慢性萎缩性胃炎6种证型胃镜像和病理学表现研究  

Gastroscopy Images and Pathological Findings in Chronic Atrophic Gastrit is with Six Kinds of Chinese Medicine Syndrome

作　　者：张金丽[1] 王春浩[1] 周文平[1] 何华[1] 李佃贵[1] 

机构地区：[1]河北医科大学研究生学院.河北省石家庄市中山东路361号,050017

出　　处：《中医杂志》2012年第11期942-944,共3页Journal of Traditional Chinese Medicine

基　　金：河北省教育厅科学研究青年基金项目(2010265)

摘　　要：目的观察慢性萎缩性胃炎(CAG)6种证型胃镜像和病理学表现,探讨其与浊毒的相关性。方法将入选的311例CAG患者辨证分为6个证型:浊毒内蕴证(62例)、肝胃不和证(84例)、脾胃虚弱证(37例)、脾胃湿热证(75例)、胃络瘀阻证(23例)、胃阴不足证(30例)。由专职医师进行胃镜检查和组织活检,记录其内镜下形态学表现,比较不同证型胃镜像与病理学表现。结果浊毒内蕴证与其他5种证型胃镜像比较差异均有统计学意义(P<0.05);与浊毒内蕴证比较,肝胃不和证、脾胃虚弱证、胃络瘀阻证病理学表现差异均有统计学意义(P<0.05),脾胃湿热证、胃阴不足证病理学表现差异无统计学意义(P>0.05)。结论 CAG各证型在胃镜像形态学、病理组织学的变化存在着特异性,浊毒内蕴证在内镜下主要表现为隆起结节、糜烂、黏膜粗糙,病理多伴有肠上皮化生和(或)不典型增生。Objective To observe the gastroscopy images and pathological findings in chronic atrophic gastritis （CAG） with six kinds of Chinese medicine syndrome and analyze its relationship with turbidity-toxin. Methods Totally 311 CAG patients were divided into 6 kinds of Chinese medicine syndrome, i.e. 62 cases of turbidity-toxin brewing internally syndrome, 75 cases of spleen-stomach damp-heat syndrome, 37 cases of spleen-stomach deficiency syndrome, 84 cases of liver-stomach disharmony syndrome, 23 cases of stasis obstructing the network vessels of the stomach syndrome and 30 cases of insufficiency of stomach yin syndrome. The gastroscopy images and pathological findings were recorded and analyzed with gastroscopy and biopsy. Results The differences between turbidity-toxin brewing internally syndrome and other five syndromes in gastroscopy images were statistically significantly （P〈0.05）. Comparing with turbidity-toxin brewing internally syndrome, the pathological findings had statistical significance in liver-stomach disharmony syndrome, spleen-stomach deficiency syndrome and stasis obstruc- ting the network vessels of the stomach syndrome （P〈0.05）. There was no significant difference in the pathological findings as comparing turbidity-toxin brewing internally syndrome with spleen-stomach damp-heat syndrome and insufficiency of stomach yin syndrome （P〉0.05）. Conclusion There exits specificity in Chinese medicine syndrome, gastroscopy image and pah- tological findings in CAG. The main gastroscopy images of turbidity-toxin brewing internally syndrome are uplift nodules, erosion and rough mucosa, often accompanied with intestinal metaplasia and （or） dysplasia in pathology.

关 键 词：慢性萎缩性胃炎 浊毒 胃镜像 病理学表现 中医证型 

分 类 号：R259[医药卫生—中西医结合]