重庆地区慢性萎缩性胃炎危险因素、中医证素分布与内镜病理的相关性研究  

Research on correlation between risk factors, distribution of traditional Chinese medicine syndromes and endoscopic pathology of chronic atrophic gastritis in Chongqing area

作　　者：田锋亮[1] 刘薇[1] 李延萍[1] 陶扬 刘西洋 李成菊 王俊伟 郭琳[6] TIAN Fengliang;LIU Wei;LI Yanping;TAO Yang;LIU Xiyang;LI Chengju;WANG Junwei;GUO Lin(Department of Spleen and Stomach Diseases,Chongqing Hospital of Traditional Chinese Medicine,Chongqing,400021,China;Department of Spleen and Stomach Diseases,Chongqing Beibei District Hospital of Traditional Chinese Medicine;Department of Spleen and Stomach Diseases,Dianjiang County Hospital of Traditional Chinese Medicine;Department of Spleen and Stomach Diseases,Chongqing Dazu District Hospital of Traditional Chinese Medicine;Department of Spleen and Stomach Diseases,Yunyang County Hospital of Traditional Chinese Medicine;Department of Spleen and Stomach Diseases,Chongqing Hechuan District Hospital of Traditional Chinese Medicine)

机构地区：[1]重庆市中医院脾胃病科,重庆400021 [2]重庆市北碚区中医院脾胃病科 [3]垫江县中医院脾胃病科 [4]重庆市大足区中医院脾胃病科 [5]云阳县中医院脾胃病科 [6]重庆市合川区中医院脾胃病科

出　　处：《中国中西医结合消化杂志》2025年第1期30-34,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：重庆市科卫联合项目-基于证素研究重庆地区不同病因导致萎缩性胃炎的证型分布关联性(No:2021ZY023589);李延萍重庆市级名中医传承工作室项目[No:渝中医(2020)20号]。

摘　　要：目的:探讨慢性萎缩性胃炎(chronic atrophic gastritis, CAG)患者的相关危险因素、中医证素与内镜病理的相关性。方法:以重庆地区经胃镜、病理确诊的606例CAG患者为研究对象,收集患者的临床资料、危险因素、中医症状、胃镜及病理诊断结果。先对危险因素进行描述性分析,然后对CAG相关的危险因素、中医证素与萎缩范围及肠化进行单因素相关性分析,最后对相关性分析中差异有统计学意义的因素进一步采用二项logistic回归分析风险比。结果:描述性统计分析显示,危险因素中辛辣饮食、油腻饮食、饮酒、吸烟、幽门螺杆菌感染与CAG相关,且CAG伴发失眠的比例为55.0%,其中部分患者合并焦虑、抑郁;病位证素上,脾、胃为主;病性证素上,气滞证最高,湿证、热证、气虚证、气逆证、燥证、瘀血证占比次之。单因素相关分析显示,胆汁反流、瘀血证、燥证与萎缩范围相关,吸烟、饮酒、胆汁反流、瘀血证、热证与肠化相关,饮酒与热证相关,吸烟与燥证相关,胆汁反流与气逆证、热证相关;二项logistic回归分析显示,胆汁反流有引起萎缩范围增大的风险(OR=3.098),燥证、瘀血证与萎缩范围大小密切相关(OR=2.935、1.885);胆汁反流、吸烟、饮酒、瘀血证、热证与肠化密切相关(OR=13.638、1.551、2.142、1.886、2.301)。结论:危险因素中年龄、辛辣饮食、油腻饮食、饮酒、吸烟、幽门螺杆菌感染与CAG相关,应加强健康宣教;CAG病位重在脾、胃,病性以气滞证、气虚证、湿证、热证、燥证、瘀血证为主,治疗可从益气健脾和胃,行气活血,清热利湿,润燥兼顾入手。Objective To investigate the correlation of risk factors,traditional Chinese medicine(TCM)syndrome elements and endoscopic pathology in patients with chronic atrophic gastritis(CAG).Methods Six hundred and six patients with CAG diagnosed by gastroscopy and pathology in Chongqing area were collected.The general data,risk factors,TCM symptoms,gastroscopy and pathological diagnosis of the patients were collected.First,descriptive analysis of risk factors was carried out,and then univariate correlation analysis was conducted for CAG related risk factors,TCM syndrome elements,atrophy scope and enterosis.Finally,binomial logistic regression was used to analyze risk ratio when correlation analysis was statistically significant.Results Descriptive statistical analysis showed that among the risk factors,spicy diet,greasy diet,drinking,smoking and Helicobacter pylori(HP)infection were related to CAG,and CAG was associated with insomnia in 55.0%of the cases,some of these patients have anxiety and depression.In terms of disease location syndrome,spleen and stomach were the main symptoms,and in terms of disease syndrome,Qi stagnation syndrome was the highest,followed by dampness syndrome,heat syndrome,Qi deficiency syndrome,Qi reverse syndrome,internal dryness syndrome and blood stasis syndrome.Single factor correlation analysis showed that bile reflux,blood stasis syndrome and dryness syndrome were related to atrophy range,smoking,drinking,bile reflux syndrome,blood stasis syndrome and heat syndrome were related to intestinal conversion,drinking was related to heat syndrome,smoking was related to dryness syndrome,bile reflux was related to Qi reversal syndrome and heat syndrome.Binomial logistic regression analysis showed that the risk of increased atrophy area caused by bile reflux(OR=3.098),and dryness syndrome and blood stasis syndrome were closely related to the size of atrophy area(OR=2.935,1.885).Bile reflux,smoking,drinking,the syndrome of blood stasis and heat were closely related to intestinal metaplasia(OR=13.638,1

关 键 词：慢性萎缩性胃炎 肠上皮化生 中医证素 

分 类 号：R259[医药卫生—中西医结合]