摘要
目的:研究胃黏膜异型增生中医证候分布规律及其与病理改变的相关性。方法:采用横断面研究方法,使用统一诊断标准,收集480例胃黏膜低级别/不确定性异型增生患者病理诊断,并采集患者主症次症、舌脉等中医四诊信息,明确其中医证候类型及病理组织分类。建立数据库,并采用IBM-SPSS 26.0软件进行数据分析。结果:共纳入病例480例,其中低级别异型增生患者261例,不确定性异型增生患者219例。所有患者单一证候及复合证候频次共计706次,单一证候患者为276例,兼夹两种证候者为182例,兼夹三种证候者为22例。证候出现频次为:肝胃郁热证>脾胃气虚证>胃络瘀阻证>脾胃湿热证>脾胃虚寒证>肝胃气滞证>胃阴不足证。脾胃气虚证年龄高于非脾胃气虚证(P<0.05)。脾胃虚寒证与萎缩范围、萎缩程度之间呈负相关(P<0.05),脾胃气虚证与异型增生、萎缩、肠化生病变范围之间呈正相关(P<0.05)。结论:肝胃郁热、脾胃气虚及胃络瘀阻是异型增生的常见证候;脾胃虚寒证较多分布在萎缩程度较轻及萎缩范围较小的疾病前期;脾胃气虚是异型增生发病的重要环节,更是其病变发生发展乃至癌变中的关键证候,常伴气滞、血瘀、郁热、湿热等兼夹为病。
Objective: To study the distribution of TCM syndromes of gastric mucosal dysplasia and its correlation with pathological changes. Methods: Using a cross-sectional research method and using unified diagnostic criteria, the pathological diagnosis of 480 patients with low-grade/uncertain dysplasia of gastric mucosal was collected, and the four diagnosis information of Traditional Chinese Medicine, such as primary and secondary symptoms, tongue and pulse, were collected to clarify their TCM syndrome types and pathological tissue classification. The database was established, and the data analysis was carried out by using IBM-SPSS 26.0 software. Results: A total of 480 cases were included in this study, there were 261 patients with low grade dysplasia and 219 patients with uncertain dysplasia. The total frequency of single syndrome and complex syndrome in all patients was 706 times, there were 276 patients with single syndrome, 182 patients with two syndromes and 22 patients with three syndromes. The frequency of syndromes was: liver-stomach stagnation-heat syndromespleen and stomach qi deficiencyblood stasis of stomach collateralsdamp-heat in spleen-stomachspleen and stomach deficiency and coldstagnation of qi in liver-stomachdeficiency of yin in stomach. The age of spleen and stomach qi deficiency syndrome is higher than that of non spleen and stomach qi deficiency syndrome(P<0.05). There is a negative correlation between spleen and stomach deficiency and cold syndrome and atrophy range and atrophy degree(P<0.05). There was a positive correlation between spleen and stomach qi deficiency and the extent of dysplasia, atrophy, and intestinal chemosis lesions(P<0.05). Conclusion: Liver-stomach stagnation-heat syndrome, spleen and stomach qi deficiency, blood stasis of stomach collaterals are common syndromes of dysplasia;spleen and stomach deficiency and cold syndrome is mostly distributed in the early stage of the disease with less atrophy degree and smaller atrophy range;the spleen and stomach qi deficiency is an impor
作者
王阳
王萍
李中玉
徐晴
田依冰
葛文通
赵晓凡
温艳东
WANG Yang;WANG Ping;LI Zhongyu;XU Qing;TIAN Yibing;GE Wentong;ZHAO Xiaofan;WEN Yandong(Institute of Digestive Diseases,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing,10009l,China;Eye Hospital,China Academy of Chinese Medical Sciences)
出处
《中国中西医结合消化杂志》
CAS
2023年第5期333-339,共7页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
中国中医科学院科技创新工程(No:CI2021A01005)
国家重点研发计划(No:2017YFC1700601)。
关键词
异型增生
胃癌前病变
中医证候
横断面研究
dysplasia
gastric precancerous lesions
syndrome of Traditional Chinese Medicine
cross sec-tional study
