慢性萎缩性胃炎与“血瘀”证素的初步研究

发布时间：2018-11-16 10:16

【摘要】：目的基于证素理论,对慢性萎缩性胃炎与"血瘀"证素作初步研究,观察血瘀的产生对慢性萎缩性胃炎疾病发展的影响,同时探求二者之间的关联性,为中医临床辨证治疗提供循证医学理论指导,为指导临床治疗CAG提供新思路。方法收集2016年1月至2017年1月就诊于福建中医药大学附属第二人民医院、符合纳排标准的慢性萎缩性胃炎诊断患者92例,经患者知情同意,进行面对面四诊信息采集,并填写证素信息表,运用证素辨证软件得出证素数据,将92例病例分成血瘀组(观察组,含有血瘀证素)和非血瘀组(对照组,不含血瘀证素),观察对比两组的基本资料、临床资料、证素资料的异同,并观察分析病程长短、舌下络脉曲张程度、胃黏膜的内镜下改变及病理组织学改变与"血瘀"证素之间的相关性。结果1.血瘀组与非血瘀组在性别、年龄、胃黏膜内镜下改变及病理改变的分布上无差异性,在病程长短的分布上存在差异性,在舌下络脉曲张程度的分布上亦存在差异性。2.CAG的病位证素频率从高到低排列主要为:血瘀组:以胃(19.37%)、肝(15.42%)、脾(15.42%)、肾(11.07%)、心(7.51%)、胆(6.32%)为主;非血瘀组:以胃(30.25%)、肝(19.33%)、脾(11.76%)、肾(11.76%)、心神(5.88%)、肺(5.04%)为主。两组在病位证素的分布上无差异性。3.CAG的病性证素频率从高到低排列主要为:血瘀组:血瘀(11.06%)、气滞(10.95%)、阳虚(10.53%)、气虚(10.32%)、阴虚(9.26%)、痰(9.05%)、湿(8.84%)、血虚(6.53%)、热(5.68%)、食积(5.05%);非血瘀组:气滞(16.74%)、阳虚(13.49%)、气虚(13.49%)、阴虚(10.70%)、湿(10.23%)、痰(7.91%)、血虚(6.51%)、食积(6.05%)、阳亢(5.12%)。两组在病性证素的分布上无差异性。4.血瘀的严重程度与病程长短、舌下络脉曲张程度和肠上皮化生的严重程度呈正相关。结论1.CAG的病位以胃、脾、肝、肾为主,涉及心、胆、肺、心神等;病性常以气滞、阳虚、气虚为主,涉及阴虚、湿、痰、血瘀等。2.血瘀的产生、加重的程度与病程长短、舌下络脉曲张程度、肠上皮化生的严重程度存在相关性,当重视血瘀在CAG疾病发展过程中的影响。
[Abstract]:Objective to study the effect of blood stasis on the development of chronic atrophic gastritis (CAG) and "blood stasis" syndrome based on syndromes theory, and to explore the relationship between them. To provide evidence-based medicine theory guidance for clinical treatment of TCM syndrome differentiation, to provide new ideas for clinical treatment of CAG. Methods from January 2016 to January 2017, 92 patients with chronic atrophic gastritis, who were admitted to the second people's Hospital affiliated to Fujian University of traditional Chinese Medicine and who met the standard of Naopai, were collected by four face-to-face consultations with the informed consent of the patients. The information form of syndromes was filled out and the data of syndromes were obtained by using syndrome differentiation software. 92 cases were divided into two groups: blood stasis group (observation group, containing blood stasis syndrome element) and non-blood stasis group (control group, without blood stasis syndrome element). The basic data of the two groups were observed and compared. The clinical data, the similarities and differences of syndromes, and the relationship between the duration of disease, the degree of sublingual varicose veins, endoscopic changes of gastric mucosa and histopathological changes were observed and analyzed. Result 1. There was no difference between the blood stasis group and the non-blood stasis group in the distribution of sex, age, endoscopic changes of gastric mucosa and pathological changes, but there were differences in the distribution of the course of disease between the blood stasis group and the non-blood stasis group. There were also differences in the distribution of the degree of sublingual varicose veins. The frequency of syndromes in 2.CAG was mainly as follows: blood stasis group: stomach (19.37%), liver (15.42%), spleen (15.42%), kidney (11.07%), blood stasis group (19.37%), liver (15.42%), spleen (15.42%), kidney (11.07%). Heart (7.51%), gallbladder (6.32%); In non-blood stasis group, stomach (30.25%), liver (19.33%), spleen (11.76%), kidney (11.76%), heart spirit (5.88%), lung (5.04%) were the main groups. There was no difference in the distribution of syndromes between the two groups. The frequency of 3.CAG syndrome syndromes from high to low were: blood stasis group (11.06%), Qi stagnation (10.95%), Yang deficiency (10.53%), Qi deficiency (10.32%). Yin deficiency (9.26%), phlegm (9.05%), dampness (8.84%), blood deficiency (6.53%), heat (5.68%), food accumulation (5.05%); Non-blood stasis group: Qi stagnation (16.74%), yang deficiency (13.49%), qi deficiency (13.49%), yin deficiency (10.70%), dampness (10.23%), phlegm (7.91%), blood deficiency (6.51%), food accumulation (6.05%). Hyperyang (5.12%). There was no difference between the two groups in the distribution of syndrome factors. 4. 4. There was a positive correlation between the severity of blood stasis and the duration of disease, the degree of sublingual varicose vein and the severity of intestinal metaplasia. Conclusion the disease location of 1.CAG is mainly stomach, spleen, liver and kidney, involving heart, gallbladder, lung, heart and spirit, and the disease is usually caused by qi stagnation, yang deficiency, qi deficiency, involving yin deficiency, dampness, phlegm, blood stasis, etc. There were correlations between blood stasis, severity of aggravation and duration of disease, degree of varicose veins under tongue, severity of intestinal metaplasia, and the influence of blood stasis on the development of CAG disease.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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