回顾法研究962例慢性萎缩性与非萎缩性胃炎的中医证治规律  

Retrospective Study on Regularity of Traditional Chinese Medicine Syndrome and Treatment Distribution of 962 Cases with Chronic Atrophic and Non-atrophic Gastritis

作　　者：吕瑞民[1] 李吉 乔美君 LYU Ruimin;LI Ji;QIAO Meijun(Department of Cardiology,the First Clinical Medical College,Heilongjiang University of Chinese Medicine,Heilongjiang Province,Harbin 150040,China;Grade 2019 Graduate of Internal Medicine of Traditional Chinese Medicine,Heilongjiang University of Chinese Medicine,Heilongjiang Province,Harbin 150040,China;Grade 2017 Graduate of Internal Medicine of Traditional Chinese Medicine,Heilongjiang University of Chinese Medicine,Heilongjiang Province,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院心血管四科,黑龙江哈尔滨150040 [2]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《中国中医药现代远程教育》2022年第4期67-69,89,共4页Chinese Medicine Modern Distance Education of China

摘　　要：目的探讨慢性萎缩性胃炎与慢性非萎缩性胃炎患者中医证治分布规律。方法病例来源于2015年1月—2017年12月于黑龙江中医药大学附属第一医院住院部及门诊就诊的慢性胃炎患者962例,其中符合诊断标准的慢性萎缩性胃炎256例,慢性非萎缩性胃炎296例。记录其临床症状、舌脉、证型及方药,用Excel数据库整理,采用频数统计法分析二者证治特点。结果 (1)慢性萎缩性胃炎证型依次:脾胃虚弱证、肝气犯胃证、胃络瘀血证、胃阴不足证;慢性非萎缩性胃炎证型依次:肝气犯胃证、脾胃湿热证、脾胃虚弱证、脾胃阳虚证、胃阴不足证。(2)慢性萎缩性胃炎高频症状:胃脘痞闷、食欲不振、倦怠乏力等;慢性非萎缩性胃炎高频症状分别腹胀满或痛、泛吐酸水、嗳气频作等。(3)慢性萎缩性胃炎高频舌象:淡舌、暗红舌、少苔、薄白苔;慢性非萎缩性胃炎高频舌象:红舌、淡舌、黄腻苔、薄白苔。(4)慢性萎缩性胃炎高频方药:炒白术、五灵脂、麦冬等;慢性萎缩性胃炎方药有:柴胡、黄芩、炒白术等。结论 CAG以脾胃为主,病程长,发病机制气虚、阴伤为主,血瘀、气滞为标;慢性非萎缩性胃炎以肝胃为主,病位浅,发病机制以气滞为主,伴肝脾失和、邪热犯胃、寒热错杂表现。Objective To explore the rules of traditional Chinese medicine syndrome and treatment distribution in patients with chronic atrophic gastritis(CAG) and chronic non-atrophic gastritis(CNAG). Methods Collecting patients with chronic gastritis these courts from 2015 to 2017, their clinical symptoms, tongue, pulse, syndrome types and prescriptions were record, and Excel was used to establish a database. The characteristics of diagnosis and treatment of CAG and CNAG were analyzed by using the method of fre-quency statistics. Results(1)The types of CAG were spleen and stomach weakness syndrome, liver-qi invading stomach syndrome,stomach collateral blood stasis syndrome, deficiency of stomach yin syndrome,and dampness-heat syndrome of spleen and stomach,while CNAG high-frequency syndrome were liver-qi invading stomach syndrome, spleen-stomach damp-heat syndrome, spleen-stomach weakness syndrome, syndrome of spleen and stomach Yang deficiency,and deficiency of stomach yin syndrome.(2)The high frequency symptoms of CAG were epigastric tiredness, loss of appetite, fatigue, while the high frequency symptoms of CNAG were epigastric fullness or pain, excessive vomiting of acid water and frequent belching.(3)CAG high frequency tongue image is light tongue, dark red tongue, little fur and thin white fur, CNAG high frequency tongue image is red tongue, light tongue, yellow greasy fur, thin white fur.(4) CAG high frequency prescriptions include fried Atractylodes macrocephala, Radix bupleuri, Wulingzhi, Ophio-pogon, etc. While CNAG high frequency prescriptions include Bupleurum, Radix Scutellariae, Fried atractylodes,etc. Conclusion The pathogenesis of CAG is mainly spleen and stomach, with a long course of disease, and its pathogenesis is mainly qi deficiency, yin injury, blood stasis and qi stagnation, while the disease site of CNAG is mainly liver and stomach, and its pathogenesis is mainly qi stagnation, often accompanied by disharmony between liver and spleen, evil heat invading stomach, cold and heat mixed and so on.

关 键 词：慢性萎缩性胃炎 慢性非萎缩性胃炎 中医证型 证治规律 

分 类 号：R259[医药卫生—中西医结合]