Study On The Correlation Between TCM Syndromes Distribution And Mental Psychology Of Gastroesophageal Reflux Disease

Background and objective:Gastroesophageal reflux diease(GERD) is a common chronic diease in alimentary system which is likely to relapse because of affecting by many factors. In recent years, the incidence of GERD increase constantly which has a great impact on the quality of life and mental status of the patients. Traditional Chinese Medicine(TCM) believes that GERD belongs to "Acid Regurgitation" "Noisy of stomach" "Esophageal pyretic abundance" and other areas. Its nature of disease is excessive syndrome,heat syndrome or intermingled deficiency and excess. Pathogenic heat,cold-evil, damp-evil, phlegm,blood stasis and other pathogen interact on each other causing liver Qi invading the stomach, disorder of movement of Qi,adverse rising of gastric Qi, then GERD will happen. A number of clinical studies at home and abroad has shown that the incidence of GERD is closely related to mental and psychological factors, which has influence on patients’dayly work and study. In this study, by collecting clinical cases,115 GERD patients are divided into five syndromes, according to the 2009 edition of Gastroesophageal reflux disease diagnosis and treatment of Traditional Chinese Medicine consense opinion. The ojective of this study is trying to fing out the GERD syndromes distribution characteristics, the psychological of GERD patients and the relationship between them.Methods:In this study, the research objects from digestive department outpatient service and ward of Beijing Universiy of traditional Chinese medicine DongZhiMen Hospital are in line with GERD diagnostic criteria and fill out the questionnaire, including general information, Gerd-Q scale, TCM symptoms scale, self-rating anxiety scale and self-rating depressive scale. Combined with the patients’tongue and pulse, they can be divided into stagnated heat in liver and stomach, gallbladder heat invading stomach syndrome, spleen-hypofunction and reverse qi syndrome, qi-phlegm stagnation syndrome, and obstruction of collaterals by blood stasis. All datum were analysed by SPSS20.0. Count data use Chi-squara test. Measurement data use the way of mean standard deviation and carry out normality test and homogeneity of variance test, if both are in, differences between the two groups use two independent sample T test; differences among groups use ANOVA analysis in analysis of variance. If do not meet the normal distribution, they ues non-parametric test.Results:① In 115 patients of the study,45 patients are male,70 patients are female, and the male to female ratio is 1:1.56. The age distribution is between 24-83 years old, the average age of onset is 50.95+14.06 years old. Incidence rate increases with age and the incidence rate of middle-aged people is higher than that of young and older people. BMI range between 17.156-36.738 and BMI above the normal range account for more than half of the total of 58 cases, accounting for 50.4%② In 115 cases of this research object, GERD of TCM syndrome type with stagnated heat in liver and stomach is the most, a total of 54 cases, accounting for 46.96%, the second order for gallbladder heat invading stomach syndrome(32cases), spleen-hypofunction and reverse qi syndrome(12 cases), qi-phlegm stagnation syndrome(11 cases), obstruction of collaterals by blood stasis is the least, a total of six cases, accounting for only 5.22%. There is no difference in gender and age stratification between TMC syndromes.(P>0.05).③ Between different TCM syndromes, Gerd-Q points have diffences. Among gallbladder heat invading stomach syndrome, spleen-hypofunction and reverse qi syndrome and obstruction of collaterals by blood stasis, the difference is statistically significant(P<0.05).,which suggests gallbladder heat invading stomach syndrome Gerd-Q points higher than other two syndromes and its symptoms are more obvious.④ SAS scores and SDS scores of GERD patients are significantly higher than normal people(P<0.05), which prompts psychological status of patients with GERD is poorer compared with normal domestic.⑤ The SAS and SDS scores of GERD patients have no relationship with gender and age-stratified.⑥ The differences between SAS/SDS scores of GERD patients and TCM syndromes are statistically significant(P<0.05), in which the SAS scores in stagnated heat in liver and stomach is higher than spleen-hypofunction and reverse qi syndrome and obstruction of collaterals by blood stasis; SAS scores of gallbladder heat invading stomach syndrome are higher than qi-phlegm stagnation syndrome and obstruction of collaterals by blood stasis. SDS scores of stagnated heat in liver and stomach syndrome and gallbladder heat invading stomach syndrome are higher than qi-phlegm stagnation syndrome and obstruction of collaterals by blood stasis.⑦ The TCM syndrome distribution has no relationship with the state of anxiety and depression.Conclusion:① GERD of TCM syndrome types are from more to less stagnated heat in liver and stomach, gallbladder heat invading stomach syndrome, spleen-hypofunction and reverse qi syndrome, qi-phlegm stagnation syndrome, and obstruction of collaterals by blood stasis.② Among different TCM syndromes, Gerd-Q points are different. The symptoms of gallbladder heat invading stomach syndrome are more obvious.③ SAS scores and SDS scores of GERD patients are significantly higher than normal people.④ The differences between SAS/SDS scores of GERD patients and TCM syndromes are statistically significant.The patients in stagnated heat in liver and stomach and gallbladder heat invading stomach syndrome are tend to more anxiety and depression.