Analysis Of TCM Syndrome Type Distribution And Antibiotic Resistance Of Helicobacter Pylori (Hp) Infection

Objective By surveying and analyzing the clinical character of patients with H.pylori(Hp)infection through retrospective study,the study aimed to analyze the TCM syndrome typing of Hp infection and the relationship between TCM syndrome types and antibiotic resistance,so as to improve the TCM's understanding of the disease,to provide a certain reference value for the selection of antibiotics and / or sequential TCM treatment of the disease in clinical syndrome differentiation,and also to provide a reference basis for HP's TCM treatment whether the use of syndrome differentiation is needed.Methods The subjects of the study were patients of the Guanggu District of Hubei traditional Chinese medicine hospital who were diagnosed as Hp infection From June 2018 to June 2019.Based on diagnostic criteria,inclusion and exclusion criteria,299 patients aged 18 to65 were included in the study.Based on understanding of patients,we helped them accomplish questionnaires,including basic information,medical history,TCM syndrome typing.After accomplishing the questionnaires,we processed data and set up a database.In addition,the HP patients who were hospitalized from June 2018 to June 2019 were selected for drug sensitivity test after HP was successfully cultured and separated.At the same time,the patients were treated with TCM syndrome differentiation to observe the drug resistance of each TCM syndrome type to six antibiotics.The Microsoft Office 2016 Excel and SPSS25.0 were used to analyze data,and the data were checked to ensure that they were correct.Chi square test(?2test)was used to express the counting data in terms of rate or constituent ratio,and t test was used to express the measuring data in terms of mean±standard deviation.Results1.A total of 299 patients were included in the study of part one.The results are as follows:1.1 The general information:140 male and 159 female were included in this part,sex ratio was 1.14.The average age was 44.04 year old,most of they between 18 to 65.1.2 In 299 patients,the proportion of each syndrome type is from high to low: disharmony of liver and stomach(53.18%);weakness of spleen and stomach(26.76%);dampness and heat of spleen and stomach(20.07%);stasis of stomach collaterals(0.67%);deficiency of stomach yin(0.33%).The number of patients with disharmony of liver and stomach was the most in all age groups,and the number of patients with dampness heat of spleen and stomach was the second most in 31-40 age groups,followed by that of weak spleen and stomach in other age groups.In male patients and female patients,the most common type is disharmony of liver and stomach,but in male patients,there is no significant difference between spleen and stomach damp heat type and spleen and stomach weak type;in female patients,the number of spleen and stomach weak type is significantly higher than that of spleen and stomach damp heat type.2.In the second part of the clinical study,52 Patients with positive growth of Helicobacter pylori culture were included.The results are as follows:2.1 TCM syndrome type:In 52 patients,the type of disharmony of liver and stomach(51.92%)>the type of weakness of spleen and stomach(32.69%)>the type of damp heat of spleen and stomach(15.39%).2.2 Drug resistance:The resistance rate of 52 HP clinical strains to 6 antibiotics was 86.54% for metronidazole,46.15% for clarithromycin,26.92% for levofloxacin,13.46% for amoxicillin,9.62% for tetracycline and 5.77% for furazolidone.The drug resistance rate of clarithromycin in the three types of syndrome was liver stomach disharmony(62.96%),spleen stomach weakness(29.41%),spleen stomach damp heat(25.00%).2.3 Drug resistance in TCM Syndromes:To compare the relationship between sex,age and antibiotic resistance rate in different syndrome types,the results showed that there were only statistical differences between sex and the resistance rate of clarithromycin in the spleen stomach weakness syndrome.Conclusion1.There was no significant correlation between Hp infection and gender.The main age of onset was 31-40 years old.The age of onset is different between men and women.The main age of onset is 31-40 years for men and 21-30 years for women.2.The proportion of HP infection in traditional Chinese medicine from high to low was as follows: disharmony of liver and stomach(53.18%);weakness of spleen and stomach(26.76%);dampness and heat of spleen and stomach(20.07%);stasis of stomach collaterals(0.67%);deficiency of stomach yin(0.33%).The number of patients with disharmony of liver and stomach was the most in all age groups,and the majority in 31-40 age groups.3.The drug resistance rate of HP to metronidazole and clarithromycin was higher than that of levofloxacin and amoxicillin,followed by tetracycline and furazolidone.The drug resistance rates of clarithromycin and levofloxacin were within the average level in China,while those of metronidazole,amoxicillin,tetracycline and furazolidone were higher than the average level in China.4.The resistance rate of clarithromycin was 62.96%,29.41%,25.00% in liver-stomach disharmony syndrome,spleen-gastric weakness syndrome,and spleen-gastric damp-heat syndrome,while the difference of the other five antibiotic resistance rates in different TCM syndromes was not significant.5.There were only statistical differences between sex and the resistance rate of clarithromycin in the spleen stomach weakness syndrome.The drug resistance rate of women was significantly higher than that of men.