Clinical Manifestations Of TCM Syndromes Distribution In Gastro-Esophageal Reflux Disease

Objective: The research aims to, through observation of clinical manifestations of different syndromes of Traditional Chinese Medicine in Gastro-Esophageal reflux Disease (GERD) , by means of modern statistics, explore the regularity of syndrome distribution, sum up the method of syndrome differentiation which is relatively objective and regular, and further analyze the correlation of GERD syndromes with disease course and gastroscopic manifestations, thus providing a foundation for syndrome differentiation and scientific research. Meanwhile, it aims to summarize common syndromes of GERD to lay a good foundation for better syndrome differentiation.Methods: On the basis of literature study, the data of patients' symptoms and signs are got through four diagnostic methods and data base is established by applying epidemiologic methods, descriptive statistics and Kruskal-Wallis are used for statistic purpose, and the regularity of syndrome is summed up as well as the relationship of syndromes with gender, age, disease course and gastroscopic presentation.Results: Among gathered 127 cases, None Erosive Reflux Disease(NERD) accounts for 40.2%, reflux Esophagitis (RE)for 55.1%, and Barrett's Esophagus(BE)for 4.7%; the syndromes can be categorized into six patterns, namely, disharmony between liver and stomach, heat accumulation in both liver and stomach, spleen-stomach deficiency type, spleen insufficiency and heat accumulation, obstruction of phlegm and qi and deficiency of stomach-yin. The syndromes of GERD have a bearing on age, disease course and gastroscopic manifestation. Disharmony between liver and stomach and heat accumulation in both liver and stomach have short disease course. The gastroscopic manifestation of heat accumulation in both liver and stomach and disharmony between liver and stomach is better than spleen insufficiency and heat accumulation and deficiency of stomach-yin.Conclusion:It is advisable to classify GERD into six syndromes which may cover a vast majority of clinical cases. Among these, heat accumulation in both liver and stomach, syndrome of heat accumulation in both liver and stomach and obstruction of phlegm and qi are the most common ones.GERD manifest frequently with excess syndrome, while syndrome of mixture and total insufficiency syndrome is rarely seen.Patients with short-term course mainly present in excess and heat syndrome, while deficiency syndrome is more occur in long-lasting course. In patients with positive endoscopic outcome, mild cases most likely present with excess syndrome, and severe ones with syndrome of mixed excess and deficiency in high frequency.