慢性浅表性胃炎中医证候分布特点的临床研究

发布时间：2018-12-06 20:27

【摘要】：目的:探讨慢性浅表性胃炎患者性别、年龄、职业、诱发因素、病程长短、HP感染程度分布、中医证候分布特点,为临床辨证论治提供指导,为未来的相关科学研究提供指导和借鉴。方法:收集2014年2月至2015年10月,在滨州医学院烟台附属医院消化内科确诊为慢性浅表性胃炎的患者四诊资料,对慢性浅表性胃炎患者进行性别、年龄、职业、诱发因素、病程长短、HP感染程度分布、中医证候进行统计。结果:本次调查的700例慢性浅表性胃炎患者中,男性患者294例(42%),女性患者406例(58%),男女比例约21:29;慢性浅表性胃炎患者以中青年居多,老年患者较少;慢性浅表性胃炎患者职业因素分布情况中,工人与职员所占比例最多;慢性浅表性胃炎诱发因素分布情况中,幽门螺旋杆菌感染者352例(50. 3%),情志不遂250例(35. 8%),这两种因素为主要因素,并且部分患者存在多种诱发因素;慢性浅表性胃炎病程分布:在调查的700例慢性浅表性胃炎患者中,病程最短10天,病程最长30余年,病程小于半年的患者130例,病程为1-3年的患者246例,病程为3-5年患者118例,病程为5-10年患者152例,病程大于10年的患者53例;慢性胃浅表性胃炎感染HP的患者较多,其中轻度、中度的患者总和占总人数的65%, HP重度感染的患者较少;脾胃湿热证患者HP感染率最高;慢性浅表性胃炎各独立证候出现的频次(包括兼证的)分别为脾胃虚弱证522次40.4%)、肝郁气滞证453次(35.0%)、脾胃湿热证133次(10.3%)、胃络瘀血证148次(11.5%)、胃阴不足证36次(2.8%);慢性浅表性胃炎实际表现的证型出现频次最高的为脾胃虚弱兼肝气郁滞证共205例;分析各独立证候与性别的关系得出女性常见的证候多以脾胃虚弱证与肝郁气滞证为主,男性患者常见证候则以脾胃湿热证与胃络瘀血证为主,胃阴不足证在男女患者之间没有显著差异。结论:慢性浅表性胃炎与性别无关;慢性浅表性胃炎患者中,中、青年人群较多,老年人较少,主要原因为慢性浅表性胃炎反复发作,最终演变为慢性萎缩性胃炎;在治疗慢性浅表性胃炎时要注重情志因素的调节以及检查是否存在幽门螺旋杆菌,感染HP的患者,需及时根除,并且针对脾胃湿热的患者要尤其注意检查是否存在HP感染;慢性浅表性胃炎患者主要症状不仅表现为脾胃的疾病,也包括其他脏腑的疾病,在制定诊断标准时应加予考虑;独立证候出现构成比最高的为脾胃虚弱证,这提示我们在治疗的过程中要注意对脾胃的调理;在辨证治疗男性慢性浅表性胃炎患者应注重清热燥湿健脾以及活血化瘀,女性患者因注重疏肝理气。
[Abstract]:Objective: to explore the gender, age, occupation, inducing factors, duration of disease, distribution of HP infection degree and TCM syndrome distribution in patients with chronic superficial gastritis, so as to provide guidance for clinical treatment based on syndrome differentiation. To provide guidance and reference for related scientific research in the future. Methods: from February 2014 to October 2015, the data of patients diagnosed as chronic superficial gastritis in the Department of Digestive Medicine of Yantai affiliated Hospital of Binzhou Medical College were collected, and the sex, age, occupation and inducing factors of patients with chronic superficial gastritis were analyzed. The duration of the disease, the distribution of HP infection, and TCM syndromes were statistically analyzed. Results: among 700 patients with chronic superficial gastritis, 294 (42%) were male, 406 (58%) were female, the ratio of male to female was 21: 29. In the distribution of occupational factors in patients with chronic superficial gastritis, the proportion of workers and employees was the largest, and 352 cases of Helicobacter pylori infection were found in the distribution of inducing factors of chronic superficial gastritis. (3%), 250 cases (35. 5%). These two factors are the main factors, and some patients have a variety of inducing factors. Distribution of chronic superficial gastritis: among 700 patients with chronic superficial gastritis, the shortest course was 10 days, the longest course was more than 30 years, the course of disease was less than half a year in 130 cases, and the course of disease was 1-3 years in 246 cases. The course of disease was 3 to 5 years (118 cases), the course of disease was 5 to 10 years (152 cases), and the course of disease was more than 10 years (53 cases). The patients with chronic superficial gastritis infected with HP were more than those with mild and moderate gastritis, and the patients with severe HP infection were less than those with mild or moderate HP infection, the infection rate of HP was the highest in the patients with damp-heat syndrome of spleen and stomach. The frequency of independent syndromes of chronic superficial gastritis (including both syndromes) were 522 times of deficiency of spleen and stomach (40.4%), 453 times of stagnation of liver and qi (35.0%), 133 times of syndrome of dampness and heat of spleen and stomach (10.3%). There were 148 (11.5%) cases of blood stasis in stomach collaterals and 36 (2.8%) cases of deficiency of stomach yin. There were 205 cases of chronic superficial gastritis with deficiency of spleen and stomach and stagnation of liver qi. By analyzing the relationship between the independent syndromes and gender, it was found that the common syndromes of female were mainly spleen and stomach deficiency and liver stagnation, while the common symptoms of male patients were spleen and stomach dampness and heat and blood stasis of stomach and collaterals. There was no significant difference between male and female patients with deficiency of stomach yin. Conclusion: chronic superficial gastritis has nothing to do with sex. In the patients with chronic superficial gastritis, there are more young people and fewer old people, the main reason is that chronic superficial gastritis occurs repeatedly, and finally it turns into chronic atrophic gastritis. In the treatment of chronic superficial gastritis we should pay attention to the regulation of emotional factors and check whether there is Helicobacter pylori infection HP patients need to be eradicated in time and the patients with dampness and heat of spleen and stomach should pay special attention to the existence of HP infection; The main symptoms of chronic superficial gastritis are not only spleen and stomach diseases, but also other viscera diseases. The highest proportion of independent syndromes is spleen and stomach weakness, which suggests that we should pay attention to the regulation of spleen and stomach in the course of treatment. In the treatment of male chronic superficial gastritis, we should pay attention to clearing heat, dampness and spleen and promoting blood circulation and removing blood stasis, while female patients should pay attention to soothing the liver and regulating qi.
【学位授予单位】：滨州医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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