基于NBI内镜的慢性糜烂性胃炎与中医体质分布相关因素的研究

发布时间：2018-02-10 01:40

  本文关键词： 慢性糜烂性胃炎(CEG) 窄带成像内镜(NBI) 中医体质　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:基于窄带成像内镜(Narrow-band imaging,NBI)对于病变胃黏膜微结构的诊断价值,探索NBI技术下的慢性糜烂性胃炎中医体质的分布特点,及与NBI镜下像表现的关系。方法:采用文献综述和临床问卷调查相结合的方法。收集100例确诊为慢性糜烂性胃炎的病例,按王琦教授的《中医体质分类判断》对体质进行分类判定,同时观察患者一般资料、NBI镜下表现及组织病理学等资料,通过Microsoft Excel建立数据库,采用SPSS21.0统计分析软件,分析糜烂性胃炎患者中医体质分布及与相关因素的关系。结果:(1)本研究中慢性糜烂性胃炎患者中偏颇体质分布依频次由多到少为:湿热质(25%),气郁质(18%),阳虚质(15%),气虚质(9%),阴虚质(8%),痰湿质(6%),血瘀质(2%),特禀质(1%)。偏颇体质占84%;平和质占16%。(2)体质类型在性别上的分布无统计学差异;本病集中分布于40-59岁年龄段,占60%,平均年龄46.50±10.878岁。在不同年龄段的分布上有统计学差异。湿热质在青年组分布居多,占青年组总例数44.1%。阳虚质、气郁质在中年组分布居多,分别占18.9%26.4%。(3)慢性糜烂性胃炎患者中医体质与胃黏膜糜烂程度:Ⅲ级胃黏膜糜烂以阳虚质(28.6%)分布最多,气虚质(17.9%)次之,Ⅱ级糜烂以气郁质(27.0%)、湿热质(24.3%)分布最多,Ⅰ级糜烂以湿热质(34.3%)、平和质(25.7%)分布最多。(4)NBI镜下胃黏膜表面微血管形态(CP)与体质的分布:CP-III型以阳虚质(40%)为主,阴虚质(24%)次之,CP-II型以湿热质(42.9%)为主,CP-I型以平和质(32.5%)、气郁质(30%)为主。(5)NBI镜下胃小凹分型(PP)与体质的分布:Ⅰ型胃小凹占22%,Ⅱ型占41%,Ⅲ型占26%,Ⅳ型占21%,Ⅴ型、Ⅵ型病例缺如。Ⅰ型以平和质为主,湿热质次之,Ⅱ型以湿热质为主,气郁质次之。Ⅲ型、Ⅳ型以虚证体质为主,其中以阳虚质多见。(6)慢性糜烂性胃炎中医体质在不同病理慢性炎等级上的分布无统计学差异;在病理有无活动性炎及萎缩改变方面,活动性炎改变多见于湿热质,萎缩改变多见于阳虚质。结论:(1)慢性糜烂性胃炎患者的体质主要是:湿热质、平和质、气郁质、阳虚质。其中最常见的偏颇体质是:湿热质,其次是气郁质。(2)本病以中青年发病较多,与性别无明显相关性。随着年龄的增长,平和质和湿热质呈减少趋势,而气郁质、阳虚质、气虚质、阴虚质呈增多趋势。青年以湿热质易患,中年以阳虚质、气郁质易患。(3)CEG体质分布特点与NBI内镜表现、病理类型具有一定相关性。阳虚质患者发病后镜下像分级较重,以Ⅲ级糜烂、CP-Ⅲ型、PP-Ⅲ型分布为主,其组织病理学多伴有萎缩改变。湿热质、气郁质患者发病后镜下分级较轻,湿热质患者发病以Ⅰ级糜烂、CP-Ⅱ型、PP-Ⅱ型为主,组织病理学多伴活动性炎改变;气郁质患者发病后以Ⅱ级糜烂、CP-Ⅰ型、PP-Ⅱ型为主,组织病理学多伴活动性炎改变。
[Abstract]:Objective: based on the diagnostic value of narrow band imaging endoscope Narrow-band imaging (NBI) for pathological gastric mucosal microstructures, to explore the distribution of TCM constitution of chronic erosive gastritis based on NBI technique. Methods: #number0# cases of chronic erosive gastritis were collected by means of literature review and clinical questionnaire survey. According to Professor Wang Qi's TCM Constitution Classification judgment, the constitution was classified and judged, and the general data of the patients were observed under microscope and histopathology. The database was established by Microsoft Excel, and the SPSS21.0 statistical analysis software was used. Analysis of the relationship between TCM physique distribution and related factors in erosive gastritis. Results: in this study, the distribution of partial constitution in patients with chronic erosive gastritis was as follows: dampness and heat 25%, Qi stagnation 18%, Yang deficiency 1515), Qi and Qi. There was no statistical difference in the distribution of physical types in sex between the two groups, and there was no statistical difference in the distribution of the physical types between the two sexes, and there was no statistical difference in the distribution of the types of constitution between the two sexes, and there was no statistical difference in the distribution of the types of constitution between the two sexes, and there was no statistical difference in the distribution of the types of constitution between the two sexes, and there was no statistical difference in the distribution of the physical types. The disease was mainly distributed in the 40-59 age group, accounting for 60 cases, with an average age of 46.50 卤10.878 years. There were statistical differences in the distribution of dampness and heat in the young group, accounting for 44.1% of the total number of cases in the young group. The proportion of TCM constitution and gastric mucosal erosion in patients with chronic erosive gastritis was 18.9 & .4. 3) the degree of gastric mucosal erosion in grade 鈪，

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