Analysis Of The Characteristics Of The Chronic Atrophic Gastritis Population And Research On The Law Of Syndrome Differentiation And Medication By Chief Physician Liu Zhe

Background:Chronic atrophic gastritis(CAG)is a common disease of digestive system,belonging to precancerous lesions of gastric cancer.CAG is divided into metaplastic atrophy and non-metaplastic atrophy.Intestinal metaplasia(IM)is considered to be a precancerous state and an independent risk factor for gastric cancer.CAG is an important part in the evolution of gastric cancer.CAG is an important part of the evolution of gastric cancer,which threatens human’s health and safety,affects the quality of life of patients,and easily causes great mental stress to patients.CAG is also a key link in the prevention of gastric cancer,which is of great significance to prevent and delay the occurrence and development of CAG.Therefore,this study intends to investigate CAG patients,explore the possible risk factors of CAG patients,analyze the characteristics of CAG patients,to prevent the occurrence of CAG and delay the progression of CAG,and guide the clinical treatment plan.The treatment of CAG aims to delay or block the progression of lesions,reduce the risk of canceration,and improve the clinical symptoms of patients.Early detection and treatment of CAG is of great significance to prevent the occurrence of gastric cancer and improve the quality of life of patients.Western medicine currently lacks a specific treatment for CAG.The main treatment methods are to remove the cause,repair the mucosa,and stabilize the microenvironment of the stomach,including eradicating Helicobacter pylori,promoting gastric motility,protecting gastric mucosa,supplementing vitamins,and endoscopic treatment.Traditional Chinese medicine treatment of CAG emphasizes overall syndrome differentiation and personalized treatment,with various treatment methods.Relevant studies have confirmed that Chinese medicine treatment of CAG has a good effect in improving the state of gastric mucosa,preventing or even reversing the development of the disease,and improving the clinical symptoms of patients.Traditional Chinese medicine has unique advantages in the treatment of CAG.Chief physician Liu Zhen has long used traditional Chinese medicine to treat CAG.He has rich experience and good curative effect.His clinical experience is worth learning.Therefore,this study will analyze and summarize the experience and clinical medication rules of chief physician Liu Zhen in the treatment of CAG,and provide reference for the diagnosis and treatment of CAG with traditional Chinese medicine.Objective:1.Explore the possible risk factors of CAG patients,guide the clinical prevention measures and nursing methods of CAG patients,and reduce the risk of low-risk CAG to high-risk CAG.2.Summarize the experience of chief physician Liu Zhen in the treatment of CAG.Methods:Study 1:Make a questionnaire survey on CAG patients in Guang’anmen Hospital of China Academy of Chinese Medical Sciences.To collect the patient ’s basic information,CAG history,gastroscopy and pathological diagnosis,TCM symptoms and other information.OLGA or OLGIM stage 0-Ⅱ was defined as low-risk CAG and OLGA or OLGIM stage Ⅲ-Ⅳas high-risk CAG.Then use SPSS26.0 for data analysis and collation.For frequency data,we conduct descriptive statistics,and take CAG risk stratification as the dependent variable and used Logistic regression analysis for correlation analysis.Study 2:Collecting medical records information of CAG patients,who was diagnosed and treated by chief physician Liu Zhen in Guang ’anmen Hospital of China Academy of Chinese Medical Sciences from January 2012 to December 2022.Using the ancient and modern medical case cloud platform for data mining to summarize the medication rules of chief physician Liu Zhen in the treatment of CAG.Combined with the experience of the teacher to further summarize the academic thought of Director Liu Zhen in the treatment of CAG.Results:1.A total of 107 valid questionnaires were collected in Study 1.There were 26 cases of low-risk CAG and 81 cases of high-risk CAG.Four risk factors associated with high-risk CAG were screened out(P<0.05).Abnormal BMI(OR=8.101,P=0.02),eating too fast(OR=12.100,P=0.025),often eating in the restaurant(OR=17.815,P=0.033)and feeling tired and weak(OR=4.741,P=0.037),these may be the promoting factors of high-risk CAG.2.Study 2 finally included 360 CAG patients,and 360 prescriptions were collected.3.There are 22 classical prescriptions and time prescriptions involved in the clinical treatment of CAG by tutor.Banxia Xiexin Decoction has the highest frequency of occurrence.Followed by Six Gentleman soup.4.In 360 cases of traditional Chinese medicine prescriptions,a total of 206 drugs were involved,with a total frequency of 7252 times,with an average of about 20 drugs per prescription.The top 10 most frequently used are Pinellia,Atractylodes,Codonopsis,Poria,Cyperus,Curcuma,Dried Ginger,Scutellaria,Coptis,Zhejiang Fritillary.The drugs are mainly warm,flat and cold.The flavors of the medicine are more bitter,pungent and sweet.The most common meridian tropism of drugs are spleen,lung,stomach and liver.Analysis of the efficacy of drugs,there are more efficacy:dry wet,rationalism,invigorating spleen,stopping pain,invigorating Qi,drain dampness,heat-clearing,dissipating phlegm,purging heat.5.Correalation analysis of traditional Chinese medicine,the commonly used drug combinations are as follows:dangshen and largehead atractylodes rhizome,tuckahoe and largehead atractylodes rhizome,nutgrass galingale rhizome and ternate pinellia rhizome,turmeric rhizome and ternate pinellia rhizome,common ginger dried rhizome and ternate pinellia rhizome,common ginger dried rhizome and nutgrass galingale rhizome,sepium and thunberg fritillary bulb,common ginger dried rhizome and dangshen,baikal skullcap rootand and dangshen and chinese goldthread rhizome,baikal skullcap rootand and ternate pinellia rhizome and chinese goldthread rhizome,baikal skullcap rootand and nutgrass galingale rhizome and chinese goldthread rhizome,baikal skullcap rootand and common ginger dried rhizome and chinese goldthread rhizome,ternate pinellia rhizome and sepium and thunberg fritillary bulb.6.Correlation analysis of TCM syndromes and traditional Chinese medicine,get six groups of prescriptions.Group 1:membrane of chicken gizzard,corydalis ambigua,dried old orange peel;Group 2:common aucklandia root,chinese radish seed;Group 3:officinal magnolia bark,root of red rooted salvia;Group 4:catclaw buttercup root,thunberg fritillary bulb,sepium;Group 5:turmeric rhizome,largehead atractylodes rhizome,tuckahoe;Group 6:dangshen,ternate pinellia rhizome,common ginger dried rhizome,nutgrass galingale rhizome,baikal skullcap root,chinese goldthread rhizome.7.Complex network analysis:ternate pinellia rhizome,dangshen,largehead atractylodes rhizome,common ginger dried rhizome,baikal skullcap root,chinese goldthread rhizome,tuckahoe,turmeric rhizome,nutgrass galingale rhizome.Conclusion:1.Abnormal BMI,eating too fast,often eating in the restaurant and feeling tired and weak may be the promoting factors for high-risk CAG.2.CAG is related to spleen and stomach,is closely related to liver and lung.Spleen and stomach weak,the dysfunction of the liver and abnormal lung water function are important conditions of the disease.Chief physician Liu Zhen mainly treats CAG from the perspective of spleen deficiency,cold and heat disorders,air-reverse random,tanshi neiting,and blood stasis.Treatment should be based on invigorating spleen as the main method,avoid the use of strong drugs when using drugs,focus on protecting the stomach.CAG shows different characteristics of cold and heat deficiency and excess in different stages of the disease.The main contradiction should be grasped in treatment,combine disease and syndrome type together,seek both temporary and permanent solutions.At the same time,the treatment should pay attention to the regulation of qi.For patients with a longer course of disease,When it shows the symptoms of stomach collateral stasis,traditional Chinese medicine for promoting blood circulation and removing blood stasis should be added.In the meantime,we should pay attention to the guidance of patients’ diet and living habits.