慢性萎缩性胃炎中医证型分布与病理特点分析  

An Analysis of TCM Syndrome Types Distribution and Pathological Characteristics of Chronic Atrophic Gastritis

作　　者：许戈林[1] XU Ge-lin(Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan,China,450008)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008

出　　处：《河南中医》2022年第8期1226-1230,共5页Henan Traditional Chinese Medicine

基　　金：河南省科技攻关计划项目(224630170)。

摘　　要：目的:探讨慢性萎缩性胃炎的中医证型分布与病理特点。方法:选择124例慢性萎缩性胃炎患者为研究对象,对患者进行辨证分型,其中脾胃虚弱证42例,脾胃湿热证35例,肝胃不和证22例,胃阴不足证14例,胃络瘀血证11例。通过胃镜、胃黏膜病理学活检及检测幽门螺杆菌(helicobacter pylori,Hp)等方法对各证型患者病理特点进行分析。结果:与胃络瘀血证比较,其余各证型黏膜白相率较高,血管透见率及颗粒增生率较低,差异具有统计学意义(P<0.05);各证型黏膜粗糙率比较,差异无统计学意义(P>0.05)。与脾胃虚弱证比较,其余各证型单纯性、伴糜烂以及伴黏膜出血比例较高,差异具有统计学意义(P<0.05);各证型伴增生及伴胆汁反流比例比较,差异无统计学意义(P>0.05)。与脾胃虚弱证比较,其余各证型轻度萎缩及重度萎缩差异具有统计学意义(P<0.05),而中度萎缩则差异无统计学意义(P>0.05)。与脾胃虚弱证比较,脾胃湿热证及胃络瘀血证萎缩伴肠化生比例较高,胃络瘀血证萎缩伴异型增生比例较高,差异具有统计学意义(P<0.05)。与脾胃湿热证比较,其余各证型Hp阳性率较低,差异具有统计学意义(P<0.05)。结论:慢性萎缩性胃炎中医证型分布以脾胃虚弱证比例较高,胃络瘀血证较低,脾胃湿热证Hp检测阳性率最高,其中胃络瘀血证患者黏膜白相、血管透见、颗粒增生以及重度萎缩等病理特点较为明显。Objective:To explore the distribution of TCM syndrome types and pathological characteristics of chronic atrophic gastritis.Methods:A total of 124 cases of chronic atrophic gastritis were selected as the research subjects,and the patients were classified according to syndrome differentiation,including 42 cases of spleen-stomach deficiency syndrome,35 cases of spleen-stomach dampness-heat syndrome,22 cases of liver-stomach disharmony syndrome,14 cases of stomach-yin deficiency syndrome and 11 cases of blood stasis syndrome in stomach collaterals.The pathological characteristics of patients with various syndrome types were analyzed by gastroscope,pathological biopsy of gastric mucosa and Helicobacter pylori(Hp).Results:Compared with the stomach collateral blood stasis syndrome,the white phase rate of mucosa in other syndrome types was higher,and the vascular penetration rate and granular hyperplasia rate were lower,and all the differences were statistically significant(P<0.05);There was no significant difference in mucosal roughness among different syndrome types(P>0.05).Compared with the spleen-stomach deficiency syndrome,the proportion of simplification,combined with erosion and mucosal hemorrhage was higher in the other syndrome types,and the difference was statistically significant(P<0.05);There was no significant difference between the syndrome types with hyperplasia and bile reflux(P>0.05).Compared with the spleen-stomach deficiency syndrome,the difference in mild atrophy and severe atrophy in other syndrome types was statistically significant(P<0.05),while the difference in moderate atrophy was not statistically significant(P>0.05).Compared with the spleen-stomach deficiency syndrome,the proportion of atrophy with intestinal metaplasia in spleen-stomach dampness-heat syndrome and the syndrome of blood stasis in the stomach collaterals was higher,and the proportion of atrophy with dysplasia in the syndrome of blood stasis in the stomach collaterals was higher,and all the differences were statistically signific

关 键 词：慢性萎缩性胃炎 证型分布 肝胃不和证 脾胃虚弱证 脾胃湿热证 胃阴不足证 胃络瘀血证 病理特点 

分 类 号：R259.733.2[医药卫生—中西医结合]