CAJ | 학술논문

目的：探讨幽门螺杆菌（ H．pylori ）相关性胃病的中医证型及证候要素的演变规律。方法采用前瞻性横断面分析及多中心的流行病学研究方法，在查阅文献，综合相关专家意见的基础上，分别设计证型、证候要素调查问卷表，对2013年9月—2014年10月于北京市3个中心就诊的符合纳入标准的384例H．pylori相关性胃病患者进行问卷调查。将调查所得数据建立数据库，运用SAS 8．0软件进行统计学分析。结果①384例H．pylori相关性胃病（慢性浅表性胃炎CSG、慢性萎缩性胃炎CAG、胃溃疡GU）患者常见7个症状出现频率由高到低依次为反酸烧心、胃痛、胃胀、食欲不振、腹胀、腹痛、神疲乏力，CAG与CSG、GU与CSG间具有统计学差异（P＜0．05）；②舌象出现频率由高到低依次为舌红苔黄（白）腻＞舌暗红苔黄（白）＞舌红苔黄（白）＞舌红少苔，各疾病间总体分布无统计学差异（P＞0．05）；③中医证型出现频率较高的是湿热证，其次为肝胃不和证、脾胃虚弱证、胃络瘀阻证，CAG与CSG、GU与CSG间具有统计学差异（P＜0．05）；④主要证候要素出现频率由高到低依次为热＞湿＞气滞＞寒＞血瘀＞气虚＞阴虚，CSG与CAG、GU与CAG间具有统计学差异（P＜0．05）。结论 H．pylori相关性胃病的中医证型以湿热证和肝胃不和证为主，中医证候要素以热、湿、气滞为主。 H．pylori相关性胃病与中医证型及证候要素具有相关性。
목적：탐토유문라간균（ H．pylori ）상관성위병적중의증형급증후요소적연변규률。방법채용전첨성횡단면분석급다중심적류행병학연구방법，재사열문헌，종합상관전가의견적기출상，분별설계증형、증후요소조사문권표，대2013년9월—2014년10월우북경시3개중심취진적부합납입표준적384례H．pylori상관성위병환자진행문권조사。장조사소득수거건립수거고，운용SAS 8．0연건진행통계학분석。결과①384례H．pylori상관성위병（만성천표성위염CSG、만성위축성위염CAG、위궤양GU）환자상견7개증상출현빈솔유고도저의차위반산소심、위통、위창、식욕불진、복창、복통、신피핍력，CAG여CSG、GU여CSG간구유통계학차이（P＜0．05）；②설상출현빈솔유고도저의차위설홍태황（백）니＞설암홍태황（백）＞설홍태황（백）＞설홍소태，각질병간총체분포무통계학차이（P＞0．05）；③중의증형출현빈솔교고적시습열증，기차위간위불화증、비위허약증、위락어조증，CAG여CSG、GU여CSG간구유통계학차이（P＜0．05）；④주요증후요소출현빈솔유고도저의차위열＞습＞기체＞한＞혈어＞기허＞음허，CSG여CAG、GU여CAG간구유통계학차이（P＜0．05）。결론 H．pylori상관성위병적중의증형이습열증화간위불화증위주，중의증후요소이열、습、기체위주。 H．pylori상관성위병여중의증형급증후요소구유상관성。
Objective To study Chinese medicine syndrome types and syndrome factors evolvement law of Helicobacter pylori ( H.pylori ) related gastropathy.Methods Based on the literature review and expert consultation, prospective, cross-sectional analysis and multi-centered epidemiological research methods were used in this study.The syndromes and syndrome factors questionnalres were designed to investigate the 384 cases of H.pylori related gastropathy in 3 medical centers of Beijing from September 2013 to October 2014, The database was established and statistically analyzed by software SAS 8.0. Results ①Among 384 cases of H.pylori related gastropathy, including chronic superficial gastritis ( CSG) ,chronic atrophic gastritis ( CAG) and gastric ulcer ( GU) , the seven top symptoms were: acid regurgitation with heartburn, stomachache, gasteremphraxis, anorexia, abdominal distension, abdominal paln and lassitude.Statistic differences of CAG vs.CSG and GU vs.CSG were significant (P<0.05).②The frequency of tongue-appearance were as follows:red tongue with yellow ( white) greasy fur, dark-red tongue with yellow ( white) fur, ( pale) red tongue with yellow ( white) fur and red tongue with thin fur.There were no significant differences among different diseases (P >0.05).③The frequencies of TCM syndromes were as follows: syndrome of damp-heat accumulation, syndrome of liver qi invading stomach, syndrome of spleen-stomach weakness, and syndrome of blood stasis in stomach collateral. Statistic differences of CAG vs.CSG and GU vs.CSG were significant ( P<0.05) .④The frequencies of syndrome factors were as follows: heat, dampness, qi stagnation, cold, blood stasis, qi deficiency and yin deficiency.Statistic differences of CSG vs.CAG and GU vs.CAG were significant ( P <0.05 ) Conclusions Damp-heat accumulation and liver qi invading stomach are the two common TCM syndromes of H.pylori related gastropathy.The three TCM syndrome factors are heat, dampness and qi stagnation.H.pylori related gastropathy has a correlation to TCM syndrome and syndrome factors.