Evolution of TCM patterns from non-atrophic to atrophic gastritis*
2015, 38 (5):
Objective To examine the evolution of TCM patterns from Non-atrophic gastritis (CSG) to atrophic gastritis (CAG). Methods We analyzed TCM patterns in 400 cases of chronic gastritis. χ2 test was used to compare the evolution of TCM patterns from CSG to CAG. Results There were nine essential pattern elements for chronic gastritis, namely, Qi deficiency, Qi stagnation, dampness, heat, Yin deficiency, Yang deficiency, blood stasis, food accumulation, and cold. Eight basic pattern categories for chronic gastritis were liver-stomach disharmony, liver-stomach constraint heat, spleen cold and stomach heat, retention of heat in the interior, spleen-stomach weakness (including Qi deficiency and yang deficiency), phlegm obstructing the stomach collaterals, food accumulation, and stomach-Yin deficiency, respectively. Chi-square test showed that CSG was closely related to Qi deficiency, Qi stagnation, heat, Yang deficiency, blood stasis, food accumulation and coldness while CAG was related to dampness, particularly to Yin deficiency. The correlation between nine essential pattern elements and Hp-positive CSG were: food accumulation > Heat > Yin deficiency; food accumulation > Qi stagnation > Yin deficiency; indigestion > coldness > Yin deficiency; food accumulation > dampness; blood stasis > dampness; Qi deficiency > Yin deficiency; Yang deficiency> Yin deficiency; blood stasis > Yin deficiency. Hp-positive CAG was just the opposite. Chi-square test also showed that stomach-Yin deficiency pattern was related to CAG and that CSG was related to other six basic pattern types except the pattern of heat retention in the interior. The correlation between the eight basic pattern categories and Hp-positive CSG were: food accumulation > liver-stomach constraint heat > stomach-Yin deficiency; food accumulation > pattern of spleen-stomach weakness > stomach-Yin deficiency; food accumulation > accumulation of damp-heat; stasis obstructing stomach collateral > pattern of heat retention in the interior; liver-stomach disharmony > stomach-Yin deficiency; stasis obstructing stomach collaterals > stomach-Yin deficiency. Hp-positive CAG was just the opposite. Conclusion Food accumulation is the earliest TCM pattern in chronic gastritis, thereafter dampness, heat, and blood stasis. Pattern of heat retention in the interior and deficiency of Healthy Qi is present throughout the development of chronic gastritis. In CSG stage, excess of pathogenic factors is often dominant. Sometimes, deficiency and excess patterns may coexist. In CAG stage, deficiency of Healthy Qi is dominant.
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