胃食管反流病辨证分型与食管24小时pH值及胆汁监测的相关性分析  

Relationship between TCM Syndrome Types of Gastroesophageal Reflux Disease and 24-Hour pH Value plus Bilirubin Measurements in the Esophagus

作　　者：朱晓燕[1] 朱生梁[2] 王晓素[2] 方盛泉[2] 马淑颖[2] 

机构地区：[1]复旦大学附属肿瘤医院中医科 [2]上海中医药大学附属岳阳中西医结合医院

出　　处：《中医杂志》2006年第2期128-130,共3页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局资助项目(02-03LL08)

摘　　要：目的:探讨食管24小时pH值及胆汁监测与胃食管反流病(GERD)中医证型之间的关系。方法:对95例GERD患者进行辨证分型,并分别行内镜检查、食管24小时pH值及胆汁监测。结果:肝胃郁热型占69.47%,该型以酸反流、混合反流为主,其酸反流次数、DeMeester评分、胆红素大于或小于0.14的时间百分比均显著高于其他证型(P<0.05)。实证内镜下的炎症程度重于虚证,虚证较少出现病理性反流。结论:GERD的中医辨证分型以肝胃郁热型为主,该型与酸反流、混合反流密切相关,推测肝胆失于疏泄,胃气上逆可能与食管下段括约肌松弛导致的酸反流及混合反流有关。To probe relationship between TCM syndrome types of gastroesophageal reflux disease and 24-hour pH value plus bilirubin in the esophagus. Methods： 95 cases of gastroesophageal reflux disease were classified according to syndrome differentiation,and they were respectively examined with endoscope,and 24-hour pH value and bilirubin were monitored. Results： The type of heat stagnation in the liver and stomach accounted for 69.47% ,with acid reflux and mixed reflux as a main reflux type. The number of acid reflux,the DeMeester score and the percentage of bile reflux time were significantly higher than those of other types（P〈0. 05）. The inflammatory degree under endoscope of excess syndrome was more severe than that of deficiency syndrome, and less pathological reflux occurred for the deficiency syndrome. Conclusion： Stagnation of heat in the liver and stomach is a main syndrome type for gastroesophageal reflux disease,which is closely related with acid reflux and mixed reflux. It is inferred that the failure of the liver and gallbladder in controlling conveyance and dispersion ,and upward invasion of stomach-qi are closely related to acid reflux and mixed reflux induced by relaxation of the spincter of the esophageal low segment.

关 键 词：胃食管反流/诊断 辨证分型 胆汁/代谢 

分 类 号：R259[医药卫生—中西医结合]