Study On The Correlation Between The Distribution Of TCM Syndromes In 252 Cases Of Chronic Atrophic Gastritis And Its Pathology

ObjectiveWe study the relation between chronic atrophic gastritis and demographic data,related to pathogenic factors,personal history and family history,the distribution of TCM syndromes in chronic atrophic gastritis as well as the distribution of atrophy,intestinal metaplasia and dysplasia(intraepithelial neoplasia)of different pathological parts of chronic atrophic gastritis.MethodsThe clinical data of 252 patients with atrophic gastritis who accord with the standard were collected and analyzed.A database was established.It is a cross-sectional study to collect basic information,personal history and family history,primary and secondary symptoms,gastroscopy and pathological findings by fill in the questionnaires.To figure out TCM syndrome classification and finish pathological diagnosis.Using SPSS.22 statistical software,descriptive statistics were used for general data,and count data was collected by x 2 test;rank data was tested by rank sum test.a=0.05.Results1.(1)Of the 252 cases,140 are male and 112 are female,with a male to female ratio of 1.25:1.(2)The minimum age is 22 years old,the maximum age is 74 years old,the average age is 52.51±10.83 years old,and the number of cases over 50 years old is mostly.(3)The most nationality is Han nationality.(4)The degree of education is mostly in middle school and undergraduate;the relationship between onset and occupational nature is mental laborer>manual laborer.(5)The origins are mainly distributed in 23 provinces and cities,most of which are in Shandong Province;the addresses are distributed in 20 provinces and cities,most of which are in Beijing.(6)The top five adverse factors affecting male patients in this group are drinking>eating too fast>smoking>eating preference>staying up late;the adverse factors that have a greater impact on women are diet preference>eating too fast>Irregular diet>staying up late>not eating breakfast often;the top five dietary preference factors for male patients are followed by hot and spicy>sweetening>greasy>salty>frying;in female patients,the effect The larger top five dietary preference factors are sweetening>hot and spicy>salty>acidophilic=fat frying.(7)The shortest course of disease is no more than 1 month,the longest is 16 years,and the most are in 5 years.(8)72.22%of patients with Hp infection;Hp infection rate is 22.62%.(9)Common past history of this disease includes chronic non-atrophic gastritis,esophagitis(including reflux esophagitis and Barrett's esophagus),duodenal diseases(including duodenal inflammation and ulcers),gastric polyps and gastric ulcers.(11)Family history of stomach and digestive diseases accounted for 30.56%;CAG family history accounted for 19.05%;family history of gastric cancer accounted for 80.95%.2.In this group of patients with CAG,the stomach fullness accounted for 86.90%,the stomach cramps accounted for 71.43%,and both of them accounted for 58.33%;(1)the stomach fistula and the stomach cramps are in the upper abdomen>under the xiphoid;stomach pain,nature,pain,pain 3 pain,tingling;the nature of both episodes are postprandial exacerbation>pre-meal exacerbation,nighttime aggravation>nighttime remission,pefer to press>refuse to press;The top five are improper diet>angry>catching cold>anxiety>drinking;the top five causes of stomach cramps are due to improper diet>angry>cold>anxiety>irregular diet;both episodes are mild>middle degree>severe;seizure frequency is 1-3 times/week>frequency more than 7 times/week,duration 2h>2-4h;(2)frequency of occurrence of more than 50%of cases of hypothyroidism is followed by warm food>upset Irritability>dry mouth>burnout fatigue>burning heart=sticky stool>mouth bitterness>stool thinning;the top five in the case of clip disease are abdominal midgut>sagittal frequency>throat dry>pharyngeal obstruction>mouth stick.3.In this group of 252 patients with CAG,the frequency of syndromes is 456.The proportion of syndromes from high to low is spleen-stomach weakness syndrome(45.18%)>gastric collateral blood stasis syndrome(17.11%)>liver-qi stagnation syndrome(14.25%)>hepatogastric stagnation syndrome(11.18%)>spleen and stomach damp-heat syndrome(8.33%)>stomach yin deficiency syndrome(3.95%);combined syndrome type,composite syndrome type(57.14%)>single syndrome type(42.86%),most patients have two or three types of syndromes.In combination with two types of syndromes,the spleen and stomach weakness syndrome+stomach collateral blood syndrome was the most(40.23%);the composite of three syndrome types,spleen and stomach weakness syndrome+ liver qi stagnation syndrome + liver and stomach stagnation syndrome(31.58%).Hp infection is most common in the spleen and stomach dampness syndrome.4.(1)Distribution of pathological positive rate in different parts:stomach angle>gastric antrum>gastric sinus junction>pyloric area>gastric body.(2)Distribution of pathological changes in different parts:atrophy and intestinal metaplasia of gastric antrum>stomach angle>corpus corpus>anterior pyloric region>gastric sinus junction;intraepithelial neoplasia in gastric antrum>stomach angle>corpuscular>gastric sinus Junction>pyloric area.(3)Distribution of atrophy degree in different parts:mild atrophy,gastric antrum>gastric angle>gastric body>pyloric area>stomach sinus junction;moderate atrophy.gastric antrum>gastric angle>gastric body>stomach sinus junction>pyloric area;severe atrophy,stomach angle>gastric antrum>stomach body>stomach sinus junction>pyloric area.Distribution of intestinal metaplasia in different parts:mild and moderate intestinal metaplasia,gastric antrum>gastric angle>gastric body>pyloric area>stomach sinus junction;severe intestinal metaplasia,stomach angle>antial sinus>gastric body>stomach body sinus junction>pyloric area.Low-grade intraepithelial neoplasia distribution:gastric antrum>gastric angle>gastric body>gastric sinus junction>pyloric anterior region.5.(1)Different syndrome types and pathological changes of individual sites:gastric antrum atrophy is mainly caused by liver and stomach qi stagnation syndrome,intestinal metaplasia is mainly based on gastric collateral blood stasis syndrome,and intraepithelial neoplasia is mainly caused by liver and stomach stagnation syndrome.Gastric atrophy is mainly caused by liver and stomach qi stagnation syndrome.Intestinalization is mainly caused by spleen and stomach weakness syndrome.Epithelial neoplasia is mainly caused by gastric collateral blood stasis syndrome.Gastric atrophy is mainly caused by deficiency of stomach yin.Intestinalization has intestinal metaplasia except for other syndromes of spleen and stomach weakness;there are fewer cases of intraepithelial neoplasia,mainly liver and stomach stagnation syndrome.The atrophy of the sinus junction of the stomach is mainly based on the syndrome of qi and blood stasis.In addition to the syndrome of intestinal yin deficiency,there are intestinal metaplasia.The number of epithelial tumors is less,and the spleen and stomach dampness syndrome is the main.The atrophy of the anterior pyloric area is mainly caused by liver and stomach stagnation and heat syndrome.In addition to the syndrome of intestinal yin deficiency,all other syndromes have intestinal metaplasia;the number of intraepithelial neoplasia is less,and the main symptoms are gastric collateral blood stasis syndrome.(2)Distribution of different syndrome types and pathological changes:mild atrophy is mainly caused by deficiency of stomach yin,moderate atrophy is mainly due to spleen and stomach weakness syndrome,severe atrophy is mainly due to spleen and stomach dampness syndrome;mild intestinal metaplasia:the main symptoms of deficiency of stomach yin,moderate intestinal metaplasia with liver and stomach qi stagnation syndrome,severe intestinal metaplasia with liver qi stagnation syndrome.(3)Distribution of pathological changes of different syndrome types and individual sites:mild atrophy of gastric antrum is mainly caused by deficiency of stomach yin,moderate atrophy is mainly caused by spleen and stomach weakness syndrome,and severe atrophy is mainly caused by spleen and stomach dampness syndrome.Mild intestinal metaplasia is mainly caused by spleen and stomach damp-heat syndrome;moderate intestinal metaplasia is mainly characterized by liver and stomach qi stagnation syndrome,and severe intestinal metaplasia is mainly spleen-stomach weakness syndrome.Mild atrophy of the stomach corner is mainly due to deficiency of stomach yin.Moderate atrophy is mainly caused by gastric collateral blood stasis syndrome.Severe atrophy is mainly caused by liver and stomach stagnation syndrome.Mild intestinal metaplasia is mainly based on deficiency of stomach yin.Moderate intestinal metaplasia is mainly due to spleen and stomach weakness syndrome and stomach yin deficiency syndrome.Severe intestinal metaplasia is mainly caused by liver and stomach qi stagnation syndrome.Mild atrophy of the corpus callosum is mainly caused by liver qi stagnation syndrome and stomach yin deficiency syndrome.Moderate atrophy is mainly caused by stomach yin deficiency syndrome,and severe atrophy is mainly spleen and stomach dampness syndrome.Mild intestinal metaplasia is mainly based on deficiency of stomach yin.Moderate intestinal metaplasia is mainly due to spleen and stomach weakness syndrome.Severe intestinal metaplasia is mainly based on gastric collateral blood stasis syndrome.ConclusionThe age of chronic atrophic gastritis is more than 50 years old;the main symptoms are stomach fullness and stomach cramps pain,no obvious specificity of symptom onset,the degree is usually lighter,mostly are easily recurrent;syndrome distribution with spleen and stomach weakness syndrome Mainly;composite syndromes are more than single syndromes;the proportion of positive lesions in different parts is gastric antrum,stomach angle,corpus,gastric atrophy and intestinal metaplasia is more serious than gastric antrum and stomach;The proportion of spleen-stomach damp-heat syndrome and liver-stomach qi stagnation is relatively high,and the proportion of qi and blood stasis syndrome is the lowest.The intestinal qi stagnation syndrome and gastric collateral blood stasis syndrome are relatively high,in low-grade intraepithelial neoplasia.The stomach yin deficiency syndrome and the liver and stomach stagnation heat syndrome accounted for a relatively high proportion.In different degrees of atrophy and intestinal lesions,gastric yin deficiency syndrome is more likely to occur in mild atrophy and intestinal metaplasia,spleen and stomach weakness syndrome is more likely to occur in moderate atrophy and moderate intestinal metaplasia,gastric collateral blood stasis syndrome and spleen and stomach dampness syndrome are more likely to occur in severe atrophy and severe intestinal metaplasia.