Discussion And Clinical Research On The Pattern Of Internal Accumulation Of Turbid-toxin In TCM For The Treatment Of Chronic Atrophic Gastritis

Part one:Discussion of the pattern of internal accumulation of turbid-toxin in TCM for the treatment of Chronic Atrophic GastritisObjective:The research aimed at clinical classification.Theresearch,with the help of epidemiological investigation of the patientssuffering Chronic Atrophic Gastritis and the application of factor analysisaimed at malcing the classification based on syndrome differentiator in TCMaccording to the symptoms of CAG,thus inducing the distribution of patternsin CAG,further exploring the syndrome principles,finding the proportion ofthe pattern of "internal accumulation of turbid—toxin" in CAG and providingclinical evidence for the diagnosis and treatment.Methods:Unified clinical research table was formulated at the basis ofhuge amount of documental research and opinions of specialized professors.Pattern analysis was finished among the247cases,which were in accordancewith the diagnosis of CAG.Outpatients of the Department of Gastrointestinalin Hebei General Hospital of TCM.The following was what was collectedaccording to the epidemiological principles:the general items includingname,gender,age.The four diagnostic data (inspection,auscultation-oflaction,interrogation and palpation).manifestations and pathological diagnosis undergastroscope.The relation between age,gender, duration, inducing factor,badhabit.HP infection and CAG was found by applying descriptive statisticalmethod.By using statistical analysis of the data collected as the result of factoranalysis,the pattern principles of TCM were explored in CAG.Results:1Six patterns of TCM in CAG were summarized after theimplementation of factor analysis:internal accumulation of turbid—toxin, dampness-heat in the spleen and stomach,weakness of the spleen andstomach,blood stasis of the stomach collateral,liver stomachdisharmony,yin-deficiency of the stomach,among which the pattern ofdisharmony between liver and stomach and internal accumulation ofturbid-toxin had the most proportions.2There were121male cases and126female cases.Their ages variedfrom29to81years old,with the mean55.86+-10.15years old.The biggestproportion of age group was the one from51to60years old(45.347%),andthen one from61to71years old(22.67%),the one from41to51yearsold(17.81%).There was no remarkable significance(P〉0.05)of the genderdistribution within each age group.3Main inducing factors were improper diet(38.46%),and emotionalstimulation(25.10%).4The frequencies of main symptoms in CAG, distending sensation(60.32%),dullpain(54.65%),poorappetite(40.49%),heartburn(39.68%),bulching(37.65%).5In terms of tongue picture,dark purple tongue with eky mosis(42.15%),and yellow and greasy coating(46.96%,27.53%)were seen mostfrequen-cy.The most commonly seen pulses were wing(40.08%),thin(51.01%)and slippery(25.51%).6The principle of patterns in CAG:liver stomach disharmony(27.12%),turbidity toxin intrinsic certificate(22.67%),spleen stomach dampheat syndrome(21.86%),the weakness of the spleen and stomachsyndrome(10.93%),stomach collateral stasis syndrome (9.72%)and stomachyin deficiency(7.69%).7The infection rate of HP show remarkable significance(P<0.01),amongthe six patterns,with the order as follows:turbidity toxin intrinsiccertificate(87.5%),spleenstomach damp heat syndrome(64.81%),stomach yindeficiency(31.58%).Conclusion:1The patterns in CAG are turbidity toxin intrinsic certificate,spleen stomach damp heat syndrome, the weakness of the spleen and stomachsyndrome,liver stomach disharmony,stomach collateral stasis syndrome andstomach yin deficiency.turbidity toxin intrinsic certificate and liver stomachdisharmony are the most.2The main characters of CAG in syndrome differentiation were mixtureof deficiency hand weakness,asthenia in origin and asthenia in superficiality ofthe spleen and stomach,the key of the affacle were internal obstruction ofdamp heat and blood stasis,the main pathogenesis was internal accumulationof turbidity toxin.3There was no obvious significance on gender in the onset of CAG,middle age or elderly people were high risk population.Early diagnosis andtreatment of the high risk population registered great significances in theprotection of gastric cancer.4CAG could be triggered by improper diet habit and emotionaldistress.Family history of cancer and HP infection constituted two major riskfactor.5Intimate relations were detected between HP infection and damp heatincluded turbid-toxin.There occurred significant difference in relation to HPinfection.Part two:Studies on gastroscopic manifestation aboat six syndrome type ofchronic atrophic gastritisObjective:we observed gastroscopic manifestations aboat six types ofchronic atrophic gastritis to find the specific changes and to explore therelationships between gastroscopic manifestations and turbidity toxin.Further,we can provide objectively gastroscopic and pathological targets forsyndrome differentiation of traditional Chinese Medicine,then offer clinicalfoundations for the method of turbidity toxin.Methods:311CAG patients are grouped into six syndrome types by twodirectors of Chinese Medicine,the six syndrome types are turbidity toxinintrinsic certificate,spleen stomach damp heat syndrome, the weakness of thespleen and stomach syndrome,liver stomach disharmony,stomach collateral stasis syndrome and stomach yin deficiency。 We formulate the case reportform (CRF) to record four diagnostic methods of traditional ChineseMedicine,such as the general condition of the patient, symptoms, tongue,pulse condition.A college full-time physicians for gastroscopy recordstheendoscopic features detailed, biopsy tissues from the same pathologist are fordiagnosis, and then the different types of gastroscope and pathologicaldiagnosis were observed.Results: CAG6kinds of TCM syndrome type of endoscopicfeatures:turbidity toxin intrinsic certificate is common by uplift, erosion,mucosal roughness, accounted for74.19%;liver stomach disharmony arecommon by erythema oozy, bleeding, bile reflux,accounted for77.39%;theweakness of the spleen and stomach syndrome is common by erythemaeffusion, mucosal roughness, accounted for59.46%; spleen stomach dampheat syndrome are common by erythema effusion,mucosal roughness, erosion,accounted for69.33%; stomach collateral stasis syndrome are common by thebleeding points,accounted for52.17%.Stomach yin deficiency are commonby erythema effusion,accounted for60%.The statistical results shows, theendoscopic manifestation of CAG turbid Toxin intrinsic syndromes comparedwith the other5syndromes has significant difference (P <0.05) statistically.gastroscope pathological findings of turbidity toxin intrinsic syndrome showthat intestinal metaplasia are in higher proportion of61.29%. dysplasia canreach27.42%.The pathological findings of Turbidity toxin intrinsic syndromecompared with liver stomach disharmony, weakness of the spleen and stomach,stomach collateral stasis syndrome have obvious differences (P <0.05),while the pathological findings of turbid toxin intrinsic syndrome,stomachdamp heat syndrome and stomach yin deficiency syndrome showed nosignificant difference (P>0.05).Conclusion:1.Various CAG clinical syndromes are related with the changes ofgastroscopic morphology and histopathology.CAG Turbid Toxin intrinsicsyndrome in endoscopic performs uplift, erosion, mucosal roughness, the pathology shows intestinal metaplasia and (or)atypical hyperplasia.2.We should pay attention to the Turbidity toxin intrinsic syndrome andits specific manifestations in gastroscopy and pathology in the clinicaldiagnosis and treatment of chronic atrophic gastritis.Part three: The treatment of chronic atrophic gastritis zhuo du nei yunsyndrome with Hua zhuo detoxification regulating stomach recipe permitsclinical researchObjective:To observe the total efficacy of the treatment of chronicatrophic gastritis cloud intrinsic toxicity syndrome with Huazhuodetoxification regulating stomach recipe, and the clinical efficacy ofhemoglobin, the blood rheology and Helicobacter pylori.Methods:230cases of CAG patients were randomly divided intotreatment group and control group,120cases in the control group of110cases.treatment groups: oral Huazhuo detoxification regulating stomach recipe.Control group: oral Weifuchun tablets. The patients of two groups duringtreatment should stop using the other traditional Chinese and Westernmedication. One course of treatment is3months.To observe the clinicalsymptoms (including epigastric fullness, blocking nausea, pain, belching,heartburn, etc.), endoscopy, and pathology results and the anti-HP infectionbetween two groups.Results: Clinical efficacy: the treatment group surpass the control groupin the total efficiency of the clinical efficacy,the improvement of endoscopyand the hemoglobin changes, the total efficiency of the clinical efficacy intreatment group was90.84%, in control group was66.36%, the differences ofstatistical treatment in both group were significant (P <0.05). Two groupscan improve the indexes of the blood rheology, the differences of statisticaltreatment were significant (P <0.05) before and after treatment. Theimprovement of the indexes of the blood rheology between the two groupsshould apply two-samples t-test (P>0.05), it can not believe the differenteffect of two drugs to improve blood rheology. Huazhuo detoxificationregulating stomach recipe has certaitn effects in anti-HP infection, the total effective rate was69.79%, there is no significant difference (P>0.05)compared with the control group.Conclusion:1Huazhuo detoxification regulating stomach recipe can improve theclinical symptoms of patients with CAG.2the Huazhuo detoxification regulating stomach recipe can betterimprove the gastric mucosa elephants of patients with CAG,such as congestiveedema, erosion, mucosal white elephant, mucosal rough, vascular permeabilityto see ect.3Huazhuo detoxification regulating stomach recipe can significantlyimprove the indexes of blood rheology with patients in the whole bloodviscosity, plasma viscosity, improve patients' hemoglobin content, improveanemia, and improve the patients' disease-resistant self-healing ability4Huazhuo detoxification regulating stomach recipe has certainanti-Hp-inflammatory effects.part four:The clinical study of Turbidity detoxification of Hewei decoction onchronic atrophic gastritis patients with syndrome of turbid poison connotation.Objective:Observation of Turbidity toxin Decoction in treating chronicatrophic gastritis patients with syndrome of turbid poison contains generalcurative effect, as well as on clinical patients with the clinical curative effectof emotion.Method:230cases of CAG were randomly divided into treatment groupand control group,120cases in the treatment group,110cases in the controlgroup.①The treatment group: Turbidity detoxification of Hewei decoction.②C ontrol group: an oral gastric compound spring. In two groups of patientsduring the treatment with no other Western medicine and traditional Chinesemedicine treatment. A course of treatment is3months.Emotional check:Using symptom checklist (Symptom Checklist90SCL-90). Security measures:before and after the treatment, testing routine urine,stool routine,Cardiacfunction,Liver function and Kidney function. At the same time, recordvarious adverse reactions. Result: Precancerous lesion of gastric cancer (PLGC) patients′emotional somatization, obsessive compulsive symptoms, interpersonalsensitivity, depression, anxiety and hostility factor scores compared with theconstant modulus,the differences were statistically significant (P＜0.05),higher than the constant modulus.Conclusion:1The occurrence and development of PLGC have a close relationshipwith emotional factors.2Turbidity detoxification of Hewei decoction can significantly improvepatients′bad emotion,such as somatization, obsessive compulsive symptoms,interpersonal sensitivity, depression, anxiety and hostility.3Turbidity detoxification of Hewei decoction can turbidity toxin, Jieyuspleen, eliminating bad emotion on the gastric mucosal injury, can be effectivein the treatment of chronic atrophic gastritis with intestinal metaplasia ordysplasia (and).