| Gastroesophageal reflux disease is one of the most common gastrointestinal motility disorder The contents of the stomach, duodenum reflux into the esophagus, causing a series of reflux symptoms and complications of a group of diseases. Clinical manifestations contains acid reflux, heartburn, typical retrosternal burning, belching, nausea, cough, etc. The pathogenesis of GERD is complex, the present research shows that related brain gut axis dysfunction, but the relationship between different TCM syndrome type with brain gut peptides changes in plasma of patients with GERD, there is no related reports; therefore this study of patients with gastroesophageal reflux disease of traditional Chinese medicine, and carry out the epidemiological investigation, detection of GERD patients plasma brain gut peptide levels, to investigate the relationship between gastroesophageal reflux disease and the changes of brain gut peptide, and to explore the relationship between ghrelin levels and TCM patterns,constitution and the course of disease.In this study,178 cases of GERD patients as the research object, We use the clinical questionnaire survey of patients includes the general, the constitution of traditional Chinese medicine, diet, lying pillow, predisposing factors, course of disease. According to the National Bureau of Technical Supervision issued the "Traditional Chinese medicine new medicine clinical research guiding principle" the syndrome type of definition, cases by differentiation of symptoms and signs, divided into 5 syndromes:liver stomach heat syndrome,Gas exchange resistance syndrome, the stagnation of phlegm and blood stasis, deficiency syndrome of Qi, qi stagnation and blood stasis syndrome, At the same time,we detected the plasma brain gut peptide levels includes 5-HT, somatostatin, vasoactive intestinal peptide, Vasoactive intestinal peptide, endothelin, motilin.The results are as follows:1, GERD and record of formal schooling, occupation related:in 178 GERD patients,119 cases of lower than high school, accounted for 66.9%; 30 cases of high school education, accounting for 16.9%:university degree in 29 cases, accounting for 16.2%; GERD with manual workers mostly, accounted for 63.4%, significantly higher than mental workers, the difference was statistically significant (P< 0.05).2.GERD and lifestyle related:pillow height, whether long-term eating greasy food, smoking and drinking are related with GERD (P< 0.05);3. Endoscopic findings of GERD patients and course of disease related:178 cases of GERD patients,73 cases of patients with disease duration less than 1 years, accounted for 41%. The course of 1-5 in patients with 72 cases, accounting for 40.5%; 33 cases of patients with the history of more than 5 years, accounted for 18.5%; The history of more than 5 years of the NERD group was significantly higher than that of RE group, the difference was statistically significant (P< 0.05),4 Different TCM Syndrome Types and endoscopic findings:178 patients with GERD, liver stomach heat syndrome of RE group was significantly increased than NERD group, the difference was statistically significant (P< 0.05), the stagnation of phlegm and blood stasis> deficiency syndrome of Qi of NERD group were higher than that of group RE, the difference was statistically significant (P< 0.05).5.GERD patients have abnormal levels of multiple brain gut peptide. The level of VIP in plasma in patients with RE group was significantly higher than the control group, the difference was statistically significant(P< 0.05), the level of VIP in NERD group was significantly higher than that in the control group, the difference was statistically significant (P< 0.05);.6.The plasma MTL level in patients were associated with the course of disease:72 cases of GERD patients, the plasma MTL level in patients with disease duration> 5 years was significantly lower than the patients with disease duration< 1 years, the difference was statistically significant (P< 0.05).7.The plasma VIP level in patients was related with the MTL level and TCM syndrome types: the plasma VIP levels in patients with liver stomach heat syndrome were significantly higher than those in the deficiency syndrome of Qi, the difference was statistically significant (P< 0.05), the plasma MTL level in patients with qi stagnation and blood stasis syndrome was significantly higher than that in the exchange resistance syndrome, the stagnation of phlegm and blood stasis, deficiency syndrome of Qi,, the differences were statistically significant (P< 0.05),Conclusion The incidence of GERD is associated with occupation, education; and GERD is closely related to the way of life. The course of disease of NERD patients was longer; There is a significant association between plasma VIP, MTL changes and development of GERD.Liver stomach heat syndrome had the highest incidence in traditional Chinese medicine,easily lead to injury of esophageal mucosa. Plasma VIP, MTL level differences related to TCM syndrome type... |
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