幽门螺杆菌既往感染胃癌前状态的中医证候学特点探究  

TCM Syndrome Characteristics of Gastric Precancerous State with Previous Helicobacter pyloriInfection

作　　者：叶王宇 张忠绵 廖翊如 吉丽 陈嘉钦 张希颜 韩睿 王岚 林子力 李志红[1] YE Wang-yu;ZHANG Zhong-mian;LIAO Yi-ru;JI Li;CHEN Jia-qin;ZHANG Xi-yan;HAN Rui;WANG Lan;LIN Zi-li;LI Zhi-hong(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Beijing Gushengtang Hospital of Traditional Chinese Medicine,Beijing 100011,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京固生堂中医医院,北京100011

出　　处：《安徽中医药大学学报》2022年第5期37-42,共6页Journal of Anhui University of Chinese Medicine

基　　金：国家自然科学基金项目(82074187);吴阶平医学基金会临床科研专项资助基金(320.6750.17233)。

摘　　要：目的基于《京都胃炎分类》中的内镜表现探讨幽门螺杆菌(helicobacter pylori,Hp)既往感染状态胃癌前状态的中医证候学特点。方法按照《京都胃炎分类》中的方法,收集内镜下表现符合Hp既往感染胃癌前状态特征的205例患者的中医四诊信息,采用因子分析和聚类分析,浅析其中医证候学特点。结果经过因子分析提取出15个公因子,主要病位证素为肝、脾、胃,涉及的病性证素为气虚、阴虚、阳虚、火热、湿浊、血瘀、血热、痰浊、食积,经聚类得出肝胃气滞兼脾气亏虚证、脾胃湿热兼气阴两伤证、湿热瘀阻证、胃气壅滞证、肝胃郁热证、肝郁脾虚证共6个证型。结论应用《京都胃炎分类》中的内镜观察方法,结合Hp既往感染病史及病理结果,所获得的Hp既往感染状态下胃癌前状态的中医证候学特点,能够为中医药诊治本病提供较为准确的辨证依据和思路。Objective To investigate the traditional Chinese medicine(TCM)syndrome characteristics of gastric precancerous state with previous Helicobacter pylori(Hp)infection based on the endoscopic manifestations in Kyoto Classification of Gastritis.Methods According to the methods in Kyoto Classification of Gastritis,the information obtained by four diagnostic methods were collected from 205patients with endoscopic manifestations consistent with the characteristics of gastric precancerous state with previous Hp infection,and factor analysis and cluster analysis were used to investigate TCM syndrome characteristics.Results A total of 15common factors were extracted by the factor analysis.The main syndrome elements of disease location were the liver,spleen,and stomach,and the syndrome elements reflecting the nature of disease were Qi deficiency,Yin deficiency,Yang deficiency,fire heat,dampness turbidity,blood stasis,blood heat,phlegm turbidity,and dyspepsia.The cluster analysis obtained six syndrome types,i.e.,syndrome of liver-stomach Qi stagnation with spleen-Qi deficiency,syndrome of spleen-stomach damp-heat with deficiency of both Qi and Yin,syndrome of stagnant dampness-heat,syndrome of stomach Qi stagnation,syndrome of liver-stomach heat accumulation,and syndrome of liver depression and spleen deficiency.Conclusion The TCM syndrome characteristics of gastric precancerous state with previous Hp infection can be obtained based on the endoscopic observation methods in Kyoto Classification of Gastritis,the history of previous Hp infection,and related pathological results,which can provide more accurate basesand ideas for syndrome differentiation in the TCM diagnosis and treatment of this disease.

关 键 词：京都胃炎分类 幽门螺杆菌既往感染 胃癌前状态 中医证候 

分 类 号：R573.3[医药卫生—消化系统]