125例消化性溃疡的中医辨证分型与其胃镜下表现及Hp感染的关系探讨

发布时间：2017-12-28 01:08

本文关键词：125例消化性溃疡的中医辨证分型与其胃镜下表现及Hp感染的关系探讨　出处：《大连医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过对消化性溃疡中医辨证分型与胃镜下表现及Hp(Helicobacter pylori,幽门螺杆菌)感染等客观指标间相互关系的研究,探究微观辨证与宏观辨证的关系,为消化性溃疡中医辨证分型更加客观化、科学化提供依据。方法:收集大连医科大学附属第二医院2015年3月-2016年1月门诊消化内镜室及消化内科的符合入选标准的病例资料,剔除符合排除标准的病例。参照2002年中华人民共和国卫生部发布的《中药新药临床研究指导原则》[1](试行)将剩余的125例病例进行中医辨证分型,同时收集他们经OLYMPUS GIF-H260Z型胃镜检查所得胃镜结果及快速尿素酶试验或14C㧟尿素呼气试验所得Hp检查结果。用SPSS 22.0统计软件对所收集的数据进行分析,探究消化性溃疡中医各证型与胃镜下表现、Hp感染的关系。结果:1、本次研究纳入的125例消化性溃疡患者各中医证型的分布比例依次为:肝胃郁热型脾胃虚弱(虚寒)型肝胃不和型胃阴不足型。2、各中医证型间年龄分布的差异具有统计学意义(P0.01),其中脾胃虚弱(虚寒)型平均发病年龄较小,与其余3型相比,差异具有统计学意义(P0.05或P0.01),而胃阴不足型平均年龄明显大于其余3型,与脾胃虚弱(虚寒)及肝胃郁热2型相比,差异具有统计学意义(P0.05或P0.01)。消化性溃疡总体患病率男性大于女性,性别在各中医证型间的分布,差异无统计学意义(P0.05)。3、消化性溃疡镜下部位分类的分布:十二指肠溃疡胃溃疡复合型溃疡。消化性溃疡部位分类在中医各证型中的分布,差异无统计学意义(P0.05)。4、中医各证型的镜下分期分布,差异有统计学意义(P0.01)。其中胃阴不足型主要分布于瘢痕期,与其余主要分布于活动期的3型相比,差异具有统计学意义(P0.05或P0.01)。5、溃疡病灶表现与中医证型的关系:溃疡病灶覆苔在各中医证型中的分布,差异具有统计学意义(P0.05),其中胃阴不足型中溃疡表面无苔情况较多,与其余3型相比,差异具有统计学意义(P0.05或P0.01)。而溃疡面积及溃疡单发、多发在各证型中的分布,差异无统计学意义(P0.05)。6、溃疡周边黏膜表现与中医证型的关系:溃疡周边黏膜糜烂在胃阴不足型中较少见,与其余3型相比,差异具有统计学意义(P0.05或P0.01)。溃疡周边皱襞集中现象在胃阴不足型中所占比例较高,但与其余3型相比,差异无统计学意义(P0.05)。溃疡周边黏膜充血、水肿在各证型间的分布,差异无统计学意义(P0.05)。7、PU镜下合并慢性浅表性胃炎、慢性萎缩性胃炎及肠胃反流在中医各证型中的分布,差异均不具有统计学意义(P0.05)。8、胃阴不足型中Hp感染率较低,与脾胃虚弱(虚寒)型及肝胃郁热型相比,差异具有统计学意义(P0.01)。结论:1、消化性溃疡中医证型分布:肝胃郁热型脾胃虚弱(虚寒)型肝胃不和型胃阴不足型。消化性溃疡镜下部位分类的分布:十二指肠溃疡胃溃疡复合性溃疡。2、年龄与消化性溃疡中医证型存在关系,性别与中医辨证分型没有关系。3、消化性溃疡胃镜下表现与中医证型存在一定关系,其中胃阴不足型与其余各型间差异较明显。4、Hp感染与消化性溃疡中医证型存在关系。
[Abstract]:Objective: through and Hp features of TCM Syndromes of peptic ulcer type and gastroscope (Helicobacter pylori, Helicobacter pylori infection) research on the relationship between objective indicators such as the relationship between microcosmic and macroscopic differentiation, for TCM syndrome of peptic ulcer type more objective and scientific basis. Methods: We collected data from the second hospital of Dalian Medical University from March 2015 to January, which met the inclusion criteria in the digestive endoscopy room and gastroenterology department of -2016 hospital, and excluded the cases that met the exclusion criteria. According to the 2002 People's Republic of China Ministry of Health issued the "Chinese medicine clinical research guiding principle" ([1] trial) 125 cases remaining TCM type, they also collected by OLYMPUS GIF-H260Z gastroscopy and rapid urease test results obtained by urea breath test or 14C? The Hp examination results. SPSS 22 statistical software was used to analyze the data collected, and to explore the relationship between the TCM Syndromes of peptic ulcer and the manifestations of gastroscope and Hp infection. Results: the distribution of 125 patients with peptic ulcer syndromes 1, this study included as follows: liver stomach disharmony (deficiency) deficiency of spleen and stomach incoordination between liver and stomach yin. There was statistically significant difference in age distribution, 2 different syndromes of traditional Chinese medicine (P0.01), the spleen and stomach (cold) the average age of onset is smaller, compared with the other 3 types, the difference was statistically significant (P0.05 or P0.01), and stomach yin deficiency type is obviously greater than that of the average age of more than 3, and the weakness of the spleen and stomach (cold) and liver stomach heat type 2 compared, the difference was statistically significant (P0.05 or P0.01). The overall prevalence rate of peptic ulcers was greater than that of women, and there was no significant difference in the distribution of sex between various TCM syndromes (P0.05). 3. The distribution of the classification of peptic ulcers: the compound ulcer of duodenal ulcer and gastric ulcer. The distribution of the parts of peptic ulcer in the TCM syndrome types was not statistically significant (P0.05). 4. The distribution of different types of TCM syndromes under the microscope was statistically significant (P0.01). The deficiency of gastric Yin was mainly distributed in the cicatricial period, and the difference was statistically significant (P0.05 or P0.01) compared with the other 3 types mainly distributed in the active stage. The relationship between the 5, ulcer lesions and TCM syndrome type distribution of ulcer lesions covered with moss in TCM syndrome types, the difference was statistically significant (P0.05), no ulcer surface moss more the stomach yin deficiency type, compared with the other 3 types, the difference was statistically significant (P0.05 or P0.01). The distribution of the area of ulcers and the single and multiple ulcers in each type of syndrome was not statistically significant (P0.05). 6, the relationship between the performance of ulcer peripheral mucosa and TCM syndromes: ulcer peripheral mucosal erosion is less frequent in the stomach yin deficiency type, compared with the other 3 types, the difference is statistically significant (P0.05 or P0.01). The concentration of the circumjacent fold of the ulcer was higher in the deficiency of the stomach yin, but there was no significant difference compared with the other 3 types (P0.05). The distribution of hyperemia and edema in the peripheral mucosa of the ulcer was not statistically significant (P0.05). 7, the distribution of chronic superficial gastritis, chronic atrophic gastritis and gastrointestinal regurgitation in TCM syndromes under PU microscope is not statistically significant (P0.05). 8 Hp infection and stomach yin deficiency type rate is low, and the weakness of the spleen and stomach (cold) compared and liver stomach disharmony, the difference was statistically significant (P0.01). Conclusion: 1, peptic ulcer syndromes: liver stomach disharmony (deficiency) deficiency of spleen and stomach incoordination between liver and stomach yin. The distribution of the sites under the mirror of peptic ulcer: the compound ulcer of the duodenal ulcer and gastric ulcer. 2. There is a relationship between age and TCM syndrome type of peptic ulcer, and there is no relationship between sex and TCM syndrome differentiation. 3. There is a certain relationship between the manifestation of peptic ulcer gastroscope and the TCM syndrome type, of which the difference between the deficiency of the stomach and the other types is obvious. 4, the relationship between Hp infection and TCM syndrome type of peptic ulcer.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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