胃食管反流病中医证候与食管测压关系研究  

Study on the correlation between the TCM syndrome of gastroesophageal reflux disease and esophageal manometry

作　　者：陶琳[1] 沈晨[1] 赵鲁卿[1] 李哲[1] 张声生[1] 

机构地区：[1]首都医科大学附属北京中医医院消化中心,北京100010

出　　处：《中华中医药杂志》2015年第3期696-698,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市中医药科技基金项目(No.JJ2010-02)~~

摘　　要：目的:研究胃食管反流病(GERD)患者不同证候分布与食管测压的相关性。方法:选取具有典型反流症状的患者88例,进行辨证分型。采用高分辨率胃肠动力测压系统,分别对健康人及不同证候GERD患者进行食管上、下括约肌功能,食管动力方面检查。结果:88例患者中,以肝胃郁热证(35例)最多见,其次为胆热犯胃证(21例)、气郁痰阻证(20例)、中虚气逆证(12例)。将它们分为肝系证候组(56例占64%)和脾系证候组(32例占36%)。GERD患者食管上、下括约肌各项功能无论是两组间比较还是与健康人比较均无统计学差异。肝系证候组在无效吞咽方面及脾系证候组在吞咽速度方面与健康人差异有统计学意义(P<0.05)。肝系证候组与脾系证候组在食管动力的同步收缩、无效吞咽、吞咽速度、下食管括约肌以上3及7cm波幅、远端收缩积分方面均有显著差异(P<0.05)。结论:GERD患者的不同证候与食管动力有一定相关性。Objective： To explore the correlation between different TCM syndrome distributions of gastroesophageal reflux disease （GERD） and esophageal manometry. Methods： 88 cases of GERD with typical gastroesophageal reflux symptoms were selected and differentiated. The high-resolution gastrointestinal motility manometry was used to examine the functions of upper esophageal sphincter （UES）, lower esophageal sphincter （LES）, the esophageal motility in patients with GERD and the healthy subjects. Results： In 88 cases, the liver and the stomach stagnated heat symptom was more than any other TCM symptoms （35 cases）, followed by the gallbladder-heat encroaching the stomach symptom （21 cases）, stagnation of qi and phlegm symptom （20 cases） and reversed flow of qi by deficiency of qi in middle-jiao symptom （12 cases）, which were divided into liver system symptom group and spleen system symptom group, each group accounting for 56 cases （64%） and 32 cases （36%） respectively. There was both no significant difference in functions of UES and LES between the liver system symptom group and spleen system symptom group or between the GERD group and the healthy subjects group. There were significant differences in the speed of swallowing between the spleen system symptom group and the healthy subjects group （P〈0.05）. There was significamt differences in the invalid swallowing between the liver system symptom group and the healthy subjects group （P〈0.05）. There were all significant differences in synchronous contraction of esophageal motility, invalid swallowing, swallowing speed, amplitude in 3, 7cm of LES and DCI between the liver system symptom group and the spleen system symptom group （P〈0.05）. Conclusion： There is some correlation between different TCM syndrome of patients with GERD and esophageal manometry.

关 键 词：胃食管反流病 中医证候 高分辨率食管测压 

分 类 号：R259[医药卫生—中西医结合]