Study On 5-year Follow-up Of Disease Evolution And Related Influencing Factors In Patients With Chronic Gastritis

Objective:Chronic gastritis is the most common digestive system disease in China,and its pathology has the evolution process of "chronic inflammation,atrophy,intestinal metaplasia and dysplasia",which is also an important way for the occurrence of gastric cancer.Due to the long clinical cycle and many influencing factors in this process,there are few studies on the correlation between disease outcome and its influencing factors,and there is a lack of clinical research on early preventive measures for its disease progression.Based on this situation,this study included patients who were diagnosed as chronic gastritis 5 years ago.By understanding the situation of gastroscopy,observing the pathological state at the present stage,and analyzing the correlation between the pathological state and the influencing factors in 5 years,to clarify the relationship between the prognosis of chronic gastritis in 5 years and various influencing factors,in order to further understand the pathological evolution of chronic gastritis.As well as the combination of traditional Chinese and western medicine to prevent and control the pathological progress of chronic gastritis to provide research basis for the formulation of clinical early prevention program.Methods:Using the method of follow-up study,1430 patients with chronic gastritis from January 1,2014 to December 31,2015 were followed up by "telephone+Wechat".Focus on the results of endoscopic reexamination,collect general clinical data,behavioral factors(smoking history,drinking history,work and rest habits,exercise habits,common dietary preferences and dietary patterns),disease factors(chronic gastritis treatment,HP infection history,other digestive system disease history,allergy history,concomitant disease history),genetic factors(family history of chronic gastritis,Various clinical information such as family history of digestive system malignant tumor,social psychological factors(emotional state,impatience,anxiety,anxiety and depression),information of four diagnosis of traditional Chinese medicine and so on.The distribution characteristics of clinical data of patients with chronic gastritis with different pathological outcomes were compared and analyzed,and the relevant factors affecting the pathological progression of chronic gastritis were explored by Logistic regression analysis.Results:1.After follow-up,among the 1430 patients who were enrolled in the previous group,113patients had endoscopic reexamination,and the average reexamination period was 1039 days.Among them,the proportion of CAG patients with endoscopic reexamination(46.0%)was significantly higher than that without endoscopic reexamination(17.3%).2.Among the 113 cases with endoscopic reexamination,the main symptoms before and after follow-up were epigastric fullness,belching and aggravation of hiccup;the overall changes of TCM syndromes showed that the number of patients with spleen-stomach damp-heat syndrome decreased and the number of patients with stomach yin deficiency syndrome increased.3.According to the results of endoscopic and pathological diagnosis,among the 113 patients,27 cases(23.9%)had "progress",43 cases(38.1%)had "reversal" and 43 cases(38.1%)had "no change".Among them,the patients with pathological "progress" of chronic gastritis have the following characteristics:(1)in terms of general clinical data,the number of patients aged 45-59 years old is significantly more than that of patients aged 18-44 years old and?60 years old;(2)in terms of behavioral factors,more patients have habits such as irregular work and rest,no exercise habits,spicy food,fast eating,irregular diet and so on.(3)in terms of disease factors,more patients had no systematic treatment of chronic gastritis,had a history of HP infection,had a history of other digestive diseases,and fewer patients had a history of other diseases.(4)there was no statistical difference in genetic factors,emotional factors and patients with no pathological progress.4.Further binary Logistic regression analysis showed that age,work and rest habits,previous history of HP infection,history of other digestive tract diseases,and TCM syndrome factor "yin deficiency" were related factors affecting pathological progression.Conclusion:There are three forms of disease prognosis in patients with chronic gastritis in 5 years:"progress","reversal" and "no change".Among them,the progression of chronic gastritis is closely related to age,work and rest habits,previous history of HP infection,history of other digestive tract diseases and TCM syndrome elements "yin deficiency".Strengthening health education for patients with chronic gastritis with high risk factors,improving their awareness of reexamination and actively correcting their bad living habits will be of great significance to control the progress of the disease.