| OBJECTIVE: In the whole system of Chinese Medicine,pathomechanism is in the basalstatus.It is a tie between theoretics and clinic, the researchful bases of pathomechanism aresymptoms and signs.The outer symptoms and signs are the reflection of the essence of theinner pathomechanisms.We can search for the rules of pathomechanism depend on thesummarization and generalizability of the symptoms and signs. Many scholar had made lotof researches on the inpersonality and standardization of syndromes. By the methods ofepidemiology and statistics, they proved the existence and rules of syndromes base on data,but the researchs on pathomechanism are less. Stomach pain(chronic gastritis) is a familiarand frequently-occurring disease. Its pathomechanisms are from the generalizability oftraditional clinic experience and has some localizations in despite of the comprehensiveunderstanding. The objective of this research is the exploration of meanings,contents andresearchful ways of pathomechanism.On the basis of clinic epidemiologic inquisitions,wewill analyse entirely the clinic data by the ways of statistics,we search for the rules ofsymptoms and signs of stomach pain(chronic gastritis). On the basis of these studys,wewill build up the integrated theories of pathomechanisms of stomach pain(chronic gastritis),and provide the gists for clinic treatment. In addition,by the research of this task,we willquest for the researchful ways and means of pathomechanism of Chinese Medicine.METHODS: The research discussed firstly the meanings,contents,relations betweendisease, syndromes and symptoms and researchful methods on the basis of the studys ofliterature,then selected stomach pain(chronic gastritis) as the object and search for itstheories of pathomechanisms.In epidemiology, we made a clinic epidemiologic questionarybase on the the four diagnostic methods and the characteristic of the symptoms and signs ofstomach pain(chronic gastritis).From 3,2006 to 11,2006,we got 812 data in the departmentof digest medicine in the Chinese Medicine hospital of Jiangsu Province.We made adatabase by EpiData3.0,then analysed the data by cluster analysis,logistic analysis andfactor analysis in SPSS13.0.On the basis of these analysis,we quested for the features of theclinic symptoms and signs,then we searched for the integrated theories of pathomechanisms by the directions of basic theoris of Chinese medicine.RESULTS: 808 data had been analysed finally.In the sufferers,men took the proportion of38.7% and women took 61.26%.Women was more but there were not statisticalsignificance in sex between the hypothetic syndrome types (P=0.090). The average agewas 46.00±13.16.Men’s average was 45.01±13.02 and women’s was 46.63±13.23.There were not statistical significance in age between sex (P=0.089), but there werestatistical significance between the hypothetic syndrome types (P=0.000),such asdeficiency of stomach-yin compare with exuberance of stomach-heat and deficiency-coldof spleen and stomach (P=0.003,P=0.000), and stagnant heat between liver and stomachcompare with deficiency-cold of spleen and stomach.The longest course of disease was480 months, the shortest was 0.25 month and the average was 30.04±61.08.Men’s was40.24±73.34 and women’s was 23.58±50.89. There were statistical significance of courseof disease between sex (P=0.000),but there were not statistical significance between thehypothetic syndrome types(P=0.624). There were statistical significance betweeninducements (P=0.000).The inducements were irregularity of diet,attack by pathogeniccold, psychataxia,overstrain and others according to bigness and smallness of thefrequencies.The proportion of irregularity of diet and attack by pathogenic cold was67%.They account for the main part of inducements and were the most familiar. Betweenthe syndrome types,the frequencies of inducements were very different. The frequenciessuch as irregularity of diet in exuberance of stomach-heat,damp-heat in spleen and stomachand stagnation of stomach-qi, attack by pathogenic cold in deficiency-cold of spleen andstomach,mixture of cold and heat and deficiency of both qi and yin, psychataxia instagnation of liver-qi and stomach-qi, stagnant heat between liver and stomach and liverdepression and spleen asthenia and overstrain in deficiency of stomach-fin and deficiencyof spleen-qi and stomach-qi were higher. There were statistical significance of inducementsbetween sex (P=0.000). The frequency of irregularity of diet in men was higher and thefrequencies of d psychataxia, attack by pathogenic cold and overstrain in women were higher.The sufferer with family history took the proportion of 34.16% and the other took 65.84%.There were not statistical significance in family history between the hypothetic syndrometypes (P=0.195). 286 data had HP test annal. 145 results were negative and 141 results werepositive. The seven main syndrome types were stagnant heat between liver and stomach,exuberance of stomach-heat, stagnation of liver-qi and stomach-qi,damp-heat in spleen andstomach, deficiency of stomach-yin, stagnation of stomach-qi and deficiency-cold of spleen and stomach according to bigness and smallness of the frequencies of HP, but Therewere not statistical significance between the hypothetic syndrome types(P=-0.125). Thethree biggest frequencies of body symptom were epigastric pain(100%),stomach distension(74.88%) and belching(47.90%).39 indexes were selected when made multiplicity. 4syndrome types stagnation of liver-qi and stomach-qi, deficiency-cold of spleen andstomach, damp-heat in spleen and stomach and stomach heat and yin-deficiency had beenclassified into when run index-cluster analysis.Sample-cluster analysis classified thesamples into 4 sorts.On the basis of sample-cluste analysin, logistic analysis analysed the 4sorts.They were deficiency-cold of spleen and stomach, damp-heat in spleen and stomach,stomach heat and yin-deficiency and stagnation of liver-qi and stomach-qi. Factor analysisdrew out 12 factors from 39 indexes. Factor 1 was damp-heat in spleen and stomach,factor2 and 3 were deficiency-cold of spleen and stomach, factor 4 and 7 were stagnation ofliver-qi and stomach-qi,factor 5 is deficiency of qi and yin,factor 6 was exuberance ofstomach-heat, factor 8 and 12 were deficiency of stomach-yin, factor 9 was stagnant heatbetween liver and stomach and factor 10 was deficiency of spleen-qi and stomach-qi. Factor 11could not been denominated. For analyzing tersely, 12 factors were taken into index-clusteranalysis.Classifying into 5,6and 7 were accordant with clinic. The 5 sorts were damp-heatin spleen and stomach, deficiency-cold of spleen and stomach, stagnation of liver-qi andstomach-qi, deficiency of qi and yin and stagnant heat between liver and stomach.The 6 sortscomprised the 5 sorts and deficiency of stomach-yin, and the 7 sorts comprised the 6 sortsand exuberance of stomach-heat. The 7 sorts was accordant with clinic most. Factoranalysis also found out that there were some larger Correlation coefficients between factors.CONCLUSION: The basic syndrome types of stomach pain(chronic gastritis) is stagnationof stomach-qi.There are 4 main syndrome types as deficiency-cold of spleen and stomach,damp-heat in spleen and stomach, stagnation of liver-qi and stomach-qi and stomach heatand yin-deficiency.In addition, exuberance of stomach-heat, deficiency of stomach-yin,deficiency of qi and yin, stagnant heat between liver and stomach and deficiency ofspleen-qi and stomach-qi may appear too.The location of disease is in stomach and relatewith liver and spleen. The nature of disease can generalize by cold, heat,excess anddeficiency. The basic pathomechanisms are the stagnation of stomach-qi and stagnationlead to pain. The main pathomechanisms are as follows: Because of insufficiency of yangand qi of spleen and stomach, stomach loses the warm and nourish. Pathogenic coldacumulates in stomach and meridian and vessels become contracted. Pathogenic damp-heat Accumulating in middle warmer,hyperactive liver-qi attacking the stomach with heat and extremestomach-heat accumulating may consume stomach-yin,then stomach loses the moistness.These canmake qi activity of stomach become stagnant and result in pain.All pathomechanisms are inbase of the stagnation of stomach-qi.They can appear singly or simultaneously.Thediversification is complicated in clinic.The correlation coefficients of factors indicate thatcorrelative factors can mix,transmit or change.We can get the rule of transmission andchange of pathomechanisms of Stomach pain(chronic gastritis) base on the correlationcoefficients as follows: damp-heat accumulating in middle burner can mix the failure ofliver to convey and disperse easily; spleen-qi, spleen- yang and stomach-yin can lack at thesame time; hyperabundant heat in stomach and stagnant heat between liver and stomachconsume stomach-yin.;and liver-qi mix heat when attacking stomach.This research also indicates that the criterions of syndrome differentiation of stomachpain(chronic gastritis) that get by the ways of traditional syndrome differentiation andmodem statistical analysis are essentially consistent.Index-cluster analysis,sample-clusteranalysis, logistic analysis and factor analysis can comfirm each other. In the Chinesemedical researches of symptoms and signs and pathomechanisms, cluster analysis, logisticanalysis and factor analysis may be used suitably. |
