消化性溃疡胃镜表现与中医证型的相关性研究

目的观察消化性溃疡不同中医证型与胃镜下表现的相关性。方法对120例消化性溃疡患者均经中医辨证分型，并行胃镜检查，主要观察中医证型与溃疡分类、溃疡面积、溃疡色泽、黏膜状况、幽门螺旋杆菌感染的关系。结果消化性溃疡不同中医证型与胃镜下表现有一定的相关性。结论胃镜检查可作为望诊的延伸应用于临床，为中医辨证提供有力的客观化指标。     

病毒性肝炎西医诊断和中医证型关系的探讨

目的 探讨病毒性肝炎西医诊断与中医证型的关系.方法 分析552例病毒性肝炎患者疾病不同临床类型、慢性肝炎不同临床分度、重型肝炎不同临床分期与中医证型的关系.结果 急性、慢性肝炎组中医证型均以肝胆湿热证为主,其次是肝郁脾虚证和肝络瘀阻证;慢性肝炎轻、中、重度组均以肝胆湿热证为主,但轻度组肝胆湿热证更多见;重型肝炎早期以肝...     

原发性高血压患者心血管功能与中医辨证关系的研究

目的 应用脉搏波检测技术探讨不同中医证型高血压病患者心血管功能的改变。方法 将100例高血压病患者按中医辨证分为肝火亢盛、阴虚阳亢、痰湿壅盛、阴阳两虚组，并将62例正常血压者设为对照组，应用XXG-E3型心血管功能检测仪分别检测各组心血管功能。结果 高血压病不同中医证型组之间心脏收缩功能、舒张功能、前后负荷、血液流变学指标及血管状态差异均无显著性（P〉0．05），左室后负荷肝火亢盛组明显高于对照组（P〈0．05），右室后负荷阴阳两虚组明显高于对照组（P〈0．05），血液流变学指标肝火亢盛、阴虚阳亢组明显高于对照组（P〈0．05），痰湿壅盛组的体重指数明显高于其他三型及对照组。结论 不同中医证型高血压病患者的心血管功能表现出一定的特征；（2）体重指数、脉压及脉压指数与中医辨证关系密切；（3）脉搏波检测技术作为临床心血管功能的检验手段之一，具有相当的应用价值。     

慢性萎缩性胃炎中医证型与血液流变学的关系

通过观察不同证型的慢性萎缩性胃炎（CAG）患者81例血液流变学变化程度及关系，探索运用微观辩证和宏观辩证相结合，来阐明CAG辩证分型的内在机理和提供可作为辅助诊断的客观定量化指标．并为CAG的辩证治疗提供客观依据。结果通过不同中医证型CAG患者与正常对照组血液流变学及各证型之间的血液流变学关系的比较，证明血液流变性与中医证型有一定的相关性，血液流变学的变化程度与不同证型的胃粘膜瘀血程度有一定的内在联系，因此血液流变学可作为CAG辩证分型的一个客观指标。     

慢性胃病脾胃湿热证研究进展

脾胃湿热证是中医重要证型之一,与胃肠疾病密切相关。胃脘痛的证型,历代认为主要是脾胃虚寒证,《素问·举痛论》所述诸痛病因,以寒邪最多,李东垣《脾胃论》更是脾胃虚寒论的代表著作,近代医家也多从脾胃虚寒论治,但也有主张胃热学说者。中医理论认为嗜食肥甘是导致湿热证候的重要因素之一,随着生活水平的提高,饮食结构的改变,慢性胃病湿热证在临床日显突出,慢性浅表性胃炎、活动性胃炎、糜烂性胃炎及溃疡病活动期的主要证型均表现为脾胃湿热证,现将有关慢性胃病脾胃湿热证的现代基础研究综述如下。1脾胃湿热证与Hp感染有关慢性胃病脾胃湿热…     

慢性萎缩性胃炎及癌前病变中医证型分布与胃镜下表现和病理改变的相关性研究

目的:研究慢性萎缩性胃炎(chronic atrophic gastritis, CAG)及CAG癌前病变中医证型分布,探讨中医证型与胃镜下表现及病理改变的相关性,为CAG及CAG癌前病变的诊疗提供客观依据。方法:采用回顾性研究方法,对牛兴东教授专家门诊收治的271例患者的病历资料进行总结分析,采用SPSS 22.0统计软件分析探讨发病情况及证型分布,采用logistic回归分析不同中医证型与胃镜下表现及病理表现的相关性。结果:271例患者中医证型分布占比由高到低依次为脾胃虚弱型、肝胃气滞型、脾胃湿热型、胃络瘀阻型、肝胃郁热型、胃阴不足型。在证型与病理变化的相关性分析中,肝胃气滞型以食管反流偏多,脾胃湿热型伴发糜烂者居多,胃络瘀阻型则多伴发异型增生,余证型与胃镜下表现及病理改变未见相关性。结论:CAG中医证型主要为脾胃虚弱型、肝胃气滞型等,其中肝胃气滞型、脾胃湿热型、胃络瘀阻型与胃镜下表现及病理表现存在相关性,可为中医辨证提供参考。临床中可通过中医宏观辨证与微观辨证相结合进行准确辨证,注重“调气活血解毒”,对于改善患者生活质量及截断病势、延缓恶化有积极意义。     

慢性萎缩性胃炎中医证型与血液流变学的关系

通过观察不同证型的慢性萎缩胃炎（ＣＡＧ）患者８１例血液流变学变化程度关系，探索运用微观辩证和宏观辩证相结合，来阐明ＣＡＧ辩证分型的内在机理和提供可作为辅助诊断的客观定量化指标，并为ＣＡＧ的辩证治疗提供客观依据。结果通过不同中医证型ＣＡＧ患者与正常对照组血液流谈学及各证型之间的血液流变学关系的比较，证明流变学性与中医证型有一定的相关性，血液流变学的变化程度与不同证的胃粘膜瘀血程度有一定的内在联系，因     

消化性溃疡与幽门螺杆菌感染关系的中西医结合研究

经过纤维胃镜检查的３６１０例病人中有７７８例为消化性溃疡病人。对其中４０１例消化性溃疡病人胃窦部粘膜作了幽门螺杆菌（ＨＰ）检测、ＨＰ阳性者为３５６例，阳性率为８６．６％。与同期检测胃炎组阳性率５５．１％相比明显为高，差异显著。ＨＰ被认为是慢性胃窦炎的主要病因，也是消化性溃疡的重要致病因素。根除ＨＰ可提高ＤＵ治愈率，降低ＤＵ复发。ＨＰ阳性率在中医证型中表现为非脾虚组明显高于脾虚组，其中以脾胃湿热组最高。     

溃疡病与ABO血型关系的探讨

溃疡病与ＡＢＯ血型关系的探讨安丘市白求恩医院（２６２１００）王守义济南市第二人民医院刘斌为探索溃疡病与ＡＢＯ血型的关系，我们对４０６例溃疡病患者的ＡＢＯ血型进行了统计分析，报告如下。资料和方法：溃疡病组４０６例，其中十二指肠溃疡３０４例，胃溃疡９５例...     

Ⅲ期胃癌患者术后中医证型分布特点及与全身炎症反应标志物的相关性研究

目的:探讨Ⅲ期胃癌患者术后中医证型分布特点及其与全身炎症反应标志物的相关性，为临床更全面的治疗提供依据。方法:随机选择2015年1月—2017年12月初治的182例术后Ⅲ期胃癌患者为研究对象，分析中医证型分布特点及其与临床特征的关系，患者均定期随访，采用受试者工作特征曲线(ROC)确定中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)的最佳截断值，分为高值组和低值组，分析中医证型与C-反应蛋白(CRP)、NLR、PLR、LMR的相关性。结果:(1)182例胃癌患者中医证型占比由高到低依次为胃阴亏虚证(27.5%)、脾肾阳虚证(20.8%)、肝气犯胃证(15.4%)、气血两亏证(14.3%)、痰瘀互结证(11.0%)、湿热内蕴证(11.0%);(2)不同中医证型间年龄分布差异有统计学意义(P<0.05),胃阴亏虚证和脾肾阳虚证患者>63岁(中位年龄)的占比高于其他4个证型；不同中医证型间性别差异有统计学意义(P<0.05),湿热内蕴证以男性居多，肝气犯胃证以女性为主；不同中医证型间T分期差异有统计学意义(P<0.0...     

消化性溃疡与局部体液免疫因子关系的研究

本文对30例消化性溃疡手术标本进行了常规HE及体液免疫因子IgA,IgG,IgA，IgE,Lys,C3的免疫组化染色。结果提示：溃疡病的发生及活动性与粘膜炎症有着密切关系，是重度炎症的结果；局部体液免疫反应可能是局部炎症和溃疡形成及演变的重要机制。因此，对于溃疡病的治疗和复发的预防应立足于胃，十二指肠炎症的防治以及对炎症中免疫反应的调控。     

幽门螺杆菌感染根除与老年消化性溃疡发生、复发关系的研究

目的　探讨老年消化性溃疡发生、复发与幽门螺杆菌 (Hp)感染的关系。方法　应用 PCR法对 78例老年性消化性溃疡幽门螺杆菌感染及幽门螺杆菌感染根除治疗后半年、 1年幽门螺杆菌再感染者进行了测定。结果　幽门螺杆菌检出率老年组明显高于青年组 ,Hp根治率青年组明显高于老年组 ,经 Hp根除治疗组溃疡愈合率明显高于未根除治疗组。结论　老年消化性溃疡发生与幽门螺杆菌感染密切相关 ,在溃疡治疗中 ,根除 Hp感染对减少溃疡复发具有重要临床意义     

北京29所医院1999年度消化性溃疡患病情况分析

目的了解北京地区消化性溃疡的发病情况及变化特点。方法回顾性分析北京地区29所医院1999年胃镜检查消化性溃疡的临床资料,并与北京地区前两次统计结果及国内部分城市统计结果相比较。结果在64874例胃镜检查中,检出消化性溃疡8832例,检出率为13.61%。其中十二指肠溃疡6179例,占69.96%;胃溃疡2058例,占23.30%;其他溃疡(包括复合溃疡和吻合口溃疡)595例,占6.74%。三级医院消化性溃疡检出率为13.16%,二级医院为19.11%(P<0.01)。城区医院消化性溃疡检出率13.23%,近郊区医院为13.55%,远郊区医院为20.59%(与前两者相比,P<0.01)。北京市市民消化性溃疡检出率为13.83%,外地来京人口为11.62%(P<0.01)。结论(1)北京地区消化性溃疡患病率呈逐渐下降趋势,特别是十二指肠溃疡,但十二指肠溃疡患者仍明显多于胃溃疡。(2)与国内其他地区相比,北京地区消化性溃疡的发病率低于南方大城市,而高于东北和西北地区;提示自北向南消化性溃疡的发病率呈逐渐升高趋势。     

Gastric ulcer and stomach aging: pathophysiology and clinical implications

138 consecutive patients with endoscopically and histologically confirmed benign gastric ulcer were investigated in order to evaluate the relationship between aging and parameters relating to gastric ulcer pathophysiology and natural history: prevalence in dyspeptic patients referred to an endoscopic unit, recurrences, gastric acid secretory capacity, peptic activity, incidence of precancerous and neoplastic changes. On the basis of our results, different populations of gastric ulcer patients seem to be identifiable: (1) young patients (aged under 40), with low prevalence and recurrence rates, with acid capacity above normal range, high peptic activity and no risk for precancerous or neoplastic changes, (2) middleaged subjects (41-50), with high prevalence and recurrence rates, high peptic activity and acid activity within the normal range, atrophic gastritis, intestinal metaplasia, dysplasia and low incidence of cancer, and (3) elderly patients (aged over 50), with lower prevalence and recurrence rates, frequent association with chronic atrophic gastritis, impaired acid and peptic secretion, in whom one may observe either an association of the ulceration with cancer or evolution of dysplasia into neoplasia. These observations confirm that elderly and middle-aged gastric ulcer patients should undergo routine follow-up, and that pathophysiological data should be taken into account before deciding upon antiulcer therapy.     

Acid secretion and gastric surgery

It was long believed that there were major differences in the pathophysiology between the three major categories of peptic ulcers. The unifying feature was that all peptic ulcers occurred in a mucosal compartment exposed to acid-pepsin secretions. All ulcers tended to heal more rapidly when acid secretion was more readily neutralized or inhibited. Decreased local resistance was considered to be present in primarily acute and chronic gastric ulcer. Surgery for peptic ulcer intended to reduce acid secretion, which also resulted in a diminished pepsin enzyme activity. The corresponding reduction could be accomplished either by gastric resection, different vagotomies or a combination of resections and vagotomies. Most of the procedures were basically abandoned at the time of introduction of modern medical therapeutic strategies. For duodenal ulcer and prepyloric ulcer diseases, various vagotomies were generally recommended or combined with antrectomy. Partial gastrectomy or antrectomy with gastroduodenostomy was the standard procedure for treatment of type 1 gastric ulcer. The great caveat associated with surgical procedures for elective treatment of uncomplicated peptic ulcer disease is confined to operative mortality, postoperative morbidity, and late postoperative metabolic sequelae. The only remaining indication today of remedial gastric surgery for peptic ulcer disease is when there is a defined risk for gastric cancer in an unhealed gastric ulcer and very seldom in a case with recurrent or therapy-resistant peripyloric ulcer.     

Smoking and mortality from peptic ulcer in the United Kingdom.

The present paper compares the temporal changes of cigarette consumption with those of peptic ulcer mortality in the United Kingdom. Cumulative cigarette consumption increased in men born between 1845 and 1915 and remained constant or decreased in all subsequent generations. It increased in women born between 1835 and 1955. In contrast, both male and female mortality from gastric and duodenal ulcer were highest in those born around 1875-1885. From the lack of coincidence in the trends of peptic ulcer mortality and cumulative cigarette consumption it is concluded that changing smoking habits were not responsible for the birth cohort patterns of the death rates from gastric and duodenal ulcer.     

Hypoglycemia following partial gastrectomy

Summary 1. One hundred and twenty-two patients were seen who had had a gastric resection for peptic ulcer.2. Fifty of these had an oral or intravenous glucose tolerance test, and the results were compared with those in controls and in patients with a peptic ulcer or gastroenterostomy. Hypoglycemia was not an immediate effect of the operation but was due to secondary changes in carbohydrate metabolism.3. The results of these investigations have been discussed in relation to previous findings in the literature. A possible relationship to a disorder of the adrenal cortex was considered. More direct evidence is required before such a relationship between post-gastrectomy hypoglycemia and the adrenal cortex can be justified.     

Gastric angiogenesis and Helicobacter pylori infection.

The formation of new blood vessels seen in conditions commonly associated with Helicobacter pylori (H. pylori) infection, including gastritis, peptic ulcer, and gastric carcinoma, prompts consideration of a potential relationship between mucosal colonization by this organism and the angiogenic process. H. pylori directly or indirectly damages endothelial cells, which induces a number of changes in the microvasculature of the gastric mucosa. In H. pylori-associated conditions, that is, in gastritis, peptic ulcer and gastric carcinoma, there is an increased concentration of angiogenic factors, and subsequently a formation of new blood vessels. However, this early angiogenesis -which is activated to repair the gastric mucosa- is subsequently inhibited in patients with peptic ulcer, and ulcer healing is thus delayed. This may be due to the antiproliferative action of this organism on endothelial cells. While the angiogenic process becomes inhibited in infected patients with peptic ulcer, it remains seemingly active in those with gastritis or gastric cancer. This fact is in support of the notion suggested by various studies that peptic ulcer and gastric cancer are mutually excluding conditions. In the case of gastric cancer, neoangiogenesis would enhance nutrient and oxygen supply to cancer cells, and thus tumor growth and metastatic spread.     

消化性溃疡患者主观睡眠质量及其与心身状况相关分析

目的 探讨消化性溃疡患者的主观睡眠质量与心身状况以及二者之间的相关性.方法 采用匹茨馒睡眠质量指数馈表(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)和症状自评量表(SCL-90)对60例消化性溃疡患者及60例正常对照组进行调查,并通过相关分析探讨消化性溃疡患者主观睡眠质量和心身状况之间的关系.结果 患者组与对照组在各项量表分的差异均有统计学意义(P＜0.05).消化性溃疡患者的PSQI与SAS、SDS、SCL-90之间呈正相关关系(P＜0.05).结论 消化性溃疡患者主观睡眠质量较差,并存在与精神症状相关的睡眠障碍.     

浙江汉族人群Toll样受体4基因多态性与幽门螺杆菌相关消化性溃疡的关系

背景：幽门螺杆菌（H.pylori）感染是消化性溃疡的主要病因,然而其致病性存在个体差异,可能与宿主遗传易感性和先天性免疫机制有关。Toll样受体（TLR）在机体的先天性抗感染免疫中起重要作用。目的：探讨浙江汉族人群TLR4基因Asp299Gly多态性与H.pylori相关消化性溃疡的关系。方法：以聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法检测118例浙江汉族消化性溃疡患者和210名健康对照者的TLR4基因Asp299Gly等位基因和基因型;行快速尿素酶试验和血清H.pyloriIgG检测判断H.pylori感染情况。结果：本组浙江汉族人群TLR4基因Asp299Gly均为AA纯合子基因型,未见突变基因型AG和GG。消化性溃疡组H.pylori感染率为94.9%,显著高于正常对照组的62.4%（P=0.000）;两组Asp299Gly基因型频率差异无统计学意义。结论：浙江汉族人群TLR4基因Asp299Gly多态性与H.pylori相关消化性溃疡无相关性。