胃食管反流病证候及证素分布规律研究  

Study on Distribution Rules of Syndromes and Syndrome Elements of Gastroesopha⁃geal Reflux Disease

作　　者：秦书敏 严景文 梁祈皓 许婧怡 刘添文 QIN Shumin;YAN Jingwen;LIANG Qihao;XU Jingyi;LIU Tianwen(State Key Laboratory of Dampness Syndrome of Chinese Medicine Jointly Established by Provincial and Ministry of Traditional Chinese Medicine Settled in Guangzhou,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510120,China;Guangdong Provincial Key Laboratory for Clinical Study on Traditional Chinese Medicine Syndromes,Guangzhou Guangdong 510120,China;Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006,China)

机构地区：[1]广州中医药大学第二附属医院省部共建中医湿证国家重点实验室,广东广州510120 [2]广东省中医证候临床研究重点实验室,广东广州510120 [3]广州中医药大学,广东广州510006

出　　处：《新中医》2024年第24期64-69,共6页New Chinese Medicine

基　　金：广东省中医药局项目(20231114);广东省中医院拔尖人才项目(2022KT1171);广东省科技计划项目(2023B1212060063)。

摘　　要：目的:分析胃食管反流病(GERD)证候、证素分布特征及规律。方法:检索中国知网(CNKI)、万方、维普(VIP)及中国生物医学数据库(CBM)四大数据库中的GERD相关文献,筛选具有辨证信息的临床研究类文献,提取证候和证素信息,分析GERD及其亚型反流性食管炎(RE)和非糜烂性反流病(NERD)证型及证素分布规律。结果:纳入文献143篇,病例数27272例,病例来源于中国22个省或直辖市及新加坡、韩国,男女比例1∶1.04。GERD证型以肝胃郁热证占比最高,为30.84%;病位证素以胃占比最高,达41.45%;病性证素以火(热)占比最高,为40.20%。RE常见证型为肝胃郁热证、肝胃不和证、脾胃虚弱证和气郁痰阻证,四者共占比79.61%;病位证素主要为胃、肝和脾,占比94.29%;病性证素主要为火(热)、气滞、气虚和痰,占比80.43%。NERD的证型分布较为集中,最常见的证型为肝胃郁热证、肝胃不和证、中虚气逆证和气郁痰阻证,占比高达87.34%;主要病位证素为胃、肝、胸膈(上焦),占比94.24%;病性证素则主要为火(热)、气滞、痰和阳虚,占比90.29%。结论:GERD以火(热)为主要病理因素,病位主要责之于胃和肝;相较于NERD,RE虚性病理因素更为明显,NERD应重视胸膈(上焦)的辨治。Objective:To analyzed the distribution characteristics rules of syndromes and syndrome elements of gastroesophageal reflux disease(GERD).Methods:The GERD-related literatures in the four databases of China National Knowledge Infrastructure(CNKI),Wanfang,China Science and Technology Journal Database(VIP)and China Biology Medicine disc(CBM)were retrieved,and the clinical research literatures covering the content of syndrome differentiation and treatment were screened for the information on syndromes and syndrome elements.The distribution rules of syndromes and syndrome elements of GERD and its subtypes reflux esophagitis(RE)and nonerosive reflux disease(NERD)were respectively analyzed.Results:A total of 143 articles and 27272 cases were included.The cases were from 22 provinces or municipalities in China,Singapore and South Korea,with a male to female ratio of 1∶1.04.The syndrome type of GERD accounting for the most(30.84%)was the syndrome of liver-stomach heat constraint;the stomach was the syndrome element of disease location with the highest proportion(41.45%);the proportion of fire(heat)was the syndrome element of disease nature with the highest proportion(40.20%).The common syndrome types of RE were syndrome of liver-stomach heat constraint,syndrome of liver-stomach disharmony,spleen-stomach weakness syndrome and syndrome of qi constraint and phlegm obstruction,and they accounted for 79.61%in total;the syndrome elements of disease location were mainly the stomach,liver and spleen,and they accounted for 94.29%.;the syndrome elements of disease nature were mainly fire(heat),qi stagnation,qi deficiency and phlegm,and they accounted for 80.43%.The distribution of NERD syndrome types was relatively concentrated,the syndrome of liver-stomach heat constraint,syndrome of liver-stomach disharmony,syndrome of middle deficiency with qi counterflow,and syndrome of qi constraint and phlegm obstruction,and they accounted for 87.34%;the main syndrome elements of disease location were the stomach,liver and chest diaphragm(up

关 键 词：胃食管反流病 反流性食管炎 非糜烂性反流病 证候 证素 

分 类 号：R573.9[医药卫生—消化系统]