慢性萎缩性胃炎及癌前病变中医证型分布与胃镜下表现和病理改变的相关性研究  

Relationship between distribution of Traditional Chinese Medicine syndrome types of chronic atrophic gastritis and precancerous lesions of gastric cancer and gastroscopic findings and pathological changes

作　　者：张瑞芬 贾婷婷 张海荣 黄新生 马宇博 孙艳梅 牛兴东 ZHANG Ruifen;JIA Tingting;ZHANG Hairong;HUANG Xinsheng;MA Yubo;SUN Yanmei;NIU Xingdong(Department of Critical Medicine,Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine,,Hohhot,010020,China)

机构地区：[1]内蒙古自治区中医医院重症医学科,呼和浩特010020

出　　处：《中国中西医结合消化杂志》2024年第1期42-48,55,共8页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：2022年青年岐黄学者培养项目[No:国中医药人教涵(2022)256号];国家中医药管理局第六批全国名老中医药专家学术经验继承项目[No:国中医药人教涵(2017)125号];内蒙古自治区中医药(蒙医药)中青年领军人才培育项目(No:2022-RC004);2021年草原英才项目(No:2080116)。

摘　　要：目的:研究慢性萎缩性胃炎(chronic atrophic gastritis,CAG)及CAG癌前病变中医证型分布,探讨中医证型与胃镜下表现及病理改变的相关性,为CAG及CAG癌前病变的诊疗提供客观依据。方法:采用回顾性研究方法,对牛兴东教授专家门诊收治的271例患者的病历资料进行总结分析,采用SPSS 22.0统计软件分析探讨发病情况及证型分布,采用logistic回归分析不同中医证型与胃镜下表现及病理表现的相关性。结果:271例患者中医证型分布占比由高到低依次为脾胃虚弱型、肝胃气滞型、脾胃湿热型、胃络瘀阻型、肝胃郁热型、胃阴不足型。在证型与病理变化的相关性分析中,肝胃气滞型以食管反流偏多,脾胃湿热型伴发糜烂者居多,胃络瘀阻型则多伴发异型增生,余证型与胃镜下表现及病理改变未见相关性。结论:CAG中医证型主要为脾胃虚弱型、肝胃气滞型等,其中肝胃气滞型、脾胃湿热型、胃络瘀阻型与胃镜下表现及病理表现存在相关性,可为中医辨证提供参考。临床中可通过中医宏观辨证与微观辨证相结合进行准确辨证,注重“调气活血解毒”,对于改善患者生活质量及截断病势、延缓恶化有积极意义。Objective:To study the distribution of Traditional Chinese Medicine(TCM) syndromes of chronic atrophic gastritis(CAG) and precancerous lesions of CAG,and to explore the correlation between syndromes and gastroscopic findings and pathological changes,so as to provide objective basis for the diagnosis and treatment of precancerous lesions of CAG and CAG.Methods:Through a retrospective study of the medical records of 271 patients in Professor NIU Xingdong's expert clinic,a CAG database of NIU Xingdong Studio was established.The data were statistically analyzed using SPSS 22.0 statistical software to analyze the incidence and distribution of the syndrome of the disease.Logistic regression was used to analyze the correlation between different TCM syndromes and gastroscopic findings and pathological findings.Results:Two hundred and seventy-one cases of TCM syndrome distribution ratio from high to low were spleen and stomach weakness type,liver and stomach Qi stagnation type,spleen and stomach damp-heat type,stomach collateral stasis type,liver and stomach stagnation heat type,stomach yin deficiency type.In the correlation between syndrome types and pathological changes,esophageal reflux was more common in liver-stomach Qi stagnation syndrome,erosion was more common in spleen-stomach damp-heat syndrome,and dysplasia was more common in stomach-collateral stasis syndrome.The remaining syndromes were not correlated with gastroscopic findings and pathological changes.Conclusion:CAG TCM syndrome types are mainly spleen and stomach weakness type,liver and stomach Qi stagnation type,etc.,of which liver and stomach Qi stagnation syndrome,spleen and stomach damp-heat syndrome,stomach collateral blood stasis syndrome and gastroscopic performance and pathological performance are correlated,which can provide a reference for TCM syndrome differentiation.Through the combination of macroscopic syndrome differentiation and microscopic syndrome differentiation of TCM for accurate syndrome differentiation,combined with the pathogenesis o

关 键 词：慢性萎缩性胃炎 胃癌癌前病变 中医证型 

分 类 号：R573.3[医药卫生—消化系统]