The Analysis Of Syndrome Differentiation And Medication Rule Of Traditional Chinese Medicine For Peptic Ulcer And Its Related Factors

Research Objective:To excavate and explore the traditional Chinese medicine（TCM）syndrome differentiation and medication rule of peptic ulcer,observe and analyze the distribution rule and correlation of peptic ulcer related factors,and provide objective support for TCM clinical syndrome differentiation treatment of PU.Research Method:Firstly,inpatients who were diagnosed with peptic ulcer in the Department of Spleen and Stomach Diseases of Hubei Provincial Hospital of Traditional Chinese Medicine from October2019 to January 2022 were selected,and then 150 medical records were finally screened for inclusion in this study in strict accordance with the inclusion and exclusion criteria.The relevant data information of the above-mentioned patients was collected,checked and confirmed by two people for multiple times,and recorded in WPS Excel in chronological order.Data such as age,gender,length of hospital stay,occupation,season of onset,the onset time,ulcer classification,stage classification of Peptic ulcer and number of ulcers were sorted and transformed.Some data were used to perform frequency analysis by WPS Excel and SPSS25.0 software.The part of data were verified correlation by using Chi-square test.Data such as TCM syndrome types and main symptoms,prescriptions,efficacy,properties,compatibility,etc were sorted and transformed.After finally data standardizing,WPS Excel,SPSS Modeler 18.0 and SPSS Statistics 25.0 software were were used to perform frequency analysis,association analysis,network analysis and cluster analysis.Research Result:In this study,150 cases of PU patients with liver-stomach disharmony syndrome and spleen-stomach weakness（cold）syndrome accounted for a higher proportion of the 6 TCM syndrome types in the latest guidelines.The main symptoms consist of epigastric pain,bloating,acid regurgitation,heartburn,dry mouth,bitter mouth,hiccups,belching,poor appetite,poor sleep,and irregular stools.First,the 150 prescriptions included 180 herbs,of which 13 herbs appeared with a frequency of more than or equal to 50 times.In descending order of frequency,they were Atractylodes,Pinellia,dried tangerine peel,Baiji,Poria,sea octopus,Amomum,licorice,white peony,Coptidis,bergamot,Citrus aurantium and Scutellaria baicalensis.Secondly,by analyzing the attributes of 180 traditional Chinese medicines obtained from 150 prescriptions,it is found that the categories are mainly used as tonic,qi-regulating,heat-clearing,phlegm-resolving and damp-removing medicines,and the medicinal properties are warm,calming,cold and slightly cold medicines are mainly used,bitter,pungent and sweet medicines are mainly used in medicinal tastes,and spleen,stomach,lung and liver meridians are mainly used in returning meridians.Then in the correlation analysis of 180 traditional Chinese medicines,the correlation support in descending order is Coptis chinensis→Pinellia,Scutellaria→Pinellia,Coptis+Atractylodes → Pinellia,etc.On the other hand,the association confidence in descending order is Scutellaria baicalensis+dried ginger → Pinellia scutellariae,Scutellaria baicalensis+licorice → Coptis chinensis,Scutellaria baicalensis+licorice → Pinellia japonica,etc.Finally,cluster analysis was performed on 33 traditional Chinese medicines with a frequency greater than or equal to 18 times,and 5 types of drug combinations were obtained.Poly 1 category: Coptis chinensis,Scutellaria baicalensis,dried ginger,Pinellia,licorice,Codonopsis,octopus,Evodia,Schisandra,white Lentils,Coix Seed,Atractylodes,Shichangpu.Poly 2 category: bergamot,perilla,white peony,angelica,acacia.Poly 3 category: Cymbidium,Corydalis,Bupleurum,Citrus aurantium.Poly 4 category: tangerine peel,Amomum.Poly 5: Baiji,Dandelion,Tulip,Zhe Fritillaria,Poria,Muxiang,Divine Comedy,Magnolia officinalis,and Citrus aurantium.Among the 150 PU patients in this study,the ratio of male to female was about 1.54:1,and the ratio of DU to GU was about 1.63:1.The highest percentage of Peptic ulcer occupation was 44.7% in the middle-aged group aged 45-59 years.Meanwhile the proportion of DU was higher than GU in each age group.The proportion of patients with ulcers whose disease duration was less than 1 year was the highest at 67.3%.There were no statistically significant differences between genders,different age groups,or different disease durations in terms of ulcer classification（P>0.01）.In terms of onset seasons,the descending order of frequency is winter,spring,autumn,and summer.In terms of onset occupations,in descending order of frequency,they were staff,retired,unemployed,individuals,farmers,workers,teachers,and students.In terms of onset incentives,in descending order of frequency,there were no obvious incentives,emotional disorders,addiction to tobacco and alcohol,improper diet,overwork,drug factors,and weather changes.Among the 150 patients,the positive rate of Hp was 62.7%,and the ratio of DU:GU in Hp-positive patients was about 2.36:1.The Hp infection was statistically significant in ulcer classification（P<0.01）.Among different Hp antibody classifications,the highest proportion of Hp-Uer B antibody positive in DU patients was 73.1%,and the highest Hp-Cag A antibody positive proportion in GU patients was 42.1%.There were statistical differences between Hp-Uer A and Hp-Uer B antibodies in ulcer classification.（P<0.01）,there was no significant difference in ulcer classification between Hp-Cag A,Hp-Vac A95 and Hp-Vac A91 antibodies（P>0.01）.In the active stage of PU,the ratio of single ulcer to multiple ulcers was about 1:1.64,and there was a statistical difference in ulcer stage with different number of ulcers（P<0.01）.Analysis Conclusion:The study found that TCM in the treatment of peptic ulcer mainly consists of tonic drugs and qi-regulating,heat-clearing,phlegm-resolving,and damp-removing medicines,which are often used in combination with drugs with warm property,flat property,cold property and slightly cold property,bitter,pungent and sweet flavors,and drugs that go attribute to the spleen,stomach,lung and liver meridian among the 150 peptic ulcer patients.According to different etiologies,pathogenesis and syndrome compatibility,it can be used to achieve the purpose of balancing cold and heat,treating both the symptoms and root causes,and simultaneously attacking and supplementing.This summarizes the rules of TCM syndrome differentiation and medication in the treatment of PU and explores potential new prescriptions to provide objective support for TCM clinical syndrome differentiation and treatment of PU.In this study,both male patients with DU and GU were more than female patients,and the number of middle-aged and elderly patients was mostly.On the one hand,there is a correlation between H.pylori infection and Hp-Uer A antibody and Hp-Uer B antibody in ulcer classification.On the other hand,there is a correlation between the number of ulcers and the stage of the ulcer.