252例慢性萎缩性胃炎中医证候分布规律及其病理相关性研究  

Study on the distribution of TCM syndromes and pathological correlation of 252 cases of chronic atrophic gastritis

作　　者：赵晓琳 诸葛丽[1] 马尚清 独思静 马丹 莫方正 周斌[1] ZHAO Xiao-lin;ZHUGE Li;MA Shang-qing;DU Si-jing;MA Dan;MO Fang-zheng;ZHOU Bin(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Wang Jing Hospital of CACMS,Beijing 100102,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]中国中医科学院望京医院,北京100102 [3]中国中医科学院西苑医院,北京100091 [4]北京中医药大学,北京100029

出　　处：《中华中医药杂志》2022年第12期7405-7408,共4页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:研究慢性萎缩性胃炎中医证候分布规律及证候与病理诊断萎缩、肠上皮化生及异型增生(上皮内瘤变)的相关性。方法:收集252例CAG患者临床资料进行分析,建立数据库;采用横断面研究,填写调查问卷,收集患者信息,确立中医证候分型,完善病理诊断。运用SPSS24.0统计软件,对一般资料采用描述性统计,计数资料采χ^(2)检验。检验水平α=0.05。结果:252例中,男性140例,女性112例,男女比例1.25:1。最小年龄22岁,最大年龄74岁,平均年龄(52.51±10.83)岁,50岁以上例数居多。本组252例CAG患者,证候频次共456次,证候占比由高到低分别为脾胃虚弱证>胃络瘀血证>肝胃气滞证>肝胃郁热证>脾胃湿热证>胃阴不足证;复合证候居多,复合证候>单一证候,多数患者兼夹2种或3种证候。复合2种证候者,脾胃虚弱证+胃络瘀血证最多;复合3种证候者,脾胃虚弱证+肝胃气滞证+肝胃郁热证最多。在萎缩中脾胃湿热证与肝胃气滞证占比相对较高,肠上皮化生中肝胃气滞证与胃络瘀血证占比较高,在低级别上皮内瘤变中,胃阴不足证与肝胃郁热证占比较高。结论:慢性萎缩性胃炎患者发病年龄多在50岁以上;证候分布以脾胃虚弱证为主;复合证候多于单一证候;萎缩、肠上皮化生、上皮内瘤变中的证候分布差异一定程度上代表不同病理因素在上述病变中的分布差异。Objective:To study the distribution of TCM syndromes of chronic atrophic gastritis and its correlation with pathological diagnosis of atrophy,intestinal metaplasia and dysplasia(intraepithelial neoplasia).Methods:The clinical data of 252 CAG patients were collected and analyzed to establish the database,the cross-sectional study,filling in the questionnaire,collecting the patients' information,establishing the syndrome classification of TCM and perfecting the pathological diagnosis.SPSS 24.0 statistical software was used to describe the general data and χ^(2) test was used to count the data.Test level α=0.05.Results:Among the 252 cases,140 were male and 112 were female,the ratio of male to female was 1.25:1.The youngest age was 22 years old,the oldest age was 74 years old,the average age was(52.51±10.83)years old,the majority were over 50 years old,the ratio of syndrome was from weak of spleen and stomach to weak of stomach>blood stasis of stomach collaterals>stagnation of qi in liver-stomach>stagnation of heat in liver-stomach>damp-heat in spleen-stomach>deficiency of yin in stomach.The combined syndrome of spleen and stomach weakness+stomach collateral blood stasis is the most,and the combined syndrome of spleen and stomach weakness+liver and stomach qi stagnation+liver and stomach stagnation and heat is the most.In atrophy,the ratio of spleen-stomach damp-heat syndrome and liver-stomach qi stagnation syndrome was relatively high,in intestinal transformation,the ratio of liver-stomach qi stagnation syndrome and stomach collateral blood stasis syndrome was relatively high,and in low grade intraepithelial neoplasia,the ratio of stomach-yin deficiency syndrome and liver-stomach stagnation-heat syndrome was relatively high.Conclusion:The age of onset of chronic Atrophic gastritis is over 50 years old,the distribution of syndromes is mainly spleen and stomach deficiency syndrome,and multiple syndromes are more than single syndromes The difference of syndrome distribution in atrophy,intestinal metaplasia and intra

关 键 词：慢性萎缩性胃炎 中医证候 病理诊断 肠上皮化生 异型增生 

分 类 号：R259[医药卫生—中西医结合]