Based On The Theory Of "Gathering In The Stomach And Related To The Lungs" To Explore The Treatment Of Chronic Urticaria From The Lungs And Stomach

Objective:To study the correlation between Helicobacter pylori infection,gastric complaints and diseases,and chronic urticaria with different TCM syndromes;to explore the influencing factors of poorly controlled chronic urticaria patients,and to explore the correlation between poorly controlled patients and gastric complaints and diseases.Methods:A cross-sectional study method was used.chronic urticaria patients who met the research criteria in the Dermatology Clinic of Guang’anmen Hospital from March 2021 to February 2022 were recruitted.The general condition,disease severity scores.comorbidities.HP infection.and gastric complaints and diseases of patients with different TCM syndromes were collected.The general situation,disease severity,comorbidities,HP infection,and gastric complaints and diseases were analyzed for chronic urticaria with different TCM syndromes.Patients were divided into HP antibody group and non HP antibody group according to with/without HP antibody.According to the type of HP antibody,the patients were divided into no HP infection(all antibodies were negative),type Ⅰ infection singlepositive group(CagA positive or Vac positive),type Ⅰ infection double-positive group(both CagA and VacA positive),type Ⅱ infection(only UreB or UreA positive,or both positive)group.Differences in general condition,disease severity,comorbidities,gastric complaints and diseases,and TCM syndromes were analyzed.The patient’s UCT score from 7 days before the visit to the visit day was recorded.For patients whose UCT less than 12,that is,the disease was not controlled well,the chronic gastrointestinal disease(PRO scale)was performed to evaluate the gastrointestinal symptom.Using UCT score as the outcome variable,regression analysis was performed on the general condition of patients,HP infection,gastrointestinal symptom scores and comorbidities.Excel was used to establish a database and graph,and SPSS25.0 was used for statistical analysis.Results:1.A total of 85 patients who met the research criteria were included in this study,including 64 females(75.3%)and 21 males(24.7%).The age ranged from 24 to 72 years old,the average age was 39.71±10.32 years old.the average total disease duration was 40.17±51.69 months,and the average disease duration of current onset was 19.05±34.45 months.Comorbidities included gastric complaints in 34 cases(40%),dermographism in 33 cases(38.8%),gastric diseases disease in 21 cases(28.8%),allergic rhinitis in 19 cases(22.4%),Hashimoto’s thyroiditis in 14 cases(16.5%),11 cases(12.9%)of thyroid nodules,5 cases(5.9%)of hypothyroidism,and 3 cases(3.5%)of allergic conjunctivitis.Heartburn is most common gastric complaints in CU,followed by acid regurgitation and bloating.The most common gastric disease is chronic superficial gastritis,followed by gastroesophageal reflux disease,gastroduodenal ulcer.2.A total of 85 CU patients who met the diagnosis of TCM disease and 5 TCM syndrome were recruitted,including 38 cases(44.71%)of gastrointestinal damp-heat syndrome,21 cases(24.71%)of wind-heat syndrome,13 cases(15.29%)of qi and blood deficiency syndrome,and 9 cases(10.59%)of toxic heat syndrome,and 4 cases(4.71%)of wind-cold syndrome.There was no statistical difference in gender,age,total duration of disease and disease duration of current onset among 5 basic TCM syndromes.There was no statistical difference in the scores of HSS,ISS,UAS and UAS7 among the 5 basic syndromes groups.According to UAS7≤6.7-15,16-27,28-42,the patients were divided into mild group,moderate group,severe group and severe group.UAS7 graded according to the severity of the disease,was no statistical difference between the five basic syndromes groups.the syndrome with the highest incidence in the severe group was toxic heat syndrome,followed by qi and blood deficiency syndrome.3.Compared with no HP antibody,chronic urticaria with HP antibody had higher UAS7,and the difference was statistically significant(P=0.033).The UAS7 was classified into four severity levels,and HP antibody group had higher severity levels than no HP antibody group,and the difference was statistically significant(P=0.030).4.There was no statistical difference in the positive rate of HP antibodies among the CU patients with five basic syndromes.There was no statistical difference in different HP antibody types among the 5 basic syndromes.5.F or patients with UCT<12,that is,the disease has not been well controlled,multivariate regression analysis was performed.It showed that total defecation score was negatively correlated with UCT(B=-0.377,P=0.026).The higher the total defecation score,the lower the UCT score.Conclusion:Although chronic urticaria manifests on the skin,it is associated with the viscera.Lungs and stomach,cooperate with each other physiologically,and influence each other pathologically.Lung-stomach disharmony is related to the pathogenesis of chronic urticaria.HP infection is the cause of"gathering in the stomach",and gastric complaints and diseases are the manifestation of "gathering in the stomach".The dysfunction of descending in the stomach,dispersing and descending of the lungs can lead to disharmony between the lungs and stomach,that is,"related to the lungs".This study found that chronic urticaria patients with HP antibodies positive,and with gastrointestinal symptoms,had higher disease severity,and were more prone to treatment resistance.The treatment of chronic urticaria should take into account the stomach.To treat the lungs and stomach simultaneously is not only suitable for gastrointestinal damp-heat syndrome,but also for other syndromes of chronic urticaria.And it can relieve symptoms and reduce recurrence.Based on the TCM theory of "gathering in the stomach and related to the lungs",to treat chronic urticaria from the lungs and stomach provides an objective basis for better studying the pathogenic mechanism of chronic urticaria and improving the clinical efficacy of chronic urticaria..