Study On The Correlation Between TCM Syndrome Differentiation Of Chronic Atrophic Gastritis And Gastric Secretory Function

Objective:Explore the relationship between chronic atrophic gastritis syndrome differentiation and gastric secretory function(serum pepsinogen(PG)and serum gastrin-17(g-17)levels).Method:On the basis of related literature and cl inical guidelines,formulate the clinical questionnaire,105 cases into met inclusion criteria and exclusion criteria of chronic atrophic gastritis patients as the research object,collect and record the object of study of general information,symptoms and signs,gastroscope and pathology results,determination of traditional Chinese medicine,detection and record serum PG,the value of G-17,analysis the CAG patients with different type of traditional Chinese medicine and the relationship between gastric secretion.Result:1.A total of 105 patients with chronic atrophic gastritis were included in this study,including 53 males(51.1%)and 52 females(48.9%).The age of the disease ranged from 83 years old to 44 years old,with an average age of 61.38±7.636 years old.The 105 patients were divided into 6 syndrome types,including 27 cases of spleen-stomach weakness(25.7%),22 cases of liver-stomach stagnation(21.0%),22 cases of liver-stomach stagnation(21.0%),19 cases of spleen-stomach dampness and heat(18.1%),11 cases of deficiency of stomach Yin(10.4%),and 4 cases of stomach-collateral stasis(3.8%).The six syndromes were classified into two types:heat syndromes and non-heat syndromes,of which 41 cases were heat syndromes,accounting for 39.0%,and 64 cases were non-heat syndromes,accounting for 61.0%.2.The relationship between CAG syndrome type and Hp infection:the infection rate was 49.52%in 52 patients with Hp positive,among which the Hp infection rate of liver-stomach stasis syndrome was the highest(59.09%),while the Hp infection rate of spleen-stomach weakness syndrome was the lowest(37.04%).According to chi-square test,there was no statistical difference in the Hp infection rate of CAG patients with different TCM syndromes.(P>0.05).The infection rate was 56.10%in 23 Hp positive patients with heat syndrome type.The infection rate was 45.30%in 29 patients with non-febrile syndrome type Hp.By chi-square test,there was no statistical difference in Hp infection rate between patients with heat syndrome-like CAG and those with non-heat syndrome-like CAG(P>0.05).3.Relationship between TCM syndromes of CAG and gastric secretion function:serum PG ?,PG ?,PGR and g-1 7 levels of CAG patients with different syndromes are different.The serum levels of PG ?,PG ? and g-17 in spleen and stomach weakness syndrome were the lowest,the serum levels of PG ? in liver and stomach stasis syndrome were the highest,and the serum levels of PG ? and g-1 7 in stomach deficiency syndrome were the highest.The serum levels of PG ? and g-17 in spleen-stomach syndrome were statistically different from other syndromes(P<0.05).There were statistically significant differences in serum PG ?,PG? and g-17 levels between the rest of the syndromes(P<0.05).There was no statistically significant difference in serum PGR level between different types of syndrome differentiation(P>0.05).Compared with the heat syndrome-type,the serum PG ? and PG ? levels of the patients with the non-heat syndrome-type were decreased,and the difference was statistically significant(P<0.05).There was no statistically significant difference in serum PGR and g-1 7 levels between the two groups(P>0.05).4.Relationship between different pathological grades of CAG and gastric secretion function:according to statistical results,serum PG ? and g-17 levels were the highest in the mildly atrophic group,and the lowest in the severely atrophic group.Compared with the mild atrophy group,the serum PG ? level of both the moderate atrophy group and the severe atrophy group decreased,with statistically significant differences(P<0.05).Compared with the mild atrophy group,the level of serum g-17 in the severe atrophy group was decreased,and the difference was statistically significant(P<0.05).There was no statistically significant difference in serum PG ? and PGR levels between different atrophy groups(P>0.05).The levels of PG ? and PG ? were the highest in the mild enterization group,and the levels of PG I,PG ? and g-17 were the lowest in the moderate enterization group.Compared with the mild intestinal metaplasia group,the levels of PG ?,PG ? and g-17 in the moderate intestinal metaplasia group were all reduced,with statistically significant differences(P<0.05).There was no significant difference in serum PGR level between the groups(P>0.05).Conclusion:1.There are some rules in the distribution of TCM syndrome differentiation in patients with chronic atrophic gastritis,most of which are spleen-stomach weakness,followed by liver-stomach stagnation and liver-stomach stagnation.2.The gastric secretory function of chronic atrophic gastritis patients with different TCM syndrome differentiation is different,and the gastric secretory function has a significant suggestive effect on the syndromes of spleen and stomach weakness and heat syndrome.When the function of gastric secretion is decreased,the syndrome type is mostly the weakness of spleen and stomach.However,when gastric secretion function was improved,the syndrome types were more likely to be heat syndromes such as liver-stomach stagnation syndrome and spleen-stomach dampness-heat syndrome.3.The degree of gastric mucosal atrophy in patients with chronic atrophic gastritis is different from the expression levels of PG ?,PG ? and g-17 in serum,in which PG ? and g-17 gradually decrease with the aggravation of atrophy.