CAJ | 학술논문

目的：研究消化性溃疡病中医证型与消化性溃疡分类、溃疡分期、胃镜征象、幽门螺杆菌（ H．pylori）感染的相关性，从而为消化性溃疡中医辨证分型提供客观依据。方法216例消化性溃疡患者均经中医辨证分型，并行胃镜检查、H．pylori检查。对中医证型与消化性溃疡分类、溃疡分期、胃镜征象、H．pylori感染的关系进行统计学相关性分析。结果中医证型与西医溃疡分类的构成比比较无显著性差异（ P＞0．05）。溃疡期中胃热炽盛型34例，愈合期和癖痕期中肝胃气滞型58例，均明显高于同期其他证型（ P均＜0．05）。胃镜下溃疡面积与中医证型之间没有显著性差异（P＞0．05）。肝胃气滞及脾胃虚实患者胃黏膜水肿，溃疡色泽白，溃疡面覆白苔为主；胃热炽盛及寒邪犯胃患者胃黏膜水肿，溃疡色泽黄，溃疡上覆黄苔为主；胃阴亏虚患者黏膜溃疡色泽白，溃疡面上覆白苔为主；食滞胃肠患者黏膜水肿，黏膜色泽黄，溃疡上覆白苔为主；瘀阻胃络患者黏膜水肿，黏膜色泽白，溃疡上覆白苔为主。胃热炽盛及肝胃气滞患者H．pylori感染率分别为88．46％及71．23％，胃热炽盛型H．pylori感染率显著高于其他证型（P＜0．05）。结论胃镜检查观察胃和十二指肠黏膜的病变情况，不宜作为中医证型判断标准，可作为望诊之延伸应用于临床，可为中医辨证提供一定的客观化指标，提高对消化性溃疡病中医辨证治疗规律的认识。
목적：연구소화성궤양병중의증형여소화성궤양분류、궤양분기、위경정상、유문라간균（ H．pylori）감염적상관성，종이위소화성궤양중의변증분형제공객관의거。방법216례소화성궤양환자균경중의변증분형，병행위경검사、H．pylori검사。대중의증형여소화성궤양분류、궤양분기、위경정상、H．pylori감염적관계진행통계학상관성분석。결과중의증형여서의궤양분류적구성비비교무현저성차이（ P＞0．05）。궤양기중위열치성형34례，유합기화벽흔기중간위기체형58례，균명현고우동기기타증형（ P균＜0．05）。위경하궤양면적여중의증형지간몰유현저성차이（P＞0．05）。간위기체급비위허실환자위점막수종，궤양색택백，궤양면복백태위주；위열치성급한사범위환자위점막수종，궤양색택황，궤양상복황태위주；위음우허환자점막궤양색택백，궤양면상복백태위주；식체위장환자점막수종，점막색택황，궤양상복백태위주；어조위락환자점막수종，점막색택백，궤양상복백태위주。위열치성급간위기체환자H．pylori감염솔분별위88．46％급71．23％，위열치성형H．pylori감염솔현저고우기타증형（P＜0．05）。결론위경검사관찰위화십이지장점막적병변정황，불의작위중의증형판단표준，가작위망진지연신응용우림상，가위중의변증제공일정적객관화지표，제고대소화성궤양병중의변증치료규률적인식。
Objective It is to study the correlations of TCM syndrome of peptic ulcer with ulcer stage and classification , gastroscopic signs ,H.pylori infection , thus to provide objective basis for the syndrome differentiation of this disease .Methods 216 patients with peptic ulcer were diagnosed by syndrome differentiation of traditional Chinese medicine , H.pylori examina-tion and gastroscopy examination .The relationships of TCM syndrome type with ulcer stage and classification , gastroscopic signs,H.pylori infection were analyzed by an statistical correlation analysis .Results There was no significant difference in constituent ratio between TCM syndrome type and ulcer classification of western medicine (P>0.05).Peptic ulcer in intense stomach heat type accounted for 34 cases, healing and scar period of stagnation of liver qi and stomach qi .In type58 cases, were significantly higher than those in other syndromes , with significant difference (P<0.05).Endoscopic examination of gastroscope signs,no significant difference between endoscopic ulcer areaand TCM syndrome type (P>0.05).Stagnation of liver qi and stomach qiand the spleen and stomach in patients with gastriculcer and mucosal edema white color mainly the ulcer surfacecoated white moss .Intense stomach heat and coldevil stomach of patients with gastric ulcer mucosa edema , the color yellow, mainlyulcer overlying yellow fur .Stomach yin deficiency patients withulcer mainlywhite color , whitemoss on the ulcer surface coating .Retention of food in the gastrointesinal mucosa in the patients with edema , mucosa ulcercolor yellow , mainly-covered with white tongue coating .Gastric blood stasis in patients with mucosal edema , mucosa ulcer of white color ,covered with whitefur.Intense stomach heat and qi stagnation in liver of patients with Hpinfection rates were 88.46%band 71.23%.In-tense stomach heat type were significantly higher than that of other syndromes (P<0.05).Conclusion Gastroscopy lesion of gastric and duodenal mucosa , not as a TCM syndrome type judgment standard , can be used as the extension of application in clinical diagnosis , which can provide objective index for TCM .To improve the understanding of peptic ulcer disease of TCM syndrome differentiation and treatment law .