消化性溃疡病中医证型的客观化临床研究  

Clinical study of objectification of TCM syndrome type in peptic ulcer disease

作　　者：晏喻婷 蒋波涛[1] 张朋[1] 周州[1] 李荣华[1] 陶阳[1] 

机构地区：[1]广州中医药大学附属重庆北碚中医院,重庆400700

出　　处：《现代中西医结合杂志》2014年第25期2748-2750,2835,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的研究消化性溃疡病中医证型与消化性溃疡分类、溃疡分期、胃镜征象、幽门螺杆菌(H.pylori)感染的相关性,从而为消化性溃疡中医辨证分型提供客观依据。方法216例消化性溃疡患者均经中医辨证分型,并行胃镜检查、H.pylori检查。对中医证型与消化性溃疡分类、溃疡分期、胃镜征象、H.pylori感染的关系进行统计学相关性分析。结果中医证型与西医溃疡分类的构成比比较无显著性差异(P>0.05)。溃疡期中胃热炽盛型34例,愈合期和癖痕期中肝胃气滞型58例,均明显高于同期其他证型(P均<0.05)。各中医证型胃镜下溃疡面积比较没有显著性差异(P>0.05)。肝胃气滞、瘀阻胃络及脾胃阳虚患者胃黏膜水肿,溃疡色泽白,溃疡面覆白苔为主;胃热炽盛及寒邪犯胃患者胃黏膜水肿,溃疡色泽黄,溃疡上覆黄苔为主;胃阴亏虚患者黏膜溃疡色泽白,溃疡面上覆白苔为主;食滞胃肠患者黏膜水肿,黏膜色泽黄,溃疡上覆白苔为主。胃热炽盛及肝胃气滞患者H.pylori感染率分别为88.46%及71.23%,胃热炽盛型H.pylori感染率显著高于其他证型(P<0.05)。结论胃镜检查观察胃和十二指肠黏膜的病变情况,不宜作为中医证型判断标准,可作为望诊之延伸应用于临床,可为中医辨证提供一定的客观化指标,提高对消化性溃疡病中医辨证治疗规律的认识。Objective It is to study the correlations of TCM syndrome of peptic ulcer with ulcer stage and classification , gastroscopic signs ,H.pylori infection , thus to provide objective basis for the syndrome differentiation of this disease .Methods 216 patients with peptic ulcer were diagnosed by syndrome differentiation of traditional Chinese medicine , H.pylori examina-tion and gastroscopy examination .The relationships of TCM syndrome type with ulcer stage and classification , gastroscopic signs,H.pylori infection were analyzed by an statistical correlation analysis .Results There was no significant difference in constituent ratio between TCM syndrome type and ulcer classification of western medicine （P〉0.05）.Peptic ulcer in intense stomach heat type accounted for 34 cases, healing and scar period of stagnation of liver qi and stomach qi .In type58 cases, were significantly higher than those in other syndromes , with significant difference （P〈0.05）.Endoscopic examination of gastroscope signs,no significant difference between endoscopic ulcer areaand TCM syndrome type （P〉0.05）.Stagnation of liver qi and stomach qiand the spleen and stomach in patients with gastriculcer and mucosal edema white color mainly the ulcer surfacecoated white moss .Intense stomach heat and coldevil stomach of patients with gastric ulcer mucosa edema , the color yellow, mainlyulcer overlying yellow fur .Stomach yin deficiency patients withulcer mainlywhite color , whitemoss on the ulcer surface coating .Retention of food in the gastrointesinal mucosa in the patients with edema , mucosa ulcercolor yellow , mainly-covered with white tongue coating .Gastric blood stasis in patients with mucosal edema , mucosa ulcer of white color ,covered with whitefur.Intense stomach heat and qi stagnation in liver of patients with Hpinfection rates were 88.46%band 71.23%.In-tense stomach heat type were significantly higher than that of other syndromes （P〈0.05）.Conclusion Gastroscopy lesion of gastric and duodenal mucosa , not as a TCM s

关 键 词：消化性溃疡 辨证分型 辨证规范化 H.PYLORI 

分 类 号：R573.1[医药卫生—消化系统]