胃痛中医分型与慢性胃炎胃息肉病理类型的相关性分析

发布时间：2018-04-15 01:35

本文选题：胃痛 + 中医辨证分型　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：本研究的目的在于通过严格科学的方案设计和规范的研究操作,在祖国医学经络理论的指导下,探讨胃痛中医辨证分型与胃息肉发生率及病理类型之间存在的可能关系,为探索祖国传统中医结合西医辨证分析、治疗胃痛患者及胃癌的防治提供有用的临床资料,为中医辨证寻求更多的客观指标及理论依据,初步揭示其客观规律,更好地为临床和科学研究服务。方法：查阅广东省中西医结合医院2012年-2014年收住院的胃痛患者共769例,收集其中符合纳入标准及不符合排除标准的胃息肉患者210例,依据胃痛的中医辩证分型分为5个证型：肝胃不和证、脾胃虚弱证、脾胃湿热证、胃阴不足证以及胃络瘀血证,统计各组病例4种不同胃息肉病理类型的分布情况,并比较各组病例之间这种分布情况是否具有统计学差异,以探讨胃痛中医分型与慢性胃炎胃息肉病理类型的可能联系。成果：1.病例组方面,胃阴不足证和胃络瘀血证病例数极少,主要集中在肝胃不和证(59.5%)、脾胃虚弱证(27.1%)、脾胃湿热证(8.6%)。而息肉病理类型方面,以胃底腺息肉(76.2%)、增生性息肉(15.7%)为主,其余炎性纤维性息肉(7.1%)、腺瘤性息肉(1.0%)则较少。2.发病率方面,在HP阳性病例,各证型胃息肉发病率分别为肝胃不和证26.37%(48/182),脾胃虚弱证18.57%(13/70),脾胃湿热证17.78%(8/45),胃阴不足证14.29%(1/7),胃络瘀血证50.00%(5/10),各证型胃息肉发病率比较无显著统计学差异(P=0.150)。在HP阴性病例,则发病率分别为肝胃不和证30.68%(77/251),脾胃虚弱证36.67%(44/120),脾胃湿热证17.24%(10/58),胃阴不足证11.76%(2/17),胃络瘀血证22.22%(2/9),各证型胃息肉发病率两两比较无显著统计学差异(P0.005)。在全部病例中,各证型胃息肉发病率肝胃不和证28.67%(125/433),脾胃虚弱证30.00%(57/190),脾胃湿热证17.48%(18/103),胃阴不足证12.50%(3/24),胃络瘀血证36.84%(7/19),各证型胃息肉发病率两两比较无显著统计学差异(P0.005)。3.各证型胃痛患者胃息肉病理类型比较,因脾胃湿热证、胃阴不足证、胃络瘀血证及腺瘤性息肉、炎性纤维性息肉例数较少,本研究中无论HP阳性与阴性,肝胃不和组与脾胃虚弱组在增生性息肉与胃底腺息肉发生率比较均无明显统计学差异(P0.05)。4.胃息肉4种病理类型与性别、年龄、中医证型、HP感染相关性的logistic分析表明,本研究中提示女性与腺瘤性息肉及胃底腺息肉呈负相关,年龄为胃底腺息肉的危险因素,HP感染与腺瘤性息肉呈正相关而与胃底腺息肉呈负相关。而胃息肉的病理类型与中医证型无确切的相关性。结论：本研究中各证型胃息肉发病率无显著统计学差异,肝胃不和组与脾胃虚弱组在增生性息肉与胃底腺息肉发生率上比较无明显统计学差异,胃息肉的病理类型与中医证型无确切的相关性。
[Abstract]:Objective: the purpose of this study was to explore the possible relationship between TCM syndrome differentiation of stomach pain and the incidence and pathological types of gastric polyps through strict and scientific scheme design and standardized research operation under the guidance of the meridian theory of traditional Chinese medicine.In order to explore the traditional Chinese medicine combined with western medicine dialectical analysis, the treatment of stomach pain patients and the prevention and treatment of gastric cancer to provide useful clinical data, for TCM syndrome differentiation to seek more objective indicators and theoretical basis, and to preliminarily reveal its objective laws.Better serve clinical and scientific research.Methods: a total of 769 patients with gastric pain were collected from Guangdong Integrated Chinese and Western Medicine Hospital from 2012 to 2014. Among them, 210 patients with gastric polyps who met the inclusion criteria and did not meet the exclusion criteria were collected.According to the dialectical classification of gastric pain, there were five types of syndrome: disharmony of liver and stomach, deficiency of spleen and stomach, dampness and heat of spleen and stomach, deficiency of stomach yin and blood stasis of stomach collaterals. The distribution of four different pathological types of gastric polyps in each group was analyzed.To study the possible relationship between TCM classification of gastric pain and pathological type of chronic gastritis gastric polyps.Result: 1.In the case group, the number of cases with deficiency of stomach yin and blood stasis of stomach collaterals was very few, mainly concentrated in liver and stomach disharmony syndrome 59.5am, spleen and stomach deficiency syndrome 27. 1 and spleen and stomach dampness and heat syndrome.In the pathological types of polyps, the gastric fundus polyps (76. 2%), proliferative polyps (15. 7%), other inflammatory fibrous polyps (7. 1%), adenomatous polyps (1. 0%) and adenomatous polyps (1. 0%) were less.In HP positive cases, the incidence of gastric polyps in each syndrome was 26.37 / 182 / 48, 18.5713 / 70 / 70, 17.78 / 45 / 45, 14.29 / 7 and 50.005 / 10 / 10, respectively. There was no significant difference in the incidence of gastric polyps among different syndromes.In HP negative cases, the incidence rates were liver and stomach disharmony (30.68 / 251), spleen and stomach weakness (36.67 / 44 / 120), spleen and stomach dampness heat (17.24 / 58), stomach yin deficiency (11.76 / 2 / 17), gastric blood stasis (22.22 / 2 / 9). There was no significant difference in the incidence of gastric polyps between the two syndromes (P 0.005).In all cases, the incidence of gastric polyps in each syndrome was 28.67125 / 433g, in spleen and stomach deficiency 30.0057 / 190N, in dampness and heat of spleen and stomach 17.48g / 103n, in deficiency of stomach and yin 12.50m / 32 / 24, in syndrome of gastric collaterals and blood stasis 36.847 / 7 / 19N, there was no significant difference in the incidence of gastric polyps between the two types (P0.0050.0.33). (2) there was no significant difference in the incidence of gastric polyps between the two types of syndrome (P 0.005. 3), and there was no significant difference in the incidence of gastric polyps between the two types (P 0.005. 3).The pathological types of gastric polyps in patients with gastric pain were less due to damp-heat syndrome of spleen and stomach, deficiency of stomach yin, blood stasis of gastric collaterals and adenomatous polyps, inflammatory fibrous polyps, no matter HP positive or negative in this study.There was no significant difference in the incidence of proliferative polyps and fundus gland polyps between the liver and stomach disharmony group and the spleen and stomach asthenia group.Logistic analysis of the correlation between four pathological types of gastric polyps and sex, age, TCM syndromes and HP infection showed that there was a negative correlation between women and adenomatous polyps and fundus adenomatous polyps in this study.Age was a risk factor for gastric fundus polyps. HP infection was positively correlated with adenomatous polyps and negatively correlated with gastric fundus polyps.But the pathological type of gastric polyp has no definite correlation with TCM syndrome type.Conclusion: there was no significant difference in the incidence of gastric polyps among different syndromes in this study, but there was no significant difference in the incidence of proliferative polyps and gastric fundus polyps between the liver and stomach disharmony group and the spleen and stomach asthenia group.There is no definite correlation between pathological type of gastric polyp and TCM syndrome type.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.3

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