type,characteristics under gastroscope,gender,age,course time,family history and past history of the patients were recorded,and the TCM syndrome type,gender,age,course of disease of the patients were analyzed at the same time Correlation among time,gastroscopy and pathology.Results:1.General information of patients:(1)gender:among the 120 patients,there were55male patients and 65 female patients.(2)age:the number of patients aged from 51 to 60was up to 48,accounting for 40.00%,among which the number of patients over 50 years old was mostly higher.(3)course of disease:the number of patients with duration of 6 to 12months was up to 49,accounting for 40.83%,followed by patients with duration of less than 6months,accounting for 33.33%.(4)the TCM syndrome types:weak spleen and stomach type is a common TCM syndrome types of chronic atrophic gastritis patients,accounted for 30.83%(37/120),the second type ofdisharmony of liver and stomach with 21.67%(26/120),20.00%(24/120),stomach Yin deficiency type,spleen and stomach syndrome of 18.33%(22/120)and gastric stasis winding resistance type(11/120),9.17%of patients.2.The correlation between TCM syndromes and patients’general data:(1)the correlation between gender and gender:there was no statistically significant difference between different TCM syndrome types(x~2=5.186,p=0.269).The number of female patients with disharmony between liver and stomach was significantly higher than that of malepatients.(2)and the correlation of age,compared to patients with different TCM syndrome types of age difference was statistically significant(x~2=20.953,p<0.001),the spleen and stomach weak,gastric stasis winding resistance are in the majority with age of patients over 60,stomach Yin deficiency and disharmony of liver and stomachhave the majority with age of 51~60 patients,spleen and stomach syndrome in patients under 50 years old and is in the majority;(3)correlation with disease course:the age difference of patients with different TCM syndromes was not statistically significant(x~2=0.528,p=0.971).3.Correlation between TCM syndromes and gastroscopy:(1)correlation with the manifestations of gastroscopy:Gastroscope like 52patients characterized by mucosa play,accounted for 43.33%,the second order for blood vessels and 29.17%(35/120),mucosal hyperplasia of rough 16.67%(20/120)and particles(13/120),10.83%.The differences between the groups were not statistically significant(x~2=11.231,p=0.312).(2)correlation with the extent of gastroscopic atrophy:73 patients under gastroscope toⅠatrophy degree,accounted for 60.83%,42 patients were under gastroscope toⅡatrophy degree,accounted for 35.00%,5 patients under gastroscope toⅢatrophy degree,accounted for 4.17%.The degree of gastroscopic atrophy of the patients with spleen stomach weakness,stomach collaterals stasis,spleen stomach damp heat and liver stomach disharmony was mainly grade I,while the degree of gastroscopic atrophy of the patients with stomach yin deficiency was mainly grade II.There was no significant difference between the groups(x~2=6.372,p=0.137).(3)correlation with gastroscopic morphology:77 patients showed hyperplasia under gastroscope,accounting for 64.17%(77/120),followed by 51.67%(62/120)with erosion,15.00%(18/120)with bleeding,15.00%(18/120)with simplicity,7.50%(9/120)with bile reflux and 0.83%(1/120)with hypertrophy.The main pattern was hyperplasia under gastroscopy in TCM syndrome groups.The difference was not statistically significant(x~2=12.724,p=0.889).4.Correlation between TCM syndromes and pathological images:(1)correlation with the degree of mucosal atrophy:Mucosa pathological degree of atrophy of the 56 patients for the moderate,accounted for 46.67%,47 patients,the mucosa pathological atrophy mild accounted for 39.17%,17 patients with mucosal pathology for severe atrophy degree,accounted for 14.17%,patients with different TCM syndrome types of mucosa pathological atrophy was statistically significant difference in(x~2=17.850,p=0.001).The results showed that there was significant difference in the degree of pathological atrophy between the patients with spleen stomach weakness and those with liver stomach disharmony(p<0.001).(2)correlation with intestinal metaplasia:57 cases of intestinal metaplasia of mild accounted for47.50%,55 cases of patients with intestinal metaplasia level is moderate,accounted for45.83%,5 patients with a severe intestinal metaplasia,accounted for 4.17%,patients with different TCM syndrome types of intestinal metaplasia level compared with the difference was statistically significant(x~2=22.189,p<0.001).There was significant difference in metaplasia degree of intestinal epithelium between the patients with spleen and stomach weakness and those with stomach collateral stasis,spleen and stomach weakness and liver stomach disharmony,stomach collateral stasis and spleen stomach damp heat(p<0.005).(3)and the correlation of intraepithelial neoplasia:95 patients of intraepithelial neoplasia showed negative,accounted for 79.17%,24 cases of mild intraepithelial neoplasia,accounted for20.00%,only 1 patients of severe intraepithelial neoplasia,accounted for 0.83%,patients with different TCM syndrome types of intraepithelial neoplasia degree,there is no statistically significant difference in(x~2=4.106,p=0.392).(4)correlation with inflammatory activity:35patients with inflammatory activity as the stationary phase,accounted for 29.17%,85 cases of inflammatory activity to activity,accounted for 70.83%,compared to patients with different TCM syndrome types of inflammatory activity there was no statistically significant difference(x~2=6.920,p=0.140).5.The correlation of TCM syndrome type and the degree of the patients with Hp infection:59 patients with negatie for Hp,accounted for 49.17%,39 patients with mild infection of Hp,accounted for 32.50%,8 patients for Hp,moderate infection accounted for6.67%,14 cases of patients with severe infection of Hp,accounted for 11.67%,compared to patients with different TCM syndrome types of Hp infection degree there was no statistically significant difference(x~2=0.500,p=0.974).Conclusion:The TCM syndrome types of chronic atrophic gastritis are mainly spleen and stomach weakness,followed by disharmony of liver and stomach,the lowest proportion of stomach collateral stasis,and the age distribution of different TCM syndrome types are different.According to the relationship between TCM Syndrome Types and pathological features of patients,there are significant differences in pathological atrophy degree of mucosa and metaplasia degree of intestinal epithelium in some TCM syndrome types.The pathological atrophy of gastric mucosa is more likely to occur in spleen stomach Asthenia Type than in liver stomach disharmony type.The metaplasia degree of intestinal epithelium in spleen stomach Asthenia Type and spleen stomach damp heat type is mainly mild,while the metaplasia degree of other syndrome types is mainly moderate. |
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