| Objective:To explore the related factors of chronic atrophic gastritis,the distribution characteristics of TCM complex syndromes,and the relationship between gender,age,course of disease,morphological changes under endoscopy,pathological manifestations,etc.It also summarizes Professor Liu Huayi’s clinical experience in treating this disease to better guide clinical practice and provide an objective basis for the improvement of TCM diagnosis and treatment of chronic atrophic gastritis.Methods:Collect 210 patients with chronic atrophic gastritis who meet the inclusion and exclusion criteria.Collect the patient’s general condition,medical history information,disease-related factors,gastroscopy,pathology,symptoms,and signs,clarify the types of complex syndromes of traditional Chinese medicine,and establish an Excel database.Use Spss25.0 for statistical analysis.The clinical medical records of Professor Liu Huayi’s treatment of atrophic gastritis are summarized and summarized from the etiology and pathogenesis,diagnosis and treatment ideas,experience in syndrome differentiation and treatment,and experience in syndrome differentiation and medication,and explore Liu Shi’s experience in treating this disease.Results:1 This study included 210 CAG patients,91 males(43.3%)and 119 females(56.7%);in terms of age distribution,61-70 years old patients accounted for 51.0%;high school or technical secondary school was the most common in terms of age distribution.Accounted for 48.6%;retirees accounted for the largest occupation distribution,accounting for 76.2%;the accompanying chronic medical diseases were patients with hypertension,accounting for29.0%;the proportion of smoking and drinking in male patients was higher than that in females,and the difference was statistically significant(P<0.01);in staying up late,there are more men than women,and the difference is statistically significant(P<0.05);male patients are more likely to eat fast,salty,carnivorous,and strong tea than female patients;female patients have more light diets and sweet foods than male patients,and the difference is statistically significant(P<0.05);in terms of psychological and mental status,only 31.9%of patients with no abnormalities,male and female patients have no statistical differences in psychological and mental abnormalities academic significance(P>0.05).2 The distribution of TCM syndromes in 210 CAG patients with Qi-deficiency and stasis syndrome(22.9%)was the most,and the syndrome of cold-heat syndrome(9.0%)was the least;the gender distribution of the syndrome of liver depression and spleen deficiency was statistically significant(χ~2=6.737,P<0.01);there was a statistical difference in the distribution of syndromes in male patients(χ~2=13.901,P<0.05),with Qi deficiency and blood stasis syndrome being the most;there was no statistical difference in the age distribution of different compound syndromes(P<0.05);There is a statistically significant difference in the distribution of the disease course in the syndrome of cold-heat complex syndrome and qi stagnation and blood stasis syndrome,damp-heat syndrome and qi and yin deficiency syndrome,cold-heat complex syndrome and qi and yin deficiency syndrome,liver stagnation and spleen deficiency syndrome and qi and yin deficiency syndrome(P<0.05).3 210 CAG patients showed significant differences in the distribution of complex syndromes of traditional Chinese medicine in the color of mucosa,vascular permeability,mucosal folds,mucosal texture,erythema and erosion under gastroscope,and distribution of bleeding and bile reflux syndromes Equivalent.4 In the correlation between TCM complex syndromes and pathological manifestations,the positive Hp infection is statistically significant in the distribution of TCM syndromes;different syndromes are statistically significant in the distribution of chronic inflammation,atrophy,intestinal metaplasia,and dysplasia,while the distribution of compound syndrome activity degree is not statistically significant.Among them,Hp positive is mainly due to damp-heat and blood stasis syndrome;chronic inflammation is mainly due to qi deficiency and blood stasis syndrome,followed by liver depression and spleen deficiency syndrome.After pairwise comparison,there are differences in the degree of chronic inflammation between Qi deficiency and blood stasis syndrome and Qi and Yin deficiency,liver depression and spleen deficiency and Qi and Yin deficiency,liver depression and spleen deficiency syndrome and damp-heat and stasis syndrome.Mild atrophy is dominated by Qi deficiency and blood stasis,moderate atrophy is dominated by liver depression and spleen deficiency,and severe atrophy is dominated by Qi and Yin deficiency.After pairwise comparison,there is a difference in the degree of atrophy between the Qi and Yin deficiency syndrome,the liver stagnation and spleen deficiency syndrome,and the Qi deficiency and blood stasis syndrome.Mild intestinal metaplasia is dominated by liver depression and spleen deficiency,moderate intestinal metaplasia is dominated by Qi and Yin deficiency,and severe intestinal metaplasia is dominated by Qi stagnation and blood stasis syndrome.After pairwise comparison,there is a difference in the degree of intestinalization between the syndrome of liver depression and spleen deficiency and the syndrome of qi stagnation and blood stasis,and the degree of intestinalization between the syndrome of qi and yin deficiency and the syndrome of spleen deficiency and qi stagnation,qi deficiency and stasis syndrome,and liver depression and spleen deficiency syndrome.Mild dysplasia is dominated by Qi deficiency and blood stasis syndrome,and moderate dysplasia is dominated by Qi and Yin deficiency.After pairwise comparisons,there are differences in the degree of dysplasia between cold-heat complex syndrome and qi stagnation and blood stasis syndrome,cold-heat complex syndrome and qi and yin deficiency syndrome,liver depression and spleen deficiency syndrome and qi deficiency syndrome,liver depression and spleen deficiency syndrome and qi stagnation and blood stasis syndrome,Liver depression and Spleen deficiency syndrome and Qi and Yin deficiency syndrome.The above differences are statistically significant(P<0.05).Conclusions:1 The CAG-affected population is mainly retired elderly people.In the distribution of compound syndromes,Qi deficiency and blood stasis syndrome is the most common.Age is not a related factor affecting the distribution of syndromes.The distribution of different syndromes is related to gender and disease course.2 The distribution of CAG compound syndromes has a certain relationship with its manifestations under gastroscopy.Among them,the syndromes of liver depression and spleen deficiency,qi deficiency and stasis syndrome,and qi and yin deficiency syndrome are more likely to have abnormal changes under gastroscopy,which can provide references for endoscopic microscopic differentiation.3 The main pathological changes of CAG are related to the distribution of complex syndromes.Different degrees of atrophy,intestinal metaplasia,and dysplasia are common in the syndrome of liver depression and spleen deficiency,qi stagnation and blood stasis syndrome,qi deficiency and blood stasis syndrome,and qi and yin deficiency.In addition,the degree of pathological changes in some syndromes is different.The pathological results can be combined to enhance the accuracy of syndrome differentiation.The judgment of the patient’s syndrome can also indirectly predict the pathological situation.It is worthwhile to further expand the research sample and increase the the connection between traditional dialectical and micro-examination.4 Professor Liu Huayi has unique insights on the treatment of this disease,paying attention to protecting the spleen and stomach,regulating the lifting and lowering of the Qi machine,overall recuperation,taking medicines to relieve and tonic,clever use of the right medicines,flexible,and remarkable clinical effects,highlighting the advantages of traditional Chinese medicine in the treatment of CAG. |
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