| Objective:To explore the characteristics of TCM syndrome differentiation and classification of chronic erosive gastritis(CEG)infected with drug-resistant Helicobacter pylori(Hp).The clinical characteristics of TCM syndrome types and their correlation with Cytotoxin associated gene A(CagA)and Vacuolating cytotoxin A(VacA)were analyzed.Methods:A total of 559 cases of Hp resistant CEG patients meeting the inclusion and exclusion criteria were selected as the research objects.According to the TCM syndrome types,the patients were divided into liver-stomach disarrangement,dampness-heat of spleen and stomach,deficiency of spleen and stomach cold,deficiency of stomach and Yin,and gastric collagal-stasis syndrome type 5.The age,gender,gastroscopic manifestations,and detection results of CagA antibody and VacA antibody of the patients were collected.The clinical characteristics of TCM syndrome types in Hp resistant infection of CEG were analyzed.Spearman analyzed the correlation between TCM syndrome types and CagA and VacA.Results:1.Clinical characteristics of chronic erosive gastritis infected by drug-resistant Helicobacter pyloriIn the 559 patients with Hp resistant infection of CEG,the distribution frequency of TCM syndrome from high to low was in the order of 258 cases of dampness-heat syndrome of spleen and stomach(46.15%)>141 cases of stomach stasis syndrome(25.22%)>74 cases of disconcerting liver and stomach(13.24%)>63 cases of deficiency of stomach Yin(11.27%)>spleen and stomach deficiency cold syndrome 23 cases(4.11%),the difference was statistically significant(P<0.05).In terms of age,the youngest age was 18 years old,the oldest age was 75 years old,and the average age was 45.96±12.33 years old.In terms of gender,310 cases were male,accounting for 55.46%,249 cases were female,accounting for 44.54%,male sex ratio was 1.245:1,male was more than female;In terms of main clinical symptoms,the frequency of main clinical symptoms in patients with Hp resistant CEG infection from high to low was stomach pain(296 cases,52.95%),bloating(227 cases,40.61%),acid vomiting(113 cases,20.21%),noisy(92 cases,16.46%),loss of appetite(71 cases,12.70%).23 patients(4.11%)had no obvious symptoms;In single erosion,most patients(127 cases,33.25%)had erosion foci located in the gastric antrum,and the least patients(39 cases,10.21%)were located in the gastric Angle.Among the multiple erosions,most patients(77 cases,13.77%)had erosive foci located in the fundus of the stomach and the stomach body,while those located in the fundus,the stomach body and the stomach corner(12 cases,2.15%)had the least.Flat erosion(387 cases,69.23%)was the highest,and uplifted erosion(172 cases,30.77%)was relatively less.2.Characteristics of virulence factors in chronic erosive gastritis infected with drug-resistant Helicobacter pyloriAmong 559 patients with Hp resistant infection of CEG,484 cases(86.58%)showed positive expression of cytotoxin-related gene A,and 493 cases(88.19%)showed positive expression of vacuole toxin A.The results of the two virulence factors were mainly positive in the Hp resistant CEG patients.Among them,there was a statistically significant difference in the positive rate of CagA antibody between the flat erosion patients and the elevated erosion patients(p<0.05),but the positive rate of CagA antibody and VacA antibody was not related to age,gender,and the location of the erosion focus.3.Clinical characteristics and correlation of different syndrome types of chronic erosive gastritis infected by drug-resistant Helicobacter pyloriAmong 559 Hp resistant CEG patients,there were statistically significant differences in the performance of erosion foci among different syndrome-types(P<0.05),and there was a negative correlation between hepato-gastric disharmony and uplift erosion(correlation coefficient-0.089),and the difference was statistically significant(P<0.05).There was no significant difference in age,sex and location of erosive foci among different syndrome types(P>0.05).4.Characteristics and correlation of virulence factors in different syndrome types of chronic erosive gastritis infected by drug-resistant Helicobacter pyloriThere was A negative correlation between hepato-stomach disharmony syndrome and spleen and stomach deficiency cold syndrome and cytotoxin-related gene A positive(P<0.05),while spleen and stomach dampness-heat syndrome,stomach Yin deficiency syndrome and stomach collagal-stasis syndrome were positively correlated with cytotoxin-related gene A positive(P>0.05).There was A positive correlation between dampness-heat syndrome of spleen and stomach and positive vacuolar toxin A(P<0.05),and there was A negative correlation between disconcerting liver and stomach and deficiency cold syndrome of spleen and stomach and positive vacuolar toxin A(P<0.05),and there was a negative correlation between deficiency of stomach and Yin and stasis of stomach and positive vacuolar toxin A(P>0.05).Conclusions:1.Spleen and stomach dampness-heat syndrome,stomach collagal-stasis syndrome and liver and stomach disharmony syndrome were the top three TCM syndroms in patients with Hp infected CEG.Deficiency of stomach and Yin syndrome and deficiency cold syndrome of spleen and stomach were relatively rare,and flat erosion had a positive correlation with liver and stomach disharmony syndrome(P<0.05).2.In Hp resistant CEG patients,the positive rate of cytotoxin-related gene A was 86.58%,and the liver and stomach disharmony syndrome was negatively correlated with spleen and stomach deficiency cold syndrome and cytotoxin-related gene A positive(P<0.05).The positive rate of vacuolar toxin A was 88.19%,spleen and stomach damp-heat syndrome was positively correlated with vacuolar toxin A positive(P<0.05),liver and stomach dissonant syndrome and spleen and stomach deficiency cold syndrome were negatively correlated with vacuolar toxin A positive(P<0.05). |
PDF Full Text Request