| Objective:To study on the relationship between the main distribution of Traditional Chinese Medicine (TCM) syndrome types and relative factors in patients with peptic ulcer bleeding (PUB) in Xiamen area. The epidemiological characteristics, clinical data of TCM syndrome types in PUB were explored to improve the therapeutic effects.Method:Using the clinical epidemiological method,327 cases with PUB who first seeked medical advice were selected as the research subjects to investigate the TCM syndrome types, specific symptoms, signs and related factors of them. All the data were analyzed by statistics.Results:1. In the observation cases, there were 112 cases of spleen deficiency with dampness heat and blood stasis syndrome,68 cases of weak spleen can not consolidation syndrome,41 cases of spleen and stomach dampness heat syndrome,34 cases of the liver-fire violate stomach syndrome,30 cases of accumulation of heat in stomach syndrome.27 cases of stomach meridian blood stasis syndrome,15 cases of deficiency of vital energy and blood exhaustion syndrome. There was a significant difference (P<0.05) between syndrome types. Syndrome types of spleen deficiency with dampness heat and blood stasis syndrome were significantly more than other syndromes (P<0.05).2. Male patients were significantly more than female patients(271 males and 56 females, P<0.05). There were age differences between TCM syndromes types (P<0.05), age of onset concentrated in the 16-29 years of age (P<0.05). But there were no gender and age differences between TCM syndromes types.3. The main symptom of each syndrome types are as follows:(1) spleen deficiency with dampness heat and blood stasis syndrome:melena, loose stools, thirst without desire to drink, spiritlessness and talking laziness, heavy cumbersome head and body, dark purple tongue, slimy yellow fur, thin slippery rapid pulse. (2) weak spleen can not consolidation syndrome: melena. loose stools, gastral cavity relief with pressure, spiritlessness and talking laziness, pale complexion, white or reddish tongue with tooth marks, thin white fur, thin pulse. (3) spleen and stomach dampness heat syndrome:melena, thirst without desire to drink, bitter taste, heavy cumbersome head and body, yellow urine, red tongue, slimy yellow fur, slippery rapid pulse. (4) liver-fire violate stomach syndrome:melena, vexation and irritability, yellow urine, thirst with desire to drink, bitter taste, gastrectasia, red tongue, thin or thick yellow fur, stringy rapid pulse. (5) accumulation of heat in stomach syndrome:melena, vomit bright red blood, thirst with desire to drink, bitter taste, gastral cavity burning pain and refuse pressure, yellow urine, red tongue, thin or thick yellow fur, slippery rapid pulse. (6) stomach meridian blood stasis syndrome:melena, thirst without desire to drink, gastral cavity stabbing pain and refuse pressure, pale complexion, aversion to cold and cold limbs, dark purple tongue with ecchymosis, thin white fur, thin pulse. (7) deficiency of vital energy and blood exhaustion syndrome:dark purple stools, pale complexion, dizziness, loose stools, oliguria, spiritlessness and talking laziness, white tongue, thin white fur, thin feeble pulse.4. The more obvious symptom of each syndrome types are as follows:(1) spleen deficiency with dampness heat and blood stasis syndrome:melena, spiritlessness and talking laziness, xerostomia and bitter taste. (2) weak spleen can not consolidation syndrome:melena, spiritlessness and talking laziness, pale complexion. (3) spleen and stomach dampness heat syndrome:gastrectasia, xerostomia and bitter taste. (4) liver-fire violate stomach syndrome: hematemesis, xerostomia and bitter taste, gastrectasia. (5) accumulation of heat in stomach syndrome:hematemesis, xerostomia and bitter taste. (6) stomach meridian blood stasis syndrome:melena, gastral cavity pain. (7) deficiency of vital energy and blood exhaustion syndrome:melena, hematemesis, palpitation, dizziness, pale complexion.5. PUB asthenia syndrome and asthenia-sthenia mixing syndrome is more serious than the sthenia syndrome.6. There were Hp infection differences between TCM syndromes types (P<0.05), which is mostly happened in spleen and stomach dampness heat syndrome and spleen deficiency with dampness heat and blood stasis syndrome.7. In terms of lifestyle factors, special hobbies of patients with PUB include eating disorders(56.88%), addicted to smoking(50.15%), overwork(49.54%), addicted to spicy food(48.32%), addicted to alcohol(47.40%), etc. The people who addicted to smoking and alcohol have the highest rates of spleen and stomach dampness heat syndrome and spleen deficiency with dampness heat and blood stasis syndrome(P<0.05). Eating disorders has the highest rates of weak spleen can not consolidation syndrome and deficiency of vital energy and blood exhaustion syndrome (P<0.05). Addicted to spicy food has the highest rates of spleen and stomach dampness heat syndrome and accumulation of heat in stomach syndrome(.P<0.05). Addicted to cold food has the highest rates of stomach meridian blood stasis syndrome(.P<0.05). Work strain and gloomy mood have the highest rates of liver-fire violate stomach syndrome(P<0.05).8. There were significant differences in educational background (P<0.05), which show up in junior college,university or higher education were significant more than others(.P<0.05). Occupation of onset concentrated was in professionals and the civil services(.P<0.05).Conclusion:1. Syndrome of spleen deficiency with dampness heat and blood stasis syndrome was dominant in PUB of TCM syndrome types, it shows that deficiency, heat, dampness and stasis was the main pathogenesis. According to the treatment should pay attention to tonifying spleen and clearing heat and damp elimination and removing blood stasis.2. The gender of PUB patients were significant more than male, while the age of onset were young people. But the distribution of TCM syndromes was not affected by gender and age. The people of male and young should pay more attention to prevent PUB.3. The main symptom of each syndrome types are as follows:(1) spleen deficiency with dampness heat and blood stasis syndrome:melena, loose stools, thirst without desire to drink, spiritlessness and talking laziness, heavy cumbersome head and body, dark purple tongue, slimy yellow fur, thin slippery rapid pulse. (2) weak spleen can not consolidation syndrome: melena, loose stools, gastral cavity relief with pressure, spiritlessness and talking laziness, pale complexion, white or reddish tongue with tooth marks, thin white fur. thin pulse. (3) spleen and stomach dampness heat syndrome:melena, thirst without desire to drink, bitter taste, heavy cumbersome head and body, yellow urine, red tongue, slimy yellow fur, slippery rapid pulse. (4) liver-fire violate stomach syndrome:melena, vexation and irritability, yellow urine, thirst with desire to drink, bitter taste, gastrectasia, red tongue, thin or thick yellow fur, stringy rapid pulse. (5) accumulation of heat in stomach syndrome:melena, vomit bright red blood, thirst with desire to drink, bitter taste, gastral cavity burning pain and refuse pressure, yellow urine, red tongue, thin or thick yellow fur, slippery rapid pulse. (6) stomach meridian blood stasis syndrome:melena, thirst without desire to drink, gastral cavity stabbing pain and refuse pressure, pale complexion, aversion to cold and cold limbs, dark purple tongue with ecchymosis, thin white fur, thin pulse. (7) deficiency of vital energy and blood exhaustion syndrome:dark purple stools, pale complexion, dizziness, loose stools, oliguria, spiritlessness and talking laziness, white tongue, thin white fur, thin feeble pulse.4. The more obvious symptom of each syndrome types are as follows:(1) spleen deficiency with dampness heat and blood stasis syndrome:melena, spiritlessness and talking laziness, xerostomia and bitter taste. (2) weak spleen can not consolidation syndrome:melena. spiritlessness and talking laziness, pale complexion. (3) spleen and stomach dampness heat syndrome:gastrectasia, xerostomia and bitter taste. (4) liver-fire violate stomach syndrome: hematemesis, xerostomia and bitter taste, gastrectasia. (5) accumulation of heat in stomach syndrome:hematemesis, xerostomia and bitter taste. (6) stomach meridian blood stasis syndrome:melena, gastral cavity pain. (7) deficiency of vital energy and blood exhaustion syndrome:melena, hematemesis, palpitation, dizziness, pale complexion.5. PUB asthenia syndrome and asthenia-sthenia mixing syndrome is more serious than the sthenia syndrome.6. Hp infection and pathological factors of damp heat were closely related, wicth easily lead to spleen and stomach dampness heat syndrome and spleen deficiency with dampness heat and blood stasis syndrome.Therefore the clinical anti Hp treatment in western medicine at the same time, can cooperate to take clearing heat and damp elimination Chinese medicine.7. In the treatment of patients with PUB guidance avoid improper regimen, eating and drinking without temperance, gloomy mood, over exertion and other factors to prevent the disease.8. Mental workers should actively prevent from PUB. |
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