| Objective:To analyze and investigate the distribution characteristics of TCM compound syndrome types of Chronic Atrophic Gastritis(CAG)in middle-aged people,and the relationship between gender,diet habits and other factors as well as morphological changes and pathological changes under gastroscopy,and to analyze and study the microscopic syndrome differentiation.The purpose of this study is to further explore and improve the diagnosis and treatment system of CAG syndrome differentiation,and provide basis for guiding clinical practice.Method:A total of 235 middle-aged patients with CAG were selected according to the inclusion and exclusion criteria.General information,medical history,morbidity related factors,Hp infection,gastroscopy,pathology,symptoms and signs of the patients were collected,and the classification of TCM complex syndrome was defined.An Excel database was established and Spss26.0 was used for statistical analysis.Results:1.General information: 235 middle-aged patients with CAG were included in this study,including 126 males and 109 females.There were 40 patients with hypertension,14 with diabetes mellitus and 10 with coronary heart disease.Esophagitis was the most common complication under gastroscopy in 26 cases,followed by ectopic esophagogastric mucosa in 23 cases and cardia in 11 cases.The course of disease was less than 5 years in 171 cases,accounting for the largest proportion,and more than 10 years in 24 cases.2.Distribution of TCM complex syndrome types: 235 middle-aged CAG patients were diagnosed.TCM complex syndrome was mainly dominated by damp-heat mixed with blood stasis,accounting for 32.7% of all cases.Followed by 48 cases of liver depression and spleen deficiency,38 cases of qi stagnation and damp-heat,36 cases of qi stagnation and blood stasis,20 cases of qi and Yin deficiency and 16 cases of cold and heat mixed syndrome.(1)In terms of gender,there was no statistical significance between CAG complex syndrome type and gender distribution(P >0.05).(2)In terms of eating habits,there was statistical significance between CAG complex syndrome and eating habits(P < 0.05).Among them,46 cases of middle-aged CAG patients had the most fat and sweet eating habits,accounting for 19.50% of the total number.(3)In terms of eating habits,there was statistical significance between TCM CAG complex syndrome and eating habits(P < 0.05).Among them,the number of people with inattention while eating was the largest,46 cases,accounting for 19.5% of the total number.(4)The course of the disease was mainly caused by dampness-heat mixed with blood stasis in 5 years,liver depression and spleen deficiency in 5-10 years,and damness-heat mixed with blood stasis after 10 years.There was statistical difference between TCM complex syndromes and course of disease(P<0.05).3.Mucosal manifestations in middle-aged CAG patients under gastroscopy and TCM complex syndromes: There were no statistical significance in mucosal color,mucosal vascular network visibility,mucosal plicae edema and TCM complex syndromes in 235 middle-aged CAG patients under gastroscopy(P > 0.05).There was statistical difference in the distribution of mucosal texture in TCM complex syndromes(P < 0.05).4.Mucosal morphology of middle-aged CAG patients under gastroscopy and TCM complex syndrome type: Among 235 cases of middle-aged CAG patients,simple atrophy,bile reflux,hemorrhage,hyperplasia,erosion and other common concomitant mucosal morphological characteristics,simple atrophy was the most common,followed by erosion and bile reflux.(1)Mucosa atrophy range: According to Kimura-Takemoto classification,222 cases were closed type,including 78 cases of C1 type,122 cases of C2 type,and 22 cases of C3 type.There were 13 cases of open type,7 cases of O1 type,4 cases of O2 type and 2 cases of O3 type.There was no statistical significance in the closed type and open atrophy range of all TCM complex syndrome types of CAG based on KimuraTakemoto classification(P > 0.05),and the closed type was the main type.In closed CAG,there was statistical difference between TCM complex syndrome type and Kimura-Takemoto closed CAG classification(P < 0.05).The syndrome of liver depression and spleen deficiency and the syndrome of qi stagnation and dampness-heat were more common in C1.C2 type with dampness-heat sandwich-stasis syndrome,qi stagnation and blood stasis syndrome is more common;C3 type of dampness-heat mixed with blood stasis syndrome,temperament dampness-heat syndrome is more common.(2)Bile reflux: there were statistically significant differences between bile reflux and different TCM complex syndrome types(P<0.05).The incidence of bile reflux from high to low was: syndrome of liver depression and spleen deficiency > syndrome of qi stagnation and dampness-heat > syndrome of qi stagnation and blood stasis,syndrome of dampness-heat mixed with blood stasis > syndrome of Qi and Yin deficiency > syndrome of cold and heat mixed.Horizontal comparison of the relationship between the syndrome types and bile reflux showed that the syndrome of liver depression and spleen deficiency in middle-aged CAG patients was mainly CAG with bile reflux,while the syndrome of dampness-heat mixed with blood stasis was mainly CAG without bile reflux(P<0.05).(3)Mucosal bleeding: there was no statistical difference between mucosal bleeding and different TCM complex syndrome types(P > 0.05).Horizontal comparison of the relationship between TCM complex syndromes and mucosal bleeding showed that the incidence of mucosal bleeding was the highest in patients with cold and heat mixed syndromes,and the distribution of mucosal bleeding was statistically significant compared with non-cold and heat mixed syndromes(P<0.05).(4)Mucosa hyperplasia: there was no statistical significance between different TCM complex syndrome types and hyperplasia(P > 0.05).Among them,middle-aged CAG patients with Qi-stagnation damp-heat syndrome had the highest incidence of hyperplasia.Compared with non-Qi-stagnation damp-heat syndrome,the hyperplasia distribution was statistically significant(P<0.05).(5)In terms of mucosal erosion,there was statistical significance between different TCM complex syndrome types and erosion(P < 0.05).The comparison of the syndrome of Qi stagnation and blood stasis with the syndrome of non-Qi stagnation and blood stasis,and the syndrome of Qi and Yin deficiency with the syndrome of non-Qi and Yin deficiency had statistical significance in the distribution of erosion(P<0.05).4.TCM complex syndrome type and pathological manifestations:(1)In terms of intestinal metaplasia,there was no statistical difference between the distribution of different TCM complex syndrome types and intestinal metaplasia(P >0.05).There was no statistical significance between different TCM complex syndrome types and the severity of intestinal metaplasia(P > 0.05).(2)In terms of intraepithelial neoplasia,there was no statistical difference in the distribution of TCM complex syndrome types in middle-aged CAG patients(P > 0.05).There was statistical difference in the distribution of intraepithelial neoplasia between Qi-stagnation damp-heat syndrome and non-Qi-stagnation damp-heat syndrome.5.Hp infection in TCM complex syndrome types: Among TCM complex syndrome types,the infection rate of Hp in middle-aged CAG patients was the highest in syndrome of cold and heat mixed,and there was no statistical difference between it and TCM complex syndrome types(P > 0.05).Conclusion:1.In the distribution of complex syndrome types in middle-aged CAG patients,the syndrome of dampness-heat mixed with blood stasis was the most common.2.There were statistical differences between TCM complex syndrome types and eating habits,eating habits and course of disease in middle-aged CAG patients.3.Middle-aged CAG patients with different TCM complex syndrome types have certain statistical differences with their gastroscopic mucosal manifestations,among which the syndrome of liver depression and spleen deficiency and the syndrome of dampness-heat mixed with blood stasis have abnormal mucosal changes under the gastroscopy.There was a certain relationship between different TCM complex syndrome types and mucosal morphology under gastroscopy in middle-aged CAG patients.Among them,the syndrome of liver depression and spleen deficiency in middle-aged CAG patients is mainly CAG accompanied by bile reflux;the occurrence of mucosal bleeding in patients with mixed cold and heat and non-mixed cold and heat has statistical significance;the syndrome of Qi stagnation and damp-heat and non-Qi stagnation and damp-heat have statistical significance in mucosal hyperplasia under gastroscopy in middle-aged CAG patients;the syndrome of Qi stagnation and blood stasis and the syndrome of Qi stagnation and blood stasis and the syndrome of Qi and Yin deficiency and the syndrome of Qi and Yin deficiency Gastroscopic mucosal erosion in middle-aged patients with CAG was statistically significant.Different TCM complex syndrome types of middle-aged CAG patients were divided into KimuraTakemoto types,mainly closed type.In closed CAG,there was statistical difference between TCM complex syndrome type and Kimura-Takemoto closed type,mainly C1 type.4.The major pathological changes of middle-aged CAG did not have statistical significance in the distribution of TCM complex syndrome types.5.There was no statistical difference in the distribution of Hp infection among middle-aged CAG patients in TCM complex syndrome types.6.TCM syndrome differentiation based on the four diagnostic information has certain statistical significance with the gastroscopic mucosal morphology and pathology of middle-aged CAG patients,so it can be used as complementary diagnostic means to predict and diagnose diseases to a certain extent. |
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