| Objective : To summarize the TCM syndrome pattern of senile ulcerative colitis by cluster analysis.According to the endoscopic manifestations of different TCM syndromes,the correlation between TCM syndromes and endoscopic manifestations was explored to provide objective evidence-based basis for TCM syndrome differentiation and treatment of ulcerative colitis in the elderly.Methods : From June 2005 to June 2019,416 patients with senile ulcerative colitis in the Department of Traditional Chinese Medicine,the Department of Geriatrics and the Department of Integrated Traditional Chinese and Western Medicine of the First Hospital of Zibo City were selected as the study cases.All the syndromes of the selected cases were counted,and the syndromes that had no significance for the diagnosis were excluded.The remaining 88 syndromes were entered into the computer SPSS26.0 software,and the 88 syndromes were clustered to summarize the TCM syndrome patterns of senile ulcerative colitis.Then,based on the TCM syndrome types obtained from the cluster analysis results as the diagnostic criteria,the four diagnostic data of 416 patients were differentiated one by one,and the TCM syndrome types of each case were determined.Finally,the colonoscopy data of 416 patients were counted to explore the relationship between TCM syndrome types and colonoscopy performance.Results :1According to the clustering pedigree chart,the elderly ulcerative colitis is divided into seven syndromes,namely : spleen and stomach qi deficiency syndrome,large intestine damp-heat syndrome,liver stagnation and spleen deficiency syndrome,yin and blood deficiency syndrome,cold and heat mixed syndrome,blood stasis intestinal collaterals syndrome.Among them,spleen and stomach qi deficiency accounted for 27.40 %,large intestine damp heat accounted for 20.19 %,spleen and kidney yang deficiency accounted for 19.71 %,liver stagnation and spleen deficiency accounted for 11.06 %,yin and blood deficiency accounted for 9.62 %,cold and heat mixed accounted for 7.21 %,blood stasis and intestinal collaterals accounted for 4.81 %.2 In this study,there was a difference between TCM syndrome types and gender(P < 0.05).The most common syndrome type of male patients was colorectal damp-heat syndrome,and the most common syndrome type of female patients was spleen-stomach qi deficiency syndrome.3 The highest proportion of patients with education in this study was junior high school education,followed by primary school education,the third highest proportion was high school education,the lowest proportion was college and above,and the lowest proportion was illiteracy.4 Patients with diet preference to the most pungent,followed by salty,and the lowest proportion of bitter.5 Patients with the course of 20 years in this study had the lowest proportion.6 There was no significant difference between TCM syndrome types and body weight in this study(P > 0.05).According to the descriptive statistics,the proportion of patients with blood stasis and intestinal collaterals syndrome in normal weight group was the highest,and the proportion of patients with excess large intestine damp-heat syndrome was the highest.The proportion of patients with spleen-stomach qi deficiency syndrome and spleen-kidney yang deficiency syndrome in obesity group was the highest.7 There was a statistically significant difference between TCM syndrome types and disease stages of ulcerative colitis in this study(P < 0.05).The proportion of patients in the active stage of colorectal damp-heat syndrome was the highest,while that in the remission stage of liver depression and spleen deficiency syndrome was the highest.8 In this study,there was no significant difference in the severity of disease between TCM syndrome types and active patients(P > 0.05).By descriptive statistics,the proportion of mild patients with yin and blood deficiency was the highest,the proportion of moderate patients with liver depression and spleen deficiency was the highest,and the proportion of severe patients with large intestine damp-heat syndrome was the highest.9 In this study,there was no statistical significance between TCM syndrome type and lesion range of ulcerative colitis(P > 0.05).According to descriptive statistics,the lesion range of yin-blood deficiency syndrome was the highest in rectum,the lesion range of spleen-stomach qi deficiency syndrome was the highest in left colon,and the lesion range of liver depression and spleen deficiency syndrome and blood stasis intestinal collaterals syndrome was the highest in whole colon.10 In terms of mucosal lesions,the difference between TCM syndrome types and mucosal erosion,ulcer,granular change,contact bleeding,congestion and edema was statistically significant(P0.05).11 In this study,there was no significant difference between TCM syndrome types and mucosal surface coating colors.According to descriptive statistics,yellow coating was more common on the mucosal surface of patients with colorectal damp-heat syndrome,and white coating was more common on the mucosal surface of patients with spleen-stomach qi deficiency syndrome.12 In this study,there was no significant difference between TCM syndrome types and inflammatory polyps,and there was no correlation between TCM syndrome types and inflammatory polyps.Descriptive statistical analysis showed that inflammatory polyps were more common in patients with spleen-stomach qi deficiency syndrome.13 There was no significant difference in TCM syndrome type and disappearance of colon bag in this study(P > 0.05).By descriptive statistical analysis,the disappearance of colonic bag was more common in patients with spleen-stomach qi deficiency syndrome and yin-blood deficiency syndrome.14 In this study,there was no statistically significant difference between TCM syndrome types and intestinal stenosis(P > 0.05).After descriptive statistics,the positive rate of intestinal stenosis in colorectal damp-heat syndrome was the highest.Conclusion :1 According to the results of cluster analysis,elderly ulcerative colitis was divided into seven syndromes : spleen-stomach qi deficiency syndrome,large intestine dampness-heat syndrome,liver depression and spleen deficiency syndrome,yin-blood deficiency syndrome,cold-heat mixed syndrome,and blood stasis and intestinal collaterals syndrome.Compared with the diagnosis and treatment plan of integrated traditional Chinese and western medicine formulated by the digestive system disease professional committee of the Chinese Society of Integrated Traditional Chinese and Western Medicine in Xichang in 2010,the similarity is high but different,indicating that the distribution of TCM syndromes in elderly patients with ulcerative colitis is different from that in young and middle-aged patients.The proportion of elderly patients with ulcerative colitis deficiency is more,which can be inferred that for most elderly patients with ulcerative colitis,clinical treatment should be more tonic-based,supplemented by purging excess.2 There were statistically significant differences between TCM syndrome types and gender,disease stage,mucosal erosion,mucosal ulcer,mucosal granular change,mucosal contact bleeding,mucosal congestion and edema in elderly patients with ulcerative colitis.It can provide objective reference for the treatment of ulcerative colitis in the elderly. |
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