| Objective:By analyzing,comparing and summarizing the multi dimensional clinical data of Western medicine and the law of syndrome differentiation and treatment of traditional Chinese medicine,we can provide reference for the treatment of this kind of disease with the combination of traditional Chinese and Western medicine.Methods:A total of 180 patients with functional dyspepsia who met the inclusion criteria in the Department of Gastroenterology of Jiangsu Hospital of traditional Chinese Medicine were collected.The information of the four diagnoses of traditional Chinese medicine and the multidimensional clinical profile of western medicine were collected,and the data were recorded in the EXCEL form,using SPSS software,using frequency analysis,frequency analysis,χ2 test,nonparametric test,multiple response and other statistical analysis methods.Summarize and compare the distribution characteristics of multidimensional clinical profile,etiology,pathogenesis,clinical symptoms,syndrome types and prescription distribution of functional dyspepsia.Results:1.General data analysis:among 180 FD patients,106(58.9%)were female,74(41.1%)were male,the ratio of male to female was 1:1.4;the minimum age was 19 years,the maximum age was 64 years,the average age was 41.2 years,and the peak age was 36-45 years.Married 157cases(87.2%),unmarried 19 cases(10.6%),divorced or widowed 4 cases(2.2%).The distribution of academic qualifications was mainly college degree or above,a total of 95 cases(52.8%),and 79 employees(43.9%)in the occupational distribution,accounting for the highest proportion.There were 22 smokers(12.2%)and 25 alcohol drinkers(13.9%).Among the predisposing factors,dietary factors,emotional factors and other factors had the greatest impact on FD,while climate factors had the least influence on the incidence of FD.Patients in PDS+EPS group had more multiple factors than PDS group and EPS group.The average course of disease was 4.37±5.94 years,with the largest distribution in 1-5 years;the average BMI of PDS group was 20.25±2.24kg/m2,the average BMI of EPS group was 21.87±2.22kg/m2,PDS+EPS group was 21.87±2.22kg/m2.The BMI of EPS group was higher than that of PDS group and PDS+EPS group(P<0.05).According to the statistical results,there was no significant difference in the distribution of FD subtypes in terms of sex,age,course of disease,marriage,smoking,drinking and educational background.2.Distribution of western medicine subtypes:Among the 180 FD patients in this study,65 cases were in the PDS group,accounting for 36.1%of the total,45 cases in the personality EPS group,and 70 cases in the 25.0%FD group,accounting for 38.9%of the total.3.The influence on daily activities:The patients thought that the overall effect of FD on daily activities was mostly mild to moderate,mild in PDS group and EPS group,and moderate in PDS+EPS group.The difference was statistically significant.4.Social psychological evaluation:among the 180 patients with FD,98(54.4%)had varying degrees of anxiety,depression or combined state,of which 58 cases(32.2%)had anxiety and depression.The proportion of anxiety and depression in PDS+EPS group was higher than that in PDS group and EPS group.There was no significant difference in the distribution of anxiety,depression and combined state among the three groups.Among the psychosocial red flag(alarm)symptoms of FD,anxiety,depression,somatic symptoms and related troubles and health worries,functional impairment or disability were the most influential.Among the nine problems,PDS+EPS group had more multiple choices than PDS group and EPS group.4.Social psychology evaluation:98(54.4%)of 180 FD patients had different degrees of anxiety,depression or anxiety and depression combined state,in which 29 cases were PDS group,accounting for 44.6%of the total number in the group;24 cases were EPS group,accounting for 53.3%of the total number in the group;45 cases were PDS+EPS group,accounting for 64.3%of the total number in the group.The proportion of anxiety and depression in PDS+EPS group was higher than that in PDS group and EPS group.There was no significant difference in the distribution of anxiety,depression and combined state among the three groups(P<0.05).Anxiety,depression,physical symptoms,related worries and health concerns,functional impairment or disability are the most important symptoms of FD.PDS+EPS group has more multiple choices than PDS group and EPS group.5,Distribution of clinical data of traditional Chinese Medicine:The symptoms with high frequency of FD include epigastric fullness(75.0%),epigastric pain(56.1%),belching(55.6%),poor sleep at night(35.6%),thin stool(35.0%),acid regurgitation(26.1%),fear of cold(24.4%),eating less or being stunned(23.9%),dry mouth(17.8%),fatigue(15.0%),and so on.Epigastric heartburn(13.9%),bitter mouth(12.2%),dry stool(12.2%),dry stool(11.1%),irritable(10.6%).The highest frequency of tongue appearance was light red tongue(68.3%),followed by red tongue(22.8%).Tooth marks on the middle edge of tongue shape accounted for 70.6%.The main coating was thin white(57.2%)and white and greasy(20.6%).The pulse string(67.2%)accounted for the most.6.Distribution of syndrome types:Among the 180 patients with FD,73 cases(40.6%)were spleen deficiency and qi stagnation syndrome,65 cases(36.1%)were liver-stomach disharmony syndrome,14 cases(7.8%)were spleen-stomach damp-heat syndrome,18 cases(10.0%)were spleen-stomach deficiency-cold syndrome,10 cases(5.5%)were cold-heat mixed syndrome.In PDS group,31 cases(47.7%)were spleen deficiency and qi stagnation syndrome,18 cases(40.0%)were liver-stomach disharmony syndrome in EPS group,28 cases(40.0%)were spleen deficiency and qi stagnation syndrome,and 27 cases(38.6%)were liver-stomach disharmony syndrome in PDS+EPS group.7.Usage of prescriptions and medicines:the 57 most frequently used traditional Chinese medicines of FD were counted,and the most frequent ones were:Atractylodes macrocephala,tangerine peel,Poria cocos,jiaoliushenqu,baked licorice,Fructus aurantii,fried malt,Codonopsis pilosula,fried rice sprout,fried coix seed.The most commonly used prescriptions were Liujunzi decoction plus and minus,which could be Xiangsha Liujunzi Decoction,guishaoliujunzi decoction,Yigong powder,etc.In addition,there are many combined prescriptions,such as Shenling Baizhu powder,Sini Powder,Xiaoyao Powder,Chaihu Shugan powder,Zuojin Pill,Baihe decoction,etc.Conclusion:The analysis of multidimensional clinical data of functional dyspepsia emphasizes the supplement and refinement of diagnosis,the change of social psychology.The differentiation and treatment of traditional Chinese medicine also emphasizes the importance of four diagnosis combined with reference,the combination of disease and syndrome and the adjustment of emotion.In terms of diagnosis,both of them have the same thinking and can participate in each other.Combined with multidimensional clinical data analysis,it helps to improve the accuracy of TCM syndrome differentiation and treatment,while TCM syndrome differentiation and treatment can improve the limitations of multidimensional clinical data analysis and treatment.TCM treatment based on syndrome differentiation emphasizes to take care of the spleen and stomach of Zhongjiao as the main part,to integrate the functions of dredging the liver,invigorating the spleen and nourishing the heart,and to attach importance to the typical symptoms,to add and subtract syndrome differentiation.In the treatment,we can take Chinese Medicine and Western medicine as the center,combine multiple therapies and comprehensive treatment,so as to achieve better clinical effect. |
