Study On The Pathological Characteristics Of Crohn’s Disease Based On Syndrome Differentiation

Objective:The method of syndrome differentiation is used to study the TCM pathological characteristics of Crohn’s disease and explore the distribution rules of anal fistula of Crohn’s disease,so as to provide ideas for the TCM syndrome differentiation treatment of Crohn’s disease anal fistula,and also provide the theoretical basis for the prevention of Crohn’s disease anal fistula.Methods:This study is an observational study,using cross-sectional observation method to collect patients who were hospitalized or outpatient in the anorectal Department of the People’s Hospital of Fujian University of Chinese Medicine from March 2022 to February 2023 and met the criteria.According to the information collection form of four diagnosis of traditional Chinese medicine formulated by the syndrome research base of Fujian University of Traditional Chinese Medicine and the clinical characteristics of syndrome differentiation compiled by Professor Zhu Wenfeng(Appendix B).The table was used to collect the information of the four diagnosis of traditional Chinese and western medicine,and the TCM health status identification system of Fujian University of Traditional Chinese Medicine was used to admit the data of the four diagnosis of the patients,so as to obtain the specific syndrome points.According to the syndrome differentiation method and the TCM syndrome scoring standard created by Professor Zhu Wenfeng,the location and characteristics of 70 were statistically analyzed,and the main location and pathological score of anal fistula in Crohn’s disease were obtained.Finally,statistical analysis was conducted to obtain the research results.Results:1.A total of 100 patients with anal fistula in Crohn’s disease were included,including 73 males and 27 females,the male to female ratio was approximately 2.7:1,and the mean age of the patients was 29.67 ± 8.88 years;In this study,the incidence of Crohn’s disease was higher in men than in women;the age of high onset was 21 to 40 years;The number of cases in the disease duration <1 year group was 28,with a composition ratio of 28%,and the number of cases in the1-year disease course group was 72,with a composition ratio of 72%.2.In this study,the overall features of Crohn’s anal fistula: the frequency of syndrome was:large intestine> spleen> liver> small intestine> stomach> skin>> kidney> table> lung;large intestine and spleen,followed by small intestine,liver,skin and stomach;The frequency of solid pathological syndrome is: dampness> heat> qi stagnation> sputum> blood stasis> cold;the frequency of pathogenic deficiency is: qi deficiency> blood deficiency> Yang deficiency> Yin deficiency;the pathological syndrome with severe lesions is mainly dampness,qi deficiency,qi stagnation,heat and blood deficiency;The overall distribution of pathogenic syndrome elements is mixed in the majority,accounting for 88%.3.The relationship between syndrome element distribution and various factors in Crohn’s disease in this study:(1)The relationship between the distribution of syndrome and sex: the distribution of syndrome liver between men and women was statistically different(P <0.05),the incidence of syndrome liver in women was higher than that of men,and there was no statistical difference in the relationship between the distribution of syndrome and sex.(2)The relationship between syndrome distribution and age: the composition ratio of pathological syndrome fever in young adults(15.6%)> that of pathological syndrome fever in middle age(7.7%)> that of pathological syndrome fever in adolescents(2.9%)was significant(P <0.05);the composition ratio of pathological syndrome gas stagnation in middle age group(17.3%)> the composition ratio of young adults(14.2%)> the composition ratio of adolescents(4.3%)(P <0.05);there was no statistical difference in the relationship between other syndrome gas distribution and age.(3)The relationship between syndrome distribution and disease course: the composition ratio of syndrome liver in 1-year group(20.8%);the composition ratio of pathological syndrome Qi stagnation(15.1%)and blood deficiency(10.2%)was significantly higher than that of <1-year group(4.7%)and blood deficiency(1.9%);the composition ratio of disease course <1-year group was higher than that of group fever(11.5%).4.This study shows that the common syndrome types of patients with Crohn’s disease are spleen and stomach deficiency syndrome,intestinal dampness and heat syndrome,qi stagnation and blood stasis syndrome.Conclusions:1.The onset of anal fistula of Crohn’s disease anal fistula involves many viscera,among which large intestine,spleen,liver,small intestine,skin and stomach are the key,which suggests that we should base on the overall concept and pay attention to the function of large intestine,spleen,liver,small intestine,skin and stomach in clinical treatment.2.The empirical disease of Crohn’s disease is mainly dampness,heat and qi stagnation,and deficiency is mainly qi deficiency and blood deficiency.The overall disease is characterized by deficiency,deficiency,and mixed disease of qi and blood.Therefore,the treatment of this disease should be combined with dispelling and strengthening,and attention should be paid to the simultaneous treatment of qi and blood.3.The present study also found that the following characteristics:(1)The performance of female patients with anal fistula of Crohn’s disease in liver disease is more significant than that of men,which indicates that we should "treat from the liver" when treating female patients with Crohn’s disease;(2)The lesions of young and middle-aged patients with Crohn’s disease anal fistula are more significant,and the lesions of middle-aged Crohn’s disease anal fistula gas arapn are more significant,which suggests that we should combine the characteristics of different ages,heat,qi and so on;(3)Patients with a long course of Crohn’s disease and anal fistula are prone to blood deficiency and qi stagnation on the basis of qi deficiency,which indicates that we should pay attention to invigorating the spleen and nourishing qi and relieving blood in the treatment of this disease.