小儿慢性胃炎辨证分型与内镜象及幽门螺杆菌感染的相关性研究

目的]探讨小儿慢性胃炎中医证型与胃黏膜改变及幽门螺杆菌感染之间的内在关系.方法]将符合入选条件的404例慢性胃炎患儿中医辨证分型后进行胃镜检查及尿素13C-呼气试验(13 C-UBT)检查,并登记造表,进行统计学处理.结果]肝胃不和型胃炎主要表现为胃黏膜充血和微小结节形成,脾胃湿热型胃炎表现以黏膜斑和黏膜糜烂为主,胃络瘀血型胃炎则以胃黏膜出现出血斑点为主,脾胃虚弱型胃炎以胃黏膜水肿为主,胃阴不足型胃炎以胃黏膜花斑为主.13 C-UBT阳性率实证高于虚证,与证型无相关性；13C-UBT值实证高于虚证,尤以肝胃不和型和脾胃湿热型为最高.结论]小儿慢性胃炎中医辨证分型与胃黏膜改变及幽门螺杆菌感染之间存在实质性联系,为辨证施治提供了理论基础.

Correlation study between the syndrome differentiation,endoscope image and Helicobacter pylori infection in children with chronic gastritis

Objective]To investigate the intrinsic relation between traditional Chinese medicine(TCM)syndrome,gastric mucosal changes and Helicobacter pylori infection in children with chronic gastritis.Methods]A total of 404 children with chronic gastritis were enrolled.After given TCM syndrome differentiation,they were taken gastroscopy and 13C-urea breath test(13C-UBT),then the registration form and statistical analysis were made.Results]The gastritis of in-coordination between liver and stomach mainly performanced as gastric hyperemia and small nodules,the gastritis of damp-heat of both spleen and stomach mainly performanced as mucosal plaques and mucosal erosion,the gastritis of blood stasis of stomach mainly performanced as bleeding spots in the gastric mucosa,the gastritis of insufficiency of spleen and stomach mainly performanced as gastric mucosa edema,and the gastritis of deficiency of stomach-yin mainly performanced as gastric mucosa piebald;for 13C-UBT-positive rate sthenia syndrome was much more than deficiency syndrome,which had no correlation with the syndrome;for 13C-UBT values,sthenia syndrome was much more than deficiency syndrome,the in-coordination between liver and stomach and damp-heat of both spleen and stomach was the main types among them.Conclusion]There is substantial correlation between the TCM syndrome,gastric mucosal changes and helicobacter pylori infection in children with chronic gastritis,which provides a theoretical basis for syndrome differentiation.