胃食管反流病不同中医证型的食管动力特点  

Features of esophageal motility in different syndromes of gastroesophageal reflux disease

作　　者：陶琳[1] 沈晨[1] 朱艳琴[1] 侯亚男[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：《中国中西医结合消化杂志》2017年第2期81-84,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：北京市医院管理局临床医学发展专项经费资助(No:ZYLX201411);北京市科学技术委员会首都临床特色应用研究(No:Z141107002514176)

摘　　要：[目的]研究胃食管反流病(GERD)患者不同中医证型的食管动力特点。[方法]选取具有典型反流症状的患者439例,进行辨证分型。采用高分辨率胃肠动力测压系统,对不同证型GERD患者进行食管上、下括约肌功能,食管动力方面检查。[结果]1食管括约肌功能比较,肝胃不和组LES静息压和LES残余压均低于气郁痰阻组患者(P<0.05)。下食管括约肌长度、UES静息压和残余压4组比较差异均无统计学意义。2食管收缩力比较,胆热犯胃组的食管运动波幅平均值低于其他3组(P<0.05)。胆热犯胃组的无效吞咽百分比高于气郁痰组和中虚气逆组(P<0.05)。胆热犯胃组的小型蠕动中断百分比高于中虚气逆组(P<0.05)。胆热犯胃组的DCI值低于其他3组(P<0.05)。3食管运动协调性比较,胆热犯胃和肝胃不和组同步收缩百分比低于中虚气逆组(P<0.01),同时还低于气郁痰阻组(P<0.05)。气郁痰阻组远端收缩延迟低于胆热犯胃组(P<0.05)。中虚气逆组快速收缩百分比高于胆热犯胃组(P<0.05)。[结论]中医证候与食管动力存在一定相关性。中虚气逆、气郁痰阻证与食管运动不协调相关。胆热犯胃、肝胃不和证与食管、下食管括约肌动力不足相关。[Objective] To explore the features of esophageal motility in gastroesophageal reflux disease （GERD） with different syndromes. [Methods]439 cases of GERD with typical gastroesophageal reflux symptoms were selected, and the syndromes were conducted. High-resolution esophageal manometry was applied to patients. [Results]There was significant difference in LESP and the residual pressure of LES be- tween the syndromes of ganweibuhe and qiyutanzu（P〈0.05）. Compared with the syndromes of danrefan- wei and the other three syndromes, there was significant difference in esophageal motion amplitude average and DCI（P〈0.05）. Compared with the syndromes of danrefanwei and zhongxuqini,qiyutanzu,there was significant difference in the percentage of invalid swallowing（P〈0.05）. Compared with the syndromes of danreanwei and zhongxuqini, there was significant difference in the percentage of small peristalsis interrupt （P〈0.05）. Compared with the syndromes of danrefanwei, ganweibuhe and zhongxuqini, qiyutanzu, there was significant difference in simultaneous contraction （P〈0.05）. Compared with the syndromes of dan- refanwei and qiyutanzu, there was significant difference in DL（P〈0.05）. Compared with the syndromes of danrefanwei and zhongxuqini, there was significant difference in rapid contraction percentage （P〈0.05）.[Conclusion]There are some correlations between different syndromes and esophageal motility in patients with GERD. The syndromes of zhongxuqini and qiyutanzu associated with the inharmonious of esophageal move- ment. The syndromes of danrefanwei and ganweibuhe associated with the short of power of esophageal and LES.

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]