The Study On The Correlation Of The Infection Of Helicobacter Pylori In Recurrent Abdominal Pain And The TCM Symptomatology

Recurrent abdominal pain(RAP) is one of the commonest clinical symptoms in pediatric, and it is also difficult to diagnose and treat. The studies show that RAP is certainly correlated with the infection of Helicobacter pylori(HP). Eradication of the HP is followed by relief of clinical symptoms in RAP. Recent studies in TCM show that the diseases correlated with the infection of HP are certainly correlated with the TCM symptomatology. Herbal medicines is a dominant method to treat RAP patients, and has reached considerable results. But there is not generally accepted and unified types in differentiation of symptom-complex yet. Quite a few studies show that the infection of HP is correlated with the symptom types of epigastric pain, but there are few studies on the relationship between the infection of HP and the symptom types of RAP. So, it is no adequate accordance in the treatment according to syndrome differentiation yet.Objective:The purpose of this study is to consider the correlation of the infection of HP in RAP and the TCM symptomatology and to probe into the rule of the TCM symptomatology in RAP. It is hoped the results and conclusions can help to guide the clinical treatment according to syndrome differentiation in RAP.Thought and methods:1. Persons studied: We took 50 cases that troubled with RAP as study group. All cases were from out-patient clinic or hospital in No. 1 Hospital attached to Guangzhou University of TCM from Nov. 2006 to Mar. 2007. We took another 23 cases that had no abdominal pain signs as control group.2. We observed and analysed the clinic signs of RAP patients, and then differentiated into some symptom types according to syndrome differentiation.3. We tested the IgG and IgM antibodies of HP in blood from the patients by ELASA. The objective is to consider the correlation of the infection of HP in RAP and the correlated factors such as TCM symptomatology and to guide the clinical treatment according to syndrome differentiation in RAP. Results:1. The distinctive feature of RAP: There are 24 male(48%) and 26 female(52%) in 50 cases of study group. There is little difference between male and female. The mean age of the group is 8.13 years and concentrates on 5 to 8 years when they should go to school. In the group, 17 cases are affected with chronic shallow gastritis, and some are accompanied with reflux esophagis or reflux of bile. It means at least 1 in 3 of the patients trouble with organic diseases. The pain is chiefly on higher abdominal region and around the umbilicus, rarely on lower abdominal region. Genelally, the pain is to a less extent, mostly can go away by themselves in a short time, partly can relieve by drug-oils or drugs with spasmolytic action, and less patient need emergency treatment for sharp and persistent pain. But the degree of pain tends to serious, followed by prolonging course and recurrent condition of the disease.2. Distribution in TCM symptomatology: 50 cases of the group were falled into four types, 24 (48%) in piweishire type, 10(20%) in ganweibuhe type, 8(16%) in piweixuhan type, 8 (16%) in weiyinbuzu type. It shows that the patients in piweishire type is the most.3. The infection of HP in RAP and the correlation between it and TCM symptomatology: The positive rate of HP was 38% in 50 cases of study group, and 30.4% in 23 cases of control group that had no abdominal pain signs. Between the two groups, no significant difference exists in IgM antibody of HP, but a significant difference is seen in IgG antibody. It suggests parts of patients infected by HP don't show classic signs of RAP, especially in early infection they may not show the gastrointestinal symptoms such as abdominal pain or anorexia. Followed by prolonging course, IgG antibody of HP in blood may take the place of IgM antibody, and the frequency to show signs of RAP will be increased. In 50 cases of RAP patients, the positive rate of IgM antibody of HP showed no remarkable difference in TCM symptomatology. The sequence in the positive rate of IgG antibody of HP is as: piweishire type(54.3%)＞weiyinbuzu type(37.5%)＞piweixuhan type(12.5%)＞ganweibuhe type(10%). It shows a significant difference between piweishire type and ganweibuhe type or piweixuhan type, which suggests that the positive rate of IgG antibody of BP is peak in piweishire type. Along with it, piweishire type significantly affects the rate of the infection of HP in RAP patients, and may be the related dangerous factor. Other factors have no remarkable effect on RAP, such as sexual distinction, area, family history, position of pain, worsening agents and other types of TCM symptomatology.Conclusion:1. The distinctive feature of RAP: RAP is one of the commonest clinical symptoms in pediatric. It shows no significant difference in sexual distinction. Most RAP patients are trouble with organic diseases. The pain is chiefly on higher abdominal region and around the umbilicus, rarely on lower abdominal region. Genelally, the pain is to a less extent, mostly can go away by themselves in a short time, and less patient need emergency treatment for sharp and persistent pain. But the degree of pain tends to serious, followed by prolonging course and recurrent condition of the disease.2. Distribution in TCM symptomatology: In this group, the patients in piweishire type are the most, as 48%, and similar in other three types as ganweibuhe type, piweixuhan type and weiyinbuzu type.3. The infection of HP in RAP and the correlation between it and TCM symptomatology: The research shows that, between the study group and control group, no significant difference exists in IgM antibody of HP, but a significant difference is seen in IgG antibody. It suggests patients in early infection of HP don't necessarily show classic signs of RAP. Followed by prolonging course, the frequency to show signs of RAP will be increased. In TCM symptomatology of RAP, the positive rate of HP is peak in piweishire type, which suggestes the infection of HP is closely correlated with piweishire type.4. Clinic significance: The patients of RAP in piweishire type are the most, and the rate of infection of HP in this type is remarkably higher than other types. It is considered that HP exogenous evil attacks the body, obstructs the collaterals of zhongjiao, and causes dysfunction of the spleen in transportation and transformation and retention of body fluid, then heat results from depression. The retention of evil wetness-heat causes stagnation of vital energy, when results as recurrent abdominal pain. So in clinic, test of HP should be actively directed to piweishire type of RAP patients, as a guide in treating, and to enhance its effect.