The Correlation Between Chinese Classification In Deficient And Demonstration Type Of NERD In Proximal Intestinel Motility

Background of theoryGastro-esophageal reflux disease is a syndrome that caused by gastric content, which leads to a esophageal damage. Negative endoscopic reflux disease is the common type among of all.Acid reflux, anti-reflux barrier disorders, esophageal and gastric disorders, can result pathology of NERD. Heartburn and acid-reflux are its typical syndrome, which usually accompany with chest pain, throat discomfort, chronic cough and asthma. According to this, TCM named it as "spit acid", "noisy", "chest".Syndrome differentiation can be devided into Qi deficiency, bgtranshepatic Yu heat and incoordination between liver and sleen.ObjectiveCollecting 20 cases and 10 healthy volenteers with gastroptosis 24h antroduodenal manometry data and 24h esophageal pH dynamic monitoring data, discusses correlation between NERD traditional Chinese symptoms differentiation, MMC, and 24h esophageal reflux, further explor the etiology and pathogenesis of NERD, look for the dynamics index differences between different TCM syndromes.MethodsRely on 24h esophageal monitoring mean to diagnosis NERD, using Gastroscopy to exclude other gastrointestinal ulcer disease, includes patients who meet Western diagnostic criteria for NERD. Collect 20 individual patient symptoms, devided them into deficiency and excess syndromes, according to Chinese classification standard,24h gastroduodenal manometry was performed in 20 patients and 10 healthy volunteers. Using SPSS 19.0 to different the correlation between TCM syndromes of esophageal acid exposuregastric and antrum and the duodenum pressure index.ResultsThere is no statistically significance in age and body mass index was between deficiency and excess syndromes(P>0.05). Dficiency syndrome were obviously higher in total reflux time, pH<4 time percentage, De-Meester integral, compared with excess syndromes (P＜0.05).Totle ruflux duration and numbers are obviously higher in NERD in phase I when compared with healthy control group(P＜0.05). Meanwhile, in phase II, NERD patients were increased no matter in totle ruflux duration, ruflux numbers compared with healthy group, but duodenal motility index, velocity, gastric duodenal coordinated contraction and duodenal propelling contration were significantly reduced. The duodenal and conlon frequency in phase II were increased in the demonstration type than healthy members. When compared with two Chinese syndrome group, the totle reflux duration in deficiency type were higher, but duodenal motility index, gastric duodenal coordinated contraction and duodenal propelling contration were obviously reduced. In the mean time, frequency of duodenal in demonstration type were higher. The duration of MMC phase Ⅲ in NERD patients, no matter origin from gastric antrum or the duodenal, was significantly shortened than control group. Duodenal retroperistalty were clearly inceased in NERD, but duodenal propelling contrations were declined. The velocity was obviously reduced in deficiency type compared with healthy group. When compared with two Chinese syndrome group, duration of phase Ⅲ, velocity and duodenal retroperistalty were increased in deficiency group.In digestive period, totle ruflux duration and numbers were obviously higher in deficiency group when compared with demonstration type. Duodenal propelling contrations in deficiency group were reduced as well. ConclusionThere is a certain specificity in 24h esophageal pH monitoring and digest motility between different TCM type in NERD patients. The dynamics index, esophageal acid exposure conditions were of great difference as well. The dynamics abnormalities in deficiency syndrome group is more specific, its acid reflux is more severe. GER has an relationship with different phase of MMC.