Study On The Characteristics And Related Influencing Factors Of TCM Syndromes Of Hiatal Herni

Research purpose and significance:To explore the relevant influencing factors of esophageal hiatal hernia through relevant questionnaires,SAS scale and SDS scale,to explore the characteristics of TCM syndrome of patients with esophageal hiatal hernia through TCM syndrome classification scale,and to further explore the relationship between TCM syndrome types and relevant influencing factors,which provides a theoretical basis for future clinical trials and experimental analysis.Methods:298 patients with esophageal hiatal hernia were selected from January 1,2021 to December 31,2022 who underwent gastroscopy at the Digestive Endoscopy Center of DongFang Hospital of Beijing University of Traditional Chinese Medicine and were diagnosed by gastroscopy.General information,diet and living habits,related chronic diseases,psychological status,gastroscopic report results and TCM syndrome distribution scale were recorded in detail through questionnaires.SPSS 26.0 software was used for statistical analysis.Descriptive analysis,chi square test,nonparametric test,factor analysis and other methods were selected according to the type of data to explore the related influencing factors of esophageal hiatal hernia,the characteristics of TCM syndromes,and the relationship between TCM syndrome types and related influencing factors.Results:1、In this study,the influencing factors that cause esophageal hiatal hernia are classified into the following four categories:①Increase intra-abdominal pressure,such as overweight and obesity,eating too fast,eating too much,sitting too long,exercising after meals,long-term constipation,chronic cough,manual workers carrying heavy objects or strenuous physical activity for a long time.Under the condition of high pressure,the contents of the abdominal cavity are easy to enter the mediastinum to form esophageal hiatal hernia;②The number of elastic tissue of diaphragm esophageal membrane gradually decreases or the relaxation of lower esophageal sphincter affects esophageal dynamics,such as the elderly,drinking,smoking;③ Affect the ability of esophageal acid clearance,such as mental workers,anxiety and depression;④Stimulate gastric acid secretion and increase abnormal acid exposure rate,such as irregular diet,preference for diet,coffee and strong tea.2、This study found that patients with esophageal hiatal hernia were prone to complicated with a variety of gastric and esophageal diseases,with reflux esophagitis,Hp infection and bile reflux gastritis accounting for the largest proportion.Reflux esophagitis can cause longitudinal muscle fibrosis,resulting in esophageal shortening and esophageal hiatus hernia formation;Hp infection will aggravate gastroesophageal reflux disease and then aggravate the symptoms of patients with existing hiatal hernia;Bile reflux gastritis and esophageal hiatal hernia both cause muscle relaxation due to spleen deficiency and lose fixation.3、According to the results of comprehensive factor analysis,in terms of the distribution of TCM syndrome types,the liver stomach heat stagnation syndrome is the most common in patients with esophageal hiatal hernia,followed by spleen stomach deficiency cold syndrome,qi stagnation phlegm stagnation syndrome,spleen stomach damp heat syndrome,qi deficiency blood stasis syndrome according to the frequency.From this we can conclude that although esophageal hiatal hernia is located in the esophagus,it is closely related to the spleen,stomach and liver,and many pathogenic factors such as qi stagnation,blood stasis,yang deficiency,qi deficiency,phlegm,heat and dampness interact,especially heat.Deficiency of temper,abnormal transportation and muscle dystrophy are the root of the disease;Gastric disharmony and depression,and the reverse of qi is the sign of disease;Losing the liver and relieving the emotion is the cause of the disease.Therefore,in the treatment,it should be mainly used to replenish the spleen,lower the stomach qi,and dredge the liver qi,with the symptoms of dampness,heat,cold,phlegm,and blood stasis.Conclusion:1、Male,elderly,mental labor,overweight and obesity,eating too fast,eating too much,eating irregularly,sweet food,spicy food,coffee,sitting long,exercise after meals,drinking,smoking,long-term constipation,chronic cough,anxiety,depression,reflux esophagitis,Hp infection,bile reflux gastritis are common influencing factors for patients with esophageal hiatal hernia.2、In clinic,patients with esophageal hiatal hernia are often accompanied by acid regurgitation,abdominal distension,stomachache,abdominal pain,gastric distension,dry stool and heartburn;In terms of the distribution of TCM syndrome types,the stagnation of heat in the liver and stomach is the most common,followed by the deficiency of cold in the spleen and stomach,stagnation of qi and phlegm,damp heat in the spleen and stomach,and deficiency of qi and blood stasis according to the frequency.3、The distribution of TCM syndrome types in age,occupation,BMI,diet preference,chronic disease,anxiety state,common diseases of esophagus and stomach,and reflux esophagitis Los Angeles classification has statistical significance.