The Study On Regulation Of TCM Syndromes Distribution In Gastroesophageal Reflux Disease And Correlation Factors

Objective:Through the summary of the clinical manifestation of different syndromes of Traditional Chinese Medicine(TCM) in Gastroesophageal Reflux Disease(GERD).the research aims to explore the regularity of syndrome distribution,and further analyze the correlation of GERD syndromes with age, gender,disease course. Hp (Helicobactor Pylori) infection, gastroscopic and pathological presentation,so that provide evidence to scientific research.Methods:1. Literature researchBy means of the study of classics in ancient times, synthesize the correspondent of TCM in modern times and the experience in the treatment of my adviser, the research aims to find the regularity of pathology change and syndrome distribution.2. Clinical researchAt the base of literature research and remark from my adviser,I designed the questionnaire of TCM symptom-sign of GERD. The data of patients'symptoms and signs are got through four diagnostic methods and data base is established by applying epidemiologic methods.Descriptive statistics and Kruskal—Wallis are used for statistic purpose,and the regularity of syndrome is summed up as well as the relationship of syndromes with age, gender,disease course, Hp (Helicobactor Pylori) infection and gastroscopic presentation.Results:Among gathered 300 cases,155 are male,while 145 are female.The age ranges from 20 to 88 years old,mean age is 52.87±13.25 years old.The course of the disease is from half a month to 10 years. Nonerosive reflux disease(NERD) accounts for 40.0%.Reflux esophagitis(RE) for 55.33%,and Barrett's esophagus(BE) for 4.67%.The RE includes four grades, grade A accounts for 38.57%,grade B accounts for 32.14%,grade C accounts for 19.29%,and grade D accounts for 10.0%. The syndromes can be categorized into six patterns,namely. heat accumulation in both liver and stomach type,disharmony between liver and stomach type,obstruction of phlegm and qi type,the deficiency of spleen-stomach and qi stagnation type, asthenic yin of stomach type, qi stagnation and blood stasis type. The syndromes of GERD have a bearing on age, gender,disease course, Hp(Helicobactor Pylori) infection and gastroscopic presentation. Among these, heat accumulation in both liver and stomach type is most commonly seen in youngsters;heat accumulation in both liver and stomach type, disharmony between liver and stomach type, the deficiency of spleen-stomach and qi stagnation type, asthenic yin of stomach type,are most commonly seen in middle-aged people; while the elderly are more likely to the deficiency of spleen-stomach and qi stagnation type, asthenic yin of stomach type.The course of heat accumulation in both liver and stomach type,disharmony between liver and stomach type,obstruction of phlegm and qi are more shorter than the other types. The level of esophagitis is less serious in heat accumulation in both liver and stomach type and disharmony between liver and stomach type.Conclusion:In clinic, heat accumulation in both liver and stomach type is at the most. disharmony between liver and stomach type and the deficiency of spleen-stomach and qi stagnation type also account for a rather high percentage. The syndromes distribution of GERD have a bearing on age,disease course and clinical symptoms in the acute stage.