胃癌前病变中医复合证候与病理改变的相关性研究  

Study on correlation between composite syndromes of traditional Chinese medicine and pathological changes in gastric precancerous lesions

作　　者：刘平 王萍[1] 李振华[1] 刘炯 LIU Ping;WANG Ping;LI Zhenhua;LIU Jiong(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院脾胃科,北京100091

出　　处：《环球中医药》2021年第8期1390-1394,共5页Global Traditional Chinese Medicine

基　　金：国家卫生计生委国家中医药管理局重大疑难疾病中西医临床协作试点项目(0500010);国家中医药管理局中医临床研究基地业务建设科研专项(JDZX2015265);“十二五”国家科技支撑计划提高中医药疗效的“病证结合”项目(2014BAI10B00)。

摘　　要：目的研讨萎缩性胃炎胃癌前病变中医复合证候与病理改变程度、范围的相关性。方法选取128例慢性萎缩性胃炎胃癌前病变患者,归纳中医证素,将证素两两配对提取为复合证候,观察其在不同病变程度、范围的分布情况。结果病性证素频次分布为气滞>气虚>血瘀>湿热>痰湿>阴虚,复合证候频次分布为脾虚气滞>气滞血瘀>脾虚血瘀>脾虚湿热>脾虚痰湿>气阴两虚。脾虚湿热在上皮内瘤变组与非上皮内瘤变组间分布差异具有统计学意义(P<0.05)。气阴两虚证在上皮内瘤变胃窦部、窦体部,组间差异具有统计学意义(P<0.05)。结论胃癌前病变中医复合证候以脾虚气滞、气滞血瘀、脾虚血瘀为主,脾虚湿热、脾虚痰湿、气阴两虚较少。脾虚湿热、气阴两虚与上皮内瘤变有关。该研究为胃癌前病变病理改变程度、范围与中医复合证候的初步探索,为临床监测和治疗提供思路。Objective To study the correlation between composite syndromes of traditional Chinese medicine and the degree and scope of pathological changes in gastritis precancerous lesions.Methods A total of 128 gastric precancerous lesions patients with patients were selected.TCM syndrome elements were summarized,and syndrome elements were extracted into composite syndromes by paired extraction,and their distribution situation in different lesion degrees and ranges were observed.Results In terms of syndrome elements of nature of disease,the frequency distribution of it from high to low was qi stagnation,qi deficiency,blood stasis,dampness and heat,phlegm dampness and yin deficiency.The frequency distribution of composite syndromes from high to low was spleen deficiency and qi stagnation,qi stagnation and blood stasis,spleen deficiency and blood stasis,spleen deficiency and dampness heat,spleen deficiency and phlegm-turbid stagnation,deficiency both qi and yin.The distribution of spleen deficiency dampness heat between the intraepithelial neoplasia group and the non-intraepithelial neoplasia group was statistically significant(P<0.05).The difference of syndrome of deficiency of both qi and yin in gastric antrum and sinus body of intraepithelial neoplasia was statistically significant(P<0.05).Conclusion The composite syndromes of traditional Chinese medicine for gastric precancerous lesions were mainly spleen deficiency and qi stagnation,qi stagnation and blood stasis,spleen deficiency and blood stasis,and spleen deficiency and dampness heat,spleen deficiency and phlegm-turbid stagnation,deficiency of both qi and yin are less.Spleen deficiency and dampness heat and deficiency of both qi and yin were related to intraepithelial neoplasia.This study is a preliminary exploration of the degree and range of pathological changes of gastric precancerous lesions combined with composite syndromes of traditional Chinese medicine,and it can provides ideas for clinical monitoring and treatment.

关 键 词：复合证候 胃癌前病变 慢性萎缩性胃炎 肠化 病理 证素 

分 类 号：R735[医药卫生—肿瘤]