从期刊文献探讨反流性食管炎的证候类型与结构特点  

Study on the Syndrome Types and Structural Characteristics of Reflux Esophagitis from the Secondary Literature

作　　者：王萌[1] 周铭心[2] 

机构地区：[1]新疆医科大学研究生院,新疆乌鲁木齐830011 [2]新疆医科大学中医学院,新疆乌鲁木齐830011

出　　处：《中医药导报》2016年第8期33-35,39,共4页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金资助项目(30660219)

摘　　要：目的:探讨反流性食管炎的辨证类型及证候结构。方法:研究对象为反流性食管炎中医辨证论治文献,通过运用方剂计量学方法进行症状、证候频次统计,选定共识症状和易发证候,以聚类分析从症状拟合证候,以相关分析测定证证贴近度、本病指数,从而确立本病证候和旁从证候。结果:(1)烧心、口干口苦、反酸、胸骨后痛等16种症状为反流性食管炎的共识症状。(2)以聚类分析将共识症状分为局部表现与全身表现,前者可拟合为胃系热结与胃府气滞,而兼有肝火犯胃,后者则共同体现为肝脾胃气滞邪停为主的证候。(3)将43项证候统一简化为20项,再以频率排序精简为8项易发证候,复以证证贴近度分析将8项易发证候精简为5项。(4)通过本病指数与综合分析,确立肝胃郁热(本病指数为0.761)为反流性食管炎的本病证候,相当于该病之局部表现;而痰气交阻、脾胃湿热、脾胃虚滞和脾胃虚寒为旁从证候,相当于全身表现。结论:通过期刊文献分析反流性食管炎的证候分布情况,可为该病辨证论治提供与大样本流行病学调查相近的科学依据。Objective： To explore the syndrome type differentiation and syndrome structure of reflux esophagitis. Methods： The object of study was that literatures of syndrome differentiation and treatment in TCM in reflux esophagitis. Through the application of methods for prescription metrology to count the frequency of syndromes and symptoms, then we selected the consensus symptoms and prone syndromes. We used cluster analysis method to fit the symptoms and syndromes, and to obtain the interrelated degree between syndromes and the disease index by analysis of correlation, then to establish the disease syndromes and the secondary syndromes. Results： （1） There are 16 kinds of consensus symptoms in reflux esophagitis, such as heartburn, dry and bitter mouth, acid regurgitation, chest pain, and so on. （2） The consensus symptoms are divided into local and systemic manifestations, which the former can be fitted for retention of heat in gastric system and the stom- ach qi stagnation, but be accompanied with liver fire invading stomach, which the latter mainly manifested in qi stagnation and pathogenic factor stop of liver, spleen and stomach. （3） Syndromes of 43 are reduced to 20, and then simplified to 8 by sorting the frequency, which are merged to 5 by analyzing the interrelated degree be- tween syndromes. （4） Through the disease index and comprehensive analysis, establishing the disease syndrome of the reflux esophagitis is the stagnated-heat in liver and stomach （the disease index of 0.761）, which equiva- lent to the local manifestations of the disease, and phlegm and qi obstructing each other, heat and dampness in the spleen and stomach, deficient stagnation of spleen and stomach, deficient cold of spleen and stomach belong to the secondary syndromes, which are systemic manifestations. Conclusions： By secondary literature, analyzing the distribution of syndromes of the reflux esophagitis, which can provide treatment based on syndrome differen- tiation of it scientific basis with similar epidemio

关 键 词：反流性食管炎 中医辨证 症状分析 证候分析 

分 类 号：R256.3[医药卫生—中医内科学]