慢性萎缩性胃炎6种证型胃镜像和病理学表现研究

目的 观察慢性萎缩性胃炎(CAG)6种证型胃镜像和病理学表现,探讨其与浊毒的相关性.方法　将入选的311例CAG患者辨证分为6个证型:浊毒内蕴证(62例)、肝胃不和证(84例)、脾胃虚弱证(37例)、脾胃湿热证(75例)、胃络瘀阻证(23例)、胃阴不足证(30例).由专职医师进行胃镜检查和组织活检,记录其内镜下形态学表现,比较不同证型胃镜像与病理学表现.结果　浊毒内蕴证与其他5种证型胃镜像比较差异均有统计学意义(P＜0.05)；与浊毒内蕴证比较,肝胃不和证、脾胃虚弱证、胃络瘀阻证病理学表现差异均有统计学意义(P＜0.05),脾胃湿热证、胃阴不足证病理学表现差异无统计学意义(P＞0.05).结论　CAG各证型在胃镜像形态学、病理组织学的变化存在着特异性,浊毒内蕴证在内镜下主要表现为隆起结节、糜烂、黏膜粗糙,病理多伴有肠上皮化生和(或)不典型增生.

Gastroscopy Images and Pathological Findings in Chronic Atrophic Gastrit is with Six Kinds of Chinese Medicine Syndrome

Objective To observe the gastroscopy images and patho logical findings i n chronic atrophic gastritis(CAG) with six kinds of Chinese medicine syndrome a nd analyze its relationship with turbidity-toxin.Methods Totally 311 CAG patien ts were divided into 6 kinds of Chinese medicine syndrome,i.e.62 cases of turb idity-toxin brewing internally syndrome,75 cases of spleen-stomach damp-heat sy ndrome,37 cases of spleen-stomach deficiency syndrome,84 cases of liver-stom ac h disharmony syndrome,23 cases of stasis obstructing the network vessels of the stomach syndrome and 30 cases of insufficiency of stomach yin syndrome.The gas troscopy images and pathological findings were recorded and analyzed with gastro scopy and biopsy.Results The differences between turbi dity-toxin brewing intern ally syndrome and other five syndromes in gastroscopy images were statistically significantly(P<0.05).Comparing with turbidity-toxin brewing internally syndro me,the pathological findings had statistical significance in liver-stomach dis h armony syndrome,spleen-stomach deficiency syndrome and stasis obstructing the n etwork vessels of the stomach syndrome(P<0.05).There was no significant d iffer ence in the pathological findings as comparing turbidity-toxin brewing internal l y syndrome with spleen-stomach damp-heat syndrome and insufficiency of stomach y in syndrome(P>0.05).Conclusion There exits speci ficity in Chinese medicine syn drome,gastroscopy image and pahtological findings in CAG.The main gastroscopy images of turbidity-toxin brewing internally syndrome are uplift nodules,erosi o n and rough mucosa,often accompanied with intestinal metaplasia and(or) dyspla sia in pathology.