Professor Xie Jingri’s Clinical Experience In Identifying And Treating Chronic Atrophic Gastritis Through The Way Of Traditional Chinese Medicine

Objective: To analyze the rules of diagnosis and treatment of the disease by the tutor through a retrospective study of the clinical medical records of my tutor Professor Xie Jingri’s past diagnosis and treatment of chronic atrophic gastritis,the patients’ general information,medical history records,diagnosis of TCM and first prescription drugs were statistically processed,and then try to summarize the clinical experience of the tutor.Methods: 120 cases of medical records with the first consultation time from January 2016 to December 2019 were collected from Professor Xie Jingri outpatient medical record system,which were in accordance with the diagnostic standards and included standards.The data were preprocessed and standardized and then entered into Microsoft Excel 2019 spreadsheet to establish the required databases.The above software is used to analyze the general situation,medical history records,diagnosis of TCM and first prescription drugs of the patients directly,and IBM SPSS modeler 18.0software is utilized to analyze the correlations between tongue manifestation and syndrome,and between pulse manifestation and syndrome.The frequently used Chinese medicinal materials used by the tutor for CAG are systematically cluster analyzed by IBM SPSS statistics 25 software.Results:1.According to the frequency analysis of general data and medical records,it showed that: The gender influence of the patients in this study had little difference in the distribution of CAG,and age within 51-60 years old was the peak age group of the disease,the number of patients under 30 years old was very small,the proportion of the patients with cancer family history was 23.33%,and the courses of disease were more than 1 year mostly when they first consulted.63.33% of the patients had dry mouth,bitter mouth or fetid breath,among which the number of patients with both dry mouth and bitter mouth was the most.And their pulse manifestation were mainly taut pulses.2.According to the frequency analysis of the diagnoses of TCM,it showed that: The name of TCM diagnosis was mainly stomachache or distention and fullness.The syndrome differentiation diagnosis was often complex syndromes,only 10 within 120 cases were diagnosed as single syndromes of liver stomach qi stagnation and liver stomach stagnation-heat syndrome.In the diagnosis of complex syndromes,the majority of the combination of two syndromes was spleen and stomach weakness syndrome +liver stomach qi stagnation syndrome,and the majority of the combination of three syndromes was spleen and stomach weakness syndrome + liver stomach qi stagnation syndrome + stomach collaterals stasis syndrome.3.According to the frequency analysis of the medication circumstances in the first prescriptions,it showed that: The 11 of Atractylodis Macrocephalae Rhizoma,Bupleuri Radix,Amomi Fructus Rotundus,Citri Reticulatae Pericarpium,Shenqu,Perillae Fructus,Sepiae Endoconcha,Citri Fructus,Citri Sarcodactylis Fructus,Magnoliae Officinalis Cortex and Linderae Radix were the high frequency Chinese medicinal materials prescribed by the tutor,and the prescription proportion is more than 50%.The main drug properties used by the tutor were warm,mild cold and peaceful,accounting for 77.57%;the flavor of the drugs were mainly spicy,bitter and sweet,accounting for 78.29%;the meridian tropism of the drugs were spleen,stomach,lung and liver,accounting for 72.34%.The main drug efficacy categories used by the tutor in treating CAG were Qi regulating medicine,tonic medicine,dampness medicine,digestive medicine,heat clearing medicine,phlegm relieving cough and asthma medicine,accounting for 69.66%.4.The correlation analysis of tongue-syndrome and pulse-syndrome showed that the tongue features of thin and white moss,tongue features with tooth marks on the tongue,fine vein pulse of string were closely related to CAG liver and stomach qi stagnation syndrome;tongue features of tongue dark red,tongue collateral vein turning bend and thicken,astringent pulse were closely related to CAG stomach collaterals blood stasis syndrome;tongue features with cleft pattern and less moss,smooth fine vein pulse were closely related to CAG deficiency of stomach yin;tongue features with yellow and greasy moss,slippery fast pulse were closely related to CAG liver and stomach depression syndrome;the features of tongue with fat tongue and deep pulse were closely related to CAG spleen and stomach weakness or spleen stomach damp heat syndrome.5.The core prescription of the tutor in CAG treatment was obtained by the association analysis of the first prescription drugs,including Bupleuri Radix,Atractylodis Macrocephalae Rhizoma,Citri Reticulatae Pericarpium,Shenqu,Amomi Fructus Rotundus,Perillae Fructus and Sepiae Endoconcha.6.The cluster analysis of frequently used drugs(frequency ≥ 12)showed that: Commonly used drug pairs were Haematitum,Inulae Flos;Lysimachia Christinae Hance,Curcumae Radix;Astragali Radix,Pseudostellariae Radix;Hordei Fructus Germinatus,Crataegi Fructus;Scutellariae Radix,Gardeniae Fructus;Longgu,Ostreae Concha;Paeoniae Radix Alba,Glycyrrhizae Radix Et Rhizoma;Sparganii Rhizoma,Curcumae Rhizoma;Scutellariae Barbatae Herba,Hedyotis Diffusa;Coptidis Rhizoma,Euodiae Fructus;Arcae Concha,Fritillariae Thunbergii Bulbus;Aurantii Fructus Immaturus,Arecae Semen;Citri Reticulatae Pericarpium,Shenqu;Dendrobii Caulis,Glehniae Radix;Dioscoreae Rhizoma,Psoraleae Fructus;Amomi Fructus Rotundus,Linderae Radix;Citri Sarcodactylis Fructus,Perillae Fructus.And commonly used drug combinations were Perillae Fructus,Citri Sarcodactylis Fructus,Aurantii Fructus;Coptidis Rhizoma,Euodiae Fructus,Arcae Concha,Sepiae Endoconcha,Haliotidis Concha;Aurantii Fructus Immaturus,Arecae Semen,Rhei Radix Et Rhizoma,Magnoliae Officinalis Cortex,Scrophulariae Radix;Amomi Fructus Rotundus,Linderae Radix,Alpiniae Katsumadai Semen;Hordei Fructus Germinatus,Crataegi Fructus,Citri Reticulatae Pericarpium,Shenqu,Galli Gigerii Endothelium Corneum;Dendrobii Caulis,Glehniae Radix,Lilii Bulbus;Glycyrrhizae Radix Et Rhizoma,Paeoniae Radix Alba,Corydalis Rhizoma.Conclusions:1.Professor Xie Jingri usually pay attention to tongue diagnosis,combine with special symptoms,and refer to pulse diagnosis to differentiate chronic atrophic gastritis.2.The basic principles of Professor Xie Jingri in the treatment of CAG are clearing liver,tonifying spleen and invigorating stomach,treating both specimens,clearing heat,detoxifying and eliminating diseases to attack the focus;and keeping the heart happy and calm,paying attention to nursing.3.Professor Xie Jingri likes to use drug pairs and drug combinations in the treatment of CAG,and makes Bupleuri Radix,Atractylodis Macrocephalae Rhizoma,Citri Reticulatae Pericarpium,Shenqu,Amomi Fructus Rotundus,Perillae Fructus and Sepiae Endoconcha as the core prescription.4.The main types of the drugs used by Professor Xie Jingri in the treatment of CAG are properties of warm,mild cold and flat;spicy,flavors of bitter and sweet taste;meridian tropisms of spleen,stomach,lung and liver;drug efficacy categories of Qi regulating medicine,tonic medicine,dampness medicine,digestive medicine,heat clearing medicine,phl egm relieving cough and asthma medicine.