反流性食管炎患者的中医证型分布规律

目的:研究本地区反流性食管炎中医证型的分布规律,为建立反流性食管炎的中医辨证分型、诊断及治疗提供客观、科学的依据。方法:以胃镜确诊的反流性食管炎患者为研究对象,采用临床流行病学调查问卷的方式,收集每位研究对象的中医症状、舌象、脉象等相关信息,再进行聚类分析,研究反流性食管炎的中医证型分布规律。结果:(1)反流性食管炎患者以男性为主;年龄40~60(47.77±13.04)岁;诱发因素主要是饮食;个人嗜好以吸烟、饮酒为主;病程多发于1 a以上为主;多为复发;多发于餐后。(2)经聚类分析发现反流性食管炎分为肝胃郁热证、肝热脾虚证、中虚气逆证、肝胃不和证4证,人数分布及比例依次为:65例、39.2%;39例、23.5%;33例、19.8%;29例、17.5%。(3)中医症状四诊信息得出:中医症状频数大于10次的症状有26项。烧心,反酸为其主要症状,病变部位涉及脏腑肝胆、脾胃、心、肾。结论:反流性食管炎患者以肝胃郁热证人数最多,其次为肝热脾虚证,再者为中虚气逆证,最后为肝胃不和证。症状以实热证为主。

The Study of Distribution Law of TCM Syndrome Types with Reflux Esophagitis

Objective:To study the distribution law of TCM syndromes of reflux esophagitis in this area,and to provide objective and scientific basis for the establishment of TCM syndrome differentiation,diagnosis and treatment of reflux esophagitis.Methods:The patients with reflux esophagitis diagnosed by gastroscopy were chosen as the research objects.With the clinical epidemiology questionnaire,each research object's TCM symptoms,tongue condition,pulse condition and other related information were collected.Then using clustering analysis,TCM syndrome type distribution law of reflux esophagitis distribution was studied.Results:①Reflux esophagitis often occured among males;age ranged from 40 to 60 (47.77 ± 13.04);the main triggering factor was mainly in the diet;personal habits included smoking and drinking;the course was often more than one year;the recurrence rate was high,and mainly occured after meals.②Cluster analysis has found that the reflux esophagitis is divided into syndrome of stagnated heat in liver and stomach,syndrome of liver heat and spleen deficiency,syndrome of middle jiao deficiency and aderse rising of qi,syndrome of disharmony between the liver and stomach.The distribution and proportion of people were as follows:65 cases,39.2％;39 cases,23.5％;33 cases,19.8％;29 cases,17.5c.③The four diagnostic information of TCM symptoms showed that there were 26 symptoms with frequency which was greater than 10 times.The main symptoms included heartburn,acid reflux.The lesions involved liver,gallbladder,spleen and stomach,heart and kidney.Conclusion:Patients with reflux esophagitis in syndrome of stagnated heat in liver and stomach have the largest number,followed by syndrome of liver heat and spleen deficiency,syndrome of middle jiao deficiency and adverse rising of qi,syndrome of disharmony between the liver and stomach successively.The symptoms were mainly manifested by sthenia heat syndrome.