| Objectiveswe summarize the clinical symptoms of 20 NERD patients, then divided into two syndromes type:Empirical and deficiency, then we would explore the relationships between the two types and 10 healthy volunteers about gastric motility index (eg:TLESR, esophageal body Department of peristalsis) and acid reflux. Then reveal the relationships between TCM syndrome and some indicators, explore the pathophysiology of NERD TCM Syndromes.MethodsNERD patients with symptoms would accept upper gastrointestinal endoscopy examination,24h dynamic monitoring diagnosed gastric, using esophageal endoscopy to exclude erosion, gastric ulcer and other diseases,20 patients are collected and the main symptoms of secondary symptoms, syndrome is divided into empirical and deficiency, and we would recruit 10 healthy volunteers, the people are all selected simultaneously gastroduodenal manometry 24h and 24h ambulatory monitoring inspection acid, the acid test record 24h manometry data in healthy volunteers and patients with NERD. Using statistical software to analysis the correlations between two kinds type of patients and gastric motility index (eg:TLESR, esophageal body peristalsis) and esophageal acid reflux. Correlation analysis using statistical software SPSS17.0.Results(1)Age of onset and body mass index (BMI) of this two kinds types NERD patients and healthy volunteers, were not statistically significant (P> 0.05). The DeMeester score of two cards of the two kinds types NERD and healthy volunteers were compared, the former is higher and the difference was statistically significant (P<0.05).(2)The basic situation of acid reflux and gastric esophageal kinetics in each phase of NERD patients and healthy volunteers in the period of the digestion:the total time of acid reflux that is less than four hour in phase Ⅰ, phase Ⅱ, phase Ⅲ were higher in NERD patients compare with healthy volunteers (P<0.05). The total number of esophageal contraction in phase Ⅲ in healthy volunteers is more than that in NERD patients (P<0.05). The average amplitude of antrum in phase Ⅱ, phase Ⅲ is higher in patient than healthy volunteers (P<0.05).(3)The basic situation of acid reflux and gastric esophageal kinetics in each phase of NERD deficiency and NERD empirical patients:compared with the total number of reflux episodes in Phase Ⅰ, Ⅲ, NERD deficiency patients is more than that in empirical patients(P<0.05). The total time of acid reflux that is more than fine minutes in NERD deficiency patients is longer than that in empirical patients(P<0.05). Comparing the time that pH is less than 4 in Phase Ⅲ, NERD deficiency patients is longer than empirical patients (p <0.01). The duration in NERD deficiency patients accompanied with TLESR acid reflux in Phase Ⅱ is longer than empirical patients (p<0.01). The total reflux episodes in Phase Ⅰ, phase Ⅱ in NERD empirical patients were more than that in healthy volunteers (P<0.01). The total reflux episodes in Phase Ⅰ, Ⅱ, Ⅲ, in NERD deficiency patients were more than that in healthy volunteers (P<0.01). In Phase Ⅰ, Ⅱ, the total time of acid reflux that is more than fine minutes in NERD deficiency patients is longer than that in healthy volunteers (P<0.05). Comparing the total time that pH is less than 4 in Phase Ⅰ,Ⅱ,Ⅲ,NERD deficiency patients is longer than healthy volunteers (P <0.01). The duration in NERD deficiency patients accompanied with TLESR acid reflux in Phase Ⅲ is longer than healthy volunteers(P<0.05). The duration in NERD deficiency patients accompanied with TLESR acid reflux in Phase II is longer than healthy volunteers(p<0.05). The average amplitude of antrum in phase Ⅲ is higher in NERD empirical patients than healthy volunteers (P<0.05).(4)The basic situation of acid reflux and gastric esophageal kinetics in each phase of NERD patients and healthy volunteers:the total number of acid reflux in digestive duration and reflux time more than 5min times in NERD patients were more than that in healthy volunteers (p<0.05). The total time of acid reflux and ph less than 4 in NERD deficiency patients is more than that in healthy volunteers(p<0.05).The distal esophagus amplitude in NERD deficiency patients with lower than that in healthy volunteers(p<0.05). The number of TLESR accompany with acid reflux in NERD patients is more than that in healthy volunteers (P<0.05), and LES resting pressure is lower than healthy volunteers (P<0.01). LES resting pressure in NERD deficiency patients and NERD empirical patients is lower than healthy volunteers(P<0.05).(5)the Phase Ⅱ of esophagus and the movement of stomach in digestive interval when acid reflux occurs between NERD patients and healthy volunteers:In phase Ⅱ, the total reflux episodes, the total number of the esophagus when acid reflux and the percentage of abnormal esophageal contraction in NERD patients is more than that in healthy volunteers (p <0.01). the distal esophageal amplitude in patients were lower than that in healthy volunteers (P<0.05), and the number of antral contractions were higher than those of healthy (P<0.01). The percentage of abnormal esophageal contraction in NERD empirical patients were higher than that in healthy volunteers, the number of antral in NERD empirical patients were higher than that in healthy volunteers when acid reflux occurs, and the difference was statistically significant. The total number of reflux episodes and esophageal in NERD deficiency patients were more than those of healthy volunteers,the distal esophageal amplitude in deficiency patients were lower than that in healthy volunteers when acid reflux occurs, and the distal esophageal amplitude in deficiency patients were lower than that in empirical patients,the difference was statistically significant. The percentage of abnormal esophageal contraction in NERD empirical patients and deficiency patients were higher those of healthy volunteers, and the difference was statistically significant.(6) In the Digestion phase, when acid reflux occurs, the total number of acid reflux more than healthy patients, abnormal esophageal contraction percentage, and the amplitude of antral contractions are all higher than those of healthy (P<0.01), the number of antral contractions are relatively more than healthy (P<0.05). the total number of Positive Patients with acid reflux,the number of esophageal contractions while acid reflux are more than healthy (P<0.05), the percentage of abnormal esophageal contraction and the average amplitude of antral contractions are higher than the healthy (P<0.01). When acid reflux occurs, the number of esophageal contractions of Deficiency Patients are more than healthy, the percentage of abnormal esophageal contraction,the average amplitude of antral contractions and the number of antral contractions are higher than the healthy (P<0.01).Conclusion(1)The Deficiency Patients of NERD are more susceptibl to occur Acid ruflux than Positive Patients.(2) In the interdigestion phase, The number of acid reflux in Patients and healthy volunteers are mainly distrubute in phase Ⅱ. The acid reflux occurs in phase Ⅰ and phase Ⅲ is less. The number o f acid reflux are mainly distrubute in duodenal phase Ⅲ.(3)The occurrence of acid reflux in Interdigestive digestion phase II and digestion phase are the results of many Comprehensive Factors, eg, the function esophageal contract, the contraction amplitude of the distal esophagus, LESP, TLESR, antral contractions coordination and so on. |
PDF Full Text Request