主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2014, Vol. 37 ›› Issue (3): 156-159.doi: 10.3969/j.issn.1006-2157.2014.03.003

• 博士之光 • 上一篇    下一篇

幽门螺杆菌相关性慢性胃炎中医证候分类研究

陈润花1, 张厂1, 苏泽琦2, 宗湘裕3, 李培彩2, 丁霞4   

  1. 1 北京中医药大学东方医院 北京 100078;
    2 北京中医药大学东直门医院;
    3 北京怀柔中医院;
    4 北京中医药大学医疗管理处
  • 收稿日期:2013-12-28 出版日期:2014-03-30 发布日期:2014-03-30
  • 通讯作者: 丁霞,女,博士,教授,博士生导师,主要研究方向:中西医结合治疗消化系统疾病,E-mail:dingx@bucm.edu.cn
  • 作者简介:陈润花,女,博士,主治医师
  • 基金资助:
    国家自然科学基金重大研究计划项目(No.91129714),国家自然科学基金项目(No.81270466)

Study on classification of TCM syndromes of Hp-related chronic gastritis

CHEN Run-hua1, ZHANG Chang1, SU Ze-qi2, ZONG Xiang-yu3, LI Pei-cai2, DING Xia4   

  1. 1 Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078;
    2 Dongzhimen Hospital, Beijing University of Chinese Medicine;
    3 Huairou Hospital of Chinese Medicine, Beijing;
    4 Department of Medical Management, Beijing University of Chinese Medicine
  • Received:2013-12-28 Online:2014-03-30 Published:2014-03-30

摘要: 目的 对幽门螺杆菌(Hp)相关性慢性胃炎的证候、证候要素进行研究,探讨Hp感染的中医证候表达。方法 收集非萎缩性胃炎和萎缩性胃炎各200例。应用因子分析和复杂系统熵聚堆2种统计方法对400例患者的四诊信息进行分析。结果 Hp阳性慢性胃炎的病位要素有4个:肝、胃、脾、胆(结合临床和专家问卷调查将“胆”舍弃);而Hp阴性慢性胃炎的病位要素有3个:肝、胃、脾。Hp阴性和Hp阳性慢性胃炎的病性要素均为9个:气虚、阴虚、阳虚、气滞、湿、热、瘀血、食积、寒。共得出8个基本证型:类肝胃郁热证、类脾胃虚弱证、类湿热蕴结证、类饮食停滞证、类脾寒胃热证、类胃阴不足证、类肝胃不和证、类瘀阻胃络证。经χ2检验,Hp阳性和Hp阴性慢性胃炎的病性要素分布无差异,但基本证型的分布有差异。经两两比较,结果表明Hp感染与证型分布明显相关(P<0.01),以类胃阴不足证为最密切,其次是类脾胃虚弱证、类湿热蕴结证及类肝胃郁热证。结论 Hp感染与湿、热相关,与阴虚关系更为密切。作为一种外来致病因素,Hp的邪气性质与湿、热密切相关,与热关系更大,且具有易伤阴液的特点。

关键词: 慢性胃炎, 幽门螺杆菌, 证候, 证候要素

Abstract: Objective To study the syndromes and syndrome factors of Helicobacter pylori (Hp)-related chronic gastritis, and discuss the expressions of TCM syndromes of Hp infection. Methods The patients with non-atrophic gastritis and atrophic gastritis (each n=200) were chosen, and their data from TCM four examinations were analyzed by using factor analysis and entropy-reactor of complex system. Results There were 4 syndrome factors related to disease locations of Hp-positive chronic gastritis, including liver, stomach, spleen and gallbladder (gallbladder being given up after clinical and expert questionnaire), and there were 3 of Hp-negative chronic gastritis, including liver, stomach and spleen. There were 9 syndrome factors related to disease nature of Hp-positive or Hp-negative chronic gastritis, including qi deficiency, yin deficiency, yang deficiency, qi stagnation, phlegm, heat, blood stasis, food accumulation and cold. There were 8 basic syndrome types, including para-syndrome of depression-heat in liver and stomach, para-syndrome of spleen-stomach weakness, para-syndrome of damp-heat accumulation, para-syndrome of food stagnation, para-syndrome of spleen cold and stomach heat, para-syndrome of stomach yin deficiency, para-syndrome of liver qi invading stomach and para-syndrome of stasis in stomach collateral. After Chi-square test, the distribution of the syndrome factors related to disease nature had no difference between Hp-positive chronic gastritis and Hp-negative chronic gastritis, but that of basic syndrome types had difference. The results of pairwise comparison showed that Hp infection was significantly correlated to syndrome distribution (P<0.01), and it was most closely related to para-syndrome of stomach yin deficiency and followed by para-syndrome of spleen-stomach weakness, para-syndrome of damp-heat accumulation and para-syndrome of depression-heat in liver and stomach. Conclusion Hp infection is correlated to dampness and heat, especially to yin deficiency. As a kind of external pathogenic factor, the evil nature of Hp is closely related to heat and dampness and more closely to heat, which is easy to cause impairment of yin.

Key words: chronic gastritis, Helicobacter pylori, syndromes, syndrome factors

中图分类号: 

  • R241