Study On The Relationship Between Gastroscopic Images Of Chronic Gastritis Complicated With Helicobacter Pylori Infection And Distribution Of TCM Syndromes Types

Objective:To explore the relationship between TCM syndromes of chronic gastritis complicated with Helicobacter pylori infection and gastric adhesion under gastroscopy,and to find the existing rules of TCM syndrome differentiation under gastroscopy.It is expected to combine the macroscopic syndrome differentiation of chronic gastritis complicated with Helicobacter pylori infection with the microscopic manifestations of modern medicine,so as to provide some reference for clinical syndrome differentiation diagnosis and more targeted prescription selection.Methods:According to the related books and literatures of chronic gastritis complicated with Hp infection,the clinical data information collection table was designed.Patients with chronic gastritis complicated with Hp infection who visited the splenic and gastric outpatient department and inpatient department of Nanjing Hospital of Traditional Chinese Medicine from May 2020 to February 2021 were selected as the research subjects.The general data,TCM symptoms,gastroscopy reports and other data of the patients were collected by using the information collection table.The syndromes of each patient in this study were determined by combining the four diagnosis data of the patients.A total of 200 study cases were screened according to inclusion and exclusion criteria;The collected case data were input into Excel,and SPSS26.0 software was used for statistical analysis,so as to explore the relationship between endoscopic images of patients in this study and TCM syndrome types.Results:1.A total of 200 patients with chronic gastritis complicated with Helicobacter pylori infection were collected in this study,including 92 males and 108 females,with a male to female ratio of 1:1.17.The average age of patients was 49.46±11.33 years old,and the peak age of patients was 50-59 years old and 40-49 years old,with the prevalence of 32%and 27.5%respectively,followed by 30-39 years old and 60-69 years old,with 18.0%and 15.5%respectively.The prevalence of patients younger than 30 years old and older than 70 years old was low,with 3.5%respectively.2.The top five TCM syndrome frequency of patients were:stomach distention(62.0%),halitosis(56.5%),stomachache(43.0%),acid reflux(41.5%)and belching(40.5%).Red tongue,yellow and greasy tongue coating,slippery and rapid pulse was seen commonly.3.According to the classification standard of chronic gastritis syndrome types,the included cases were divided into five syndrome types.The composition ratio of TCM syndromes in this study from high to low was:dampness-heat syndrome of spleen and stomach(37.0%)>syndrome of weakness of spleen and stomach(21.5%)>syndrome of disharmony between liver and stomach(20.0%)>syndrome of stomach yin deficiency(12.0%)>stomach-collateral stasis syndrome(9.5%).4.According to gastroscopy data of 200 patients,the detection rate of gastric mucosa congestion and edema was the highest(65.5%),gastric mucosa rough(56.5%),patchy,strip or diffuse erythema(mucosal erythema)(41.5%).The detection rate of bleeding point or spot,white mucosa,granular or nodular changes was low and accounting for 10.0%,18.0%,8%respectively.5.Mucosal congestion and edema,mucosal roughness,mucosal erythema,white mucosa,granular or nodular changes were different in the distribution of TCM syndromes types(P<0.05).Congestion and edema and rough mucosa were the most common in dampness-heat of spleen and stomach,patchy.Patchy,strip or diffuse erythema were the most common in liver and stomach discord.White mucosa was the most common in spleen and stomach weakness.Granular or nodular changes were the most common in stomach-collateral stasis syndrome.Bleeding point or spot had no statistical difference in the distribution of TCM syndromes(P>0.05).Conclusion:1.Gastroscopic images of chronic gastritis complicated with Helicobacter pylori infection showed a higher detection rate of mucosal congestion and edema,mucosal roughness,mucosal erythema.White mucosa,granular or nodular changes,and bleeding points or spots had a lower detection rate.2.There is a close relationship between the performance of gastroscope and TCM syndrome types in chronic gastritis complicated with Helicobacter pylori infection.Hyperemia,edema and mucosal roughness are the most common in the syndrome of dampness-heat of spleen and stomach.Patchy,strip or diffuse erythema are the most common in the syndrome of disharmony between liver and stomach.White mucosa is the most common in the syndrome of spleen and stomach weakness.The granular or nodular changes are the most common in the syndrome of stomach collateral stasis.