摘要
目的:探讨幽门螺杆菌相关性胃病(慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡、十二指肠溃疡、胃癌)证候分布规律及年龄、性别、职业因素与其证型的关系,从而为临床辨治本病提供客观依据。
方法:采用前瞻性流行病学研究方法,设计出幽门螺杆菌相关性胃病中医证候调查表,依据纳入标准选出合格病例共980例,根据患者中医证候四诊资料,建立数据库,应用频数分析、X2检验等统计学方法,分析幽门螺杆菌相关性胃病中医证候的分布情况,并探讨其规律。
结果:
1.不同病种HP相关性胃病经频数分析后,证型分布比例由高到低排序为:
⑴HP相关性慢性浅表性胃炎:脾胃湿热证>肝胃不和证>脾胃虚弱证>胃阴不足证>胃络瘀血证;⑵HP相关性慢性萎缩性胃炎:胃络瘀血证>寒热错杂证>脾胃虚寒证>肝胃不和证>胃阴不足证;⑶HP相关性胃溃疡:脾胃湿热证>肝胃不和证>脾胃虚弱证>胃络瘀血证>胃阴不足证;⑷HP相关性十二指肠溃疡:脾胃湿热证>肝胃不和证>脾胃虚弱证>胃络瘀血证>胃阴不足证;⑸HP相关性胃癌:脾胃虚弱证>脾胃湿热证>肝胃不和证>胃络瘀血证>胃阴不足证。
2.综合各病种HP相关性胃病经频数分析后,证型分布比例由高到低排序为:脾胃湿热证>肝胃不和证>脾胃虚弱证>胃络瘀血证>寒热错杂证>胃阴不足证>脾胃虚寒证。
3.HP相关性胃病不同证型与年龄分布的关系:脾胃湿热证主要集中在30岁-59岁年龄段,肝胃不和证主要集中在45岁-59岁年龄段,脾胃虚弱证、胃络瘀血证、寒热错杂证、胃阴不足证、脾胃虚寒证主要集中在45岁-70岁年龄段。
4.HP相关性胃病不同证型与性别分布的关系:男性以脾胃湿热证最多,女性以肝胃不和证最多。
5.HP相关性胃病不同证型与职业分布的关系:体力劳动者、脑力劳动者均以脾胃湿热证最多,退休与无职业者以脾胃虚弱证最多。
6.HP相关性胃病中主要证候出现频次由多至少为:烧心、胃脘灼痛、痞满、吞酸、纳呆、嗳气、大便粘腻不爽、口干、口臭、胃脘胀痛,舌象以舌红苔黄腻为主,脉象以弦、滑为主。
结论:
1.HP相关性胃病证型分布以脾胃湿热证为主,其次分别为肝胃不和证>脾胃虚弱证>胃络瘀血证>寒热错杂证>胃阴不足证>脾胃虚寒证。
2.HP相关性胃病的证型分布与年龄、性别、职业存在相关性。
3.HP相关性胃病中主要证候出现频次由多至少为:烧心、胃脘灼痛、痞满、吞酸、纳呆、嗳气、大便粘腻不爽、口干、口臭、胃脘胀痛,舌象以舌红苔黄腻为主,脉象以弦、滑为主。
Objective:Explore helicobacter pylori associated gastropathy(chronic superficial gastritis,chronic atrophic gastritis,gastric ulcer,duodenal ulcer, gastric cancer) syndromes distribution, relationship between syndrome and age, gender, profession factors, which provides an objective basis for clinical diagnosis and treatment of the disease.
Methods: Adopt forward-looking epidemiological research methods, design the helicobacter pylori associated gastropathy syndromes questionnaire, according to the inclusion criteria chosen 980 cases, according to patients syndromes of the four diagnostic material, the establishment of database, application the statistical methods of frequency analysis and X2 inspection, analysis of the distribution of helicobacter pylori associated gastropathy syndromes, and discusses their rule.
Ressults:
1.Different diseases of helicobacter pylori associated gastropathy by frequency analysis, syndrome distribution proportion from high to low ranking for:
⑴helicobacter pylori associated chronic superficial gastritis: heat and dampness in the spleen and stomach> liver-stomach disharmony syndrome >deficiency of the spleen and stomach syndrome> deficiency of stomach-yin syndrome > static blood in stomach collaterals syndrome;⑵helicobacter pylori associated chronic atrophic gastritis: static blood in stomach collaterals syndrome> chill-heat concurrent deficiency body type> deficient cold of spleen and stomach syndrome> liver-stomach disharmony syndrome > deficiency of stomach-yin syndrome;⑶helicobacter pylori associated gastric ulcer: heat and dampness in the spleen and stomach> liver-stomach disharmony syndrome >deficiency of the spleen and stomach syndrome> static blood in stomach collaterals syndrome> deficiency of stomach-yin syndrome;⑷helicobacter pylori associated duodenal ulcer: heat and dampness in the spleen and stomach> liver-stomach disharmony syndrome >deficiency of the spleen and stomach syndrome> static blood in stomach collaterals syndrome>deficiency of stomach-yin syndrome;⑸h elicobacter pylori associated gastric cancer: deficiency of the spleen and stomach syndrome> heat and dampness in the spleen and stomach> liver-stomach disharmony syndrome > static blood in stomach collaterals syndrome> deficiency of stomach-yin syndrome.
2. Taking all helicobacter pylori associated gastropathy by frequency analysis, syndrome distribution proportion from high to low ranking for: heat and dampness in the spleen and stomach> liver-stomach disharmony syndrome >deficiency of the spleen and stomach syndrome> static blood in stomach collaterals syndrome> chill-heat concurrent deficiency body type>deficiency of stomach-yin syndrome>deficient cold of spleen and stomach syndrome.
3.The relationship of helicobacter pylori associated gastropathy syndromes and age distribution: heat and dampness in the spleen and stomach is mainly in ages between thirty and fifty-nine; liver-stomach disharmony syndrome is mainly in ages between forty-five and fifty-nine;deficiency of the spleen and stomach syndrome, static blood in stomach collaterals syndrome, chill-heat concurrent deficiency body type, deficiency of stomach-yin syndrome,deficient cold of spleen and stomach syndrome.are mainly in ages between forty-five and seventy.
4. The relationship of helicobacter pylori associated gastropathy syndromes and gender distribution: heat and dampness in the spleen and stomach is the highest type in the male patients;liver-stomach disharmony syndrome is the highest type in the female patients.
5. The relationship of helicobacter pylori associated gastropathy syndromes and profession distribution: heat and dampness in the spleen and stomach is the highest type both in the menta workers and manual workers;deficiency of the spleen and stomach syndrome is the highest type in people retired and without work.
6. The main syndromes of helicobacter pylori associated gastropathy by frequency analysis, from high to low ranking for: epigastric burning,stomach burning pain,stuffiness and fullness,acid regurgitation,anorexia, eructation,sticky stool,thirsty,bad breath,stomach swollerpain,tongue manifestation with red tongue,yellow greasy fur-based,Pulse to taut,slide-based.
Conclusions:
1. Syndromes of helicobacter pylori associated gastropathy distribution proportion from high to low ranking for: heat and dampness in the spleen and stomach> liver-stomach disharmony syndrome >deficiency of the spleen and stomach syndrome> static blood in stomach collaterals syndrome> chill-heat concurrent deficiency body type>deficiency of stomach-yin syndrome> deficient cold of spleen and stomach syndrome.
2.Dsitributtion of helicobacter pylori associated gastropathy syndromes is related with age, gender,profession factors.
3. The main syndromes of helicobacter pylori associated gastropathy by frequency analysis, from high to low ranking for: epigastric burning, stomach burning pain,stuffiness and fullness,acid regurgitation,anorexia, eructation,sticky stool,thirsty,bad breath,stomach swollerpain,tongue manifestation with red tongue,yellow greasy fur-based,Pulse to taut,slide-based.
引文
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