Study On The Relationship Between Traditional Chinese Medicine Syndromes Distribution In GERD And Esophageal Manometry Parameters

Objective: To investigate the distribution of TCM Syndromes of gastroesophageal reflux disease(GERD) and its influencing factors and to study the correlation of the dynamic parameters of each syndrome type based on the high resolution esophageal measurement technique(HRM).Methods: According to the GERD western medicine diagnostic criteria, 114 cases of GERD were divided into five groups, including cold-heat complicated syndrome group,stomach and liver heat syndrome group, hepatogastric disharmony syndrome group,stagnation of phlegm dampness syndrome group,deficiency and reversing of Qi syndrome group,by the deputy director or above it according to diagnostic criteria of TCM syndrome differentiation. And gather into the patient information, including gender, age, height, weight, helicobacter pylori(HP) infection.Then high resolution esophageal pressure measurement was performed to record and analyze the dynamic parameters of upper esophageal sphincter, esophageal body and lower esophageal sphincter.Result: 1.The distribution and influencing factors:In 114 patients with GERD, cold-heat complicated syndrome group is 39 cases(34.2%); stomach and liver heat syndrome group is 27 cases(23.7%); hepatogastric disharmony syndrome group is 21 cases(18.4%); stagnation of phlegm dampness syndrome group is 16 cases(14.0%);deficiency and reversing of Qi syndrome is 11 cases(9.6%). There was no statistical difference in the distribution of the syndrome types and the composition of Western Medicine(P >0.05). In epatogastric disharmony syndrome group and stomach and liver heat syndrome group, the incidence rate of male was higher than female, while in the remaining three groups, the incidence rate of female was higher than male. There was no significant difference in gender between the groups(P>0.05). The average age of onset of deficiency and reversing of Qi syndrome group(60.45±9.99) was higher than the other four groups(P<0.05). There was significant difference in age group between the groups(P>0.05)?And there were no significant differences in body mass index and HP infection rate among the groups(P >0.05). 2.Study on esophageal motility parameters:(1) UES dynamic parameters: In resting pressure of UES, stagnation of phlegm dampness syndrome group was lower than stomach and liver heat syndrome group and deficiency and reversing of Qi syndrome group(P<0.05). Different TCM Syndrome Types in UES length,UES residual pressure were not statistically different(P > 0.05).(2) LES dynamic parameters:In resting pressure of LES, deficiency and reversing of Qi syndrome and cold-heat complicated syndrome group was lower than stomach and liver heat syndrome group and stagnation of phlegm dampness syndrome group(P<0.05).Different TCM Syndrome Types in 4S IRP?LES length were not statistically different(P > 0.05).(3) Esophageal body dynamic parameters: In distant contraction index(DCI), stomach and liver heat syndrome group was higher than deficiency and reversing of Qi syndrome group and cold-heat complicated syndrome group.(P< 0.05). In the peristalsis interruption, deficiency and reversing of Qi syndrome group was higher than cold-heat complicated syndrome group.There were no statistical differences in the contraction front velocity(CFV), distal latency(DL)(P>0.05).(4) Ineffective contraction: The stagnation of phlegm dampness syndrome group was stronger in esophageal contraction than other four groups(P < 0.05).In the rate of ineffective contraction, stagnation of phlegm dampness syndrome group was lower than other four groups(P<0.05).(5)In the success rate of wet pharyngeal, stagnation of phlegm dampness syndrome group was higher than cold-heat complicated syndrome group,hepatogastric disharmony syndrome group and stomach and liver heat syndrome group?(P<0.05).The deficiency and reversing of Qi syndrome was lower than stomach and liver heat syndrome group,cold-heat complicated syndrome group and stagnation of phlegm dampness syndrome group(P<0.05).Conclusion: Cold-heat complicated syndrome is the most common GERD syndrome type, Followed by the stomach and liver heat syndrome,hepatogastric disharmony syndrome, stagnation of phlegm dampness syndrome,deficiency and reversing of Qi syndrome. Different syndrome types from GERD patients have a certain correlation with age, UES resting pressure, LES resting pressure,DCI, the proportion of ineffective contraction, esophageal contraction strength and success rate of wet pharyngeal.