| Objective:By observing the distribution and pathological characteristics of tongue image in patients with raised erosive gastritis(raised erosive gastritis,REG),to summarize the relationship between tongue image,pathological manifestations and Helicobacter pylori(Helicobacter pylori,Hp)infection,and provide relevant reference for the clinical diagnosis and treatment of REG with integrated traditional Chinese and Western medicine.Methods:186 patients diagnosed as REG through gastroscopy and matching the inclusion criteria were collected from January 1,2021 to January 1,2022 at Ningde Hospital of traditional Chinese Medicine.The name,gender,age,BMI,smoking and drinking history,gastroscopic diagnosis,tongue features,histopathological diagnosis,Hp test results and other information of each subject were recorded.SPSS 22.0 software was used for data processing and analysis,to summarize the relationship between tongue image,pathological manifestations and Helicobacter pylori(Helicobacter pylori,Hp)infection.Result:1.(1)There was no significant difference between men and women in 186 REG patients(P>0.05).The average age of onset was 53 ± 10 years old,and uneven distribution of age at onset(P<0.05),with 98 cases(52.7%)aged 45 ～ 59 years old(middle age),followed by 47cases(25.3%)aged 60 ～ 75 years old(old age).(2)The highest proportion of overweight patients was 75 cases(40.3%),and obesity was 38 cases(20.4%).The proportion of smoking history was 37.1%,and the proportion of drinking history was 38.7%.2.(1)186 patients with REG had uneven distribution of tongue color and coating(P<0.05).Red tongue accounted for the highest proportion of tongue color distribution,which was 69 cases of red tongue(37.1%)>61 cases of light red tongue(32.8%)>23 cases of cyan(ecchymosis)tongue(12.4%)>22 cases of light white tongue(11.8%)>11 cases of crimson tongue(5.9%).yellow thick(greasy)fur accounted for the highest proportion of tongue fur distribution,the distribution was yellow thick(greasy)fur in 51 cases(27.4%)>thin white fur in 44 cases(23.7%)>white thick(greasy)fur in 38 cases(20.4%)>thin yellow fur in 32cases(17.2%)>peeling(less)fur in 21 cases(11.3%).(2)There were 103 patients with Hp positive,the Hp infection rate was 55.4%.(3)186 patients with REG had different degrees of chronic inflammation,of which 104 cases(55.9%)were mild;158 cases(84.9%)had active inflammation,of which 96 cases(51.6%)were mild.The pathological manifestations were common in non atrophic gastritis(P<0.05),107 cases(57.5%),atrophy in 79 cases(42.5%),intestinal metaplasia in 63 cases(33.9%),and low-grade intraepithelial neoplasia(low-grade intraepithelial neoplasia,LGIN)in 21 cases(11.3%).(4)In 186 patients with REG,the proportion of active inflammation,atrophy and intestinal metaplasia in Hp positive group was higher than that in Hp negative group(P<0.05).There was no significant difference in the distribution of LGIN between the two groups(P>0.05).3.(1)in 186 patients with REG,the overall tongue color and tongue coating distribution of non atrophic group and atrophic group were different(P<0.05).Further comparison,the proportion of cyan(ecchymosis)tongue and exfoliated(less)coating in atrophic group was higher than that in non atrophic group(P<0.05);There was no significant difference in the overall tongue color distribution between the intestinal metaplasia group and the intestinal metaplasia group(P>0.05).Further comparison,the proportion of cyan(ecchymosis)tongue in the intestinal metaplasia group was higher than that in the intestinal metaplasia group(P<0.05),and there was difference in the overall distribution of tongue coating between the two groups(P<0.05).Further comparison,the proportion of peeling(less)fur in the intestinal metaplasia group was higher than that in the intestinal metaplasia group(P<0.05);There was a difference in the overall distribution of tongue color between the group without intraepithelial neoplasia and the group with low-grade intraepithelial neoplasia(P <0.05).Further comparison,the proportion of cyan(ecchymosis)tongue in the group with LGIN was higher than that in the group without LGIN(P<0.05),and there was no significant difference in the overall distribution of tongue coating(P>0.05),The proportion of exfoliated(less)moss in LGIN group was higher than that in non LGIN group(P<0.05).(2)The distribution of overall tongue color and tongue coating in inactive inflammation group and active inflammation group were different(P<0.05).The tongue color of inactive inflammation was mainly light red tongue in 18 cases(64.3%),thin white tongue coating in 13 cases(46.4%),the tongue color of active inflammation was mainly red tongue in 64 cases(40.5%),and yellow thick(greasy)fur in 48 cases(30.4%),by correlation analysis,there was a negative weak correlation between thin white fur and active inflammation(P<0.05),and a positive weak correlation between red tongue,crimson tongue and yellow thick(greasy)fur and the grade of active inflammation(P<0.05).(3)There was no significant difference in the overall tongue color distribution between Hp negative group and Hp positive group(P > 0.05).Further comparison,the proportion of red tongue in Hp positive group was higher than that in Hp negative group(P<0.05);There were differences in the overall distribution of tongue coating between the two groups(P<0.05).Further comparison showed that the proportion of yellow thick(greasy)fur in Hp positive group was higher than that in Hp negative group,and the proportion of thin yellow fur was lower than that in Hp negative group.Conclusion:1.(1)REG tongue color distribution is mainly red tongue,and the tongue coating is mainly yellow thick(greasy)fur.(2)The common pathological manifestations of REG were nonatrophic gastritis and chronic active inflammation.(3)In REG patients,the proportion of active inflammation,atrophy and intestinal metaplasia in patients with HP infection was higher than that in patients without Hp infection.2.(1)the proportion of cyan(ecchymosis)tongue and exfoliated(less)fur in atrophy,intestinal metaplasia and LGIN was higher than that in patients without such pathological manifestations.(2)Red tongue,crimson tongue and yellow thick(greasy)fur were positively correlated with active inflammation,while light red tongue and thin white fur were negatively correlated with active inflammation.(3)In REG patients,the proportion of red tongue and yellow thick(greasy)fur with Hp infection was higher than that without Hp infection.3.There is a certain correlation between tongue image,pathological manifestation and Hp in patients with REG,which can provide a reference for the treatment of this disease with integrated traditional Chinese and Western medicine. |
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