Research On The Correlation Between Spleen-qi Deficiency Syndrome And T Cell Subsets In Chronic Atrophic Gastritis And Summary Of The Supervisor’s Experience

Purpose Organize and explore the clinical thinking pattern and medication experience of mentor Professor Li Zhenhua’s syndrome differentiation treatment of chronic atrophic gastritis(CAG)for the purpose of promotion;and to observe the changes of T lymphocyte subsets in patients with CAG spleen Qi deficiency syndrome before and after treatment with Shenqi granules,and compare with the healthy control group to explore the correlation between CAG spleen-qi deficiency syndrome and T lymphocyte subsetsMethods Collect and organize the complete medical records of chronic atrophic gastritis of the instructor’s outpatient records,and use the "ancient and modern medical case cloud platform" to conduct statistical analysis on the symptom,syndrome types,and prescription medications,and combined with the guidance of the instructor himself,to Summarize the experience of his thinking and selection of medicines of CAG;observe the distribution of T lymphocyte subsets before and after treatment with "Shenqi Granules" in patients with CAG spleen Qi deficiency syndrome,and compare it with healthy control group to discuss the crrelation between CAG spleen deficiency syndrome and body T lymphocyte subsetsResult1 The data mining and experience summary of Professor Li Zhenhua about the treatment of CAG.A total of 150 cases were included,and the syndrome types were spleen-deficiency dampness-heat syndrome(42 cases),spleen-gastric dampness-heat syndrome(22 cases),liver-stomach disharmony syndrome(20 cases),liver-gastric yin deficiency syndrome(20 cases),liver-stomach stagnation-heat syndrome(15 cases),spleen and stomach weakness syndrome(11 cases),liver spleen deficiency syndrome(10 cases),liver depression and spleen deficiency syndrome(9 cases);and the commonly used prescriptions:Ban-xia-xie-xin-tang,(36times),Zuo-jin-wan(36 times),Jin-ling-zi-san(48 times),Tong-xie-yao-fang(27times),S-in-san(26times),Bai-he-tang(24times),Yi-guan-jian(18 times),Xiang-su-san(16 times),Chai-hu-gui-zhi-tang(14 times),Hua-gan-jian(14 times),Xiao-chai-hu-tang(12 times),Huang-lian-wen-dan-tang(12 times).Chai-hu-gui-zhi-gan-j iang-tang(11times),Chai-hu-shu-gan-san(8times)and other prescriptions;total of 157 flavors are used,commonly used drugs are:Chai-hu,Bai-shao,Huang-qin,Zhi-gan-cao,Fa-ban-xia,Chao-bai-zhu,Huang-lian,Zhi-shi,Dang-shen,Da-zao,Chen-pi,Chuang-lian-zi,Yuan-hu,Gan-jiang,Fu-ling,Gui-zhi,Duan-mu-li,Wu-zhu-yu,Dang-gui,Xiang-fu,Bai-he,Wu-yao,etc;the main prescription of Spleen Deficiency Dampness and Heat Syndrome is Banxia Xiexin Decoction and Tongxie Yaofang;the main prescription of Spleen and stomach damp heat syndrome is Huanglian Wendan Soup;the main prescription of liver and stomach discordant syndrome is Chaihu Guizhi soup or Bupleurum Shugan powder,the main prescription of liver and stomach yin deficiency syndrome is Baihe decoction and Sini powder,the main prescription of liver and stomach stagnation heat syndrome is Huaganjian,Zuojinwan and Jinlingzi powder,the main prescription of spleen and stomach weakness syndrome is Xiangsha Liujunzi,the main prescription of Ganwang spleen deficiency syndrome is Chaihu Guizhiganjiang decoction and Zuojinwan,the main prescription of Ganyu spleen deficiency syndrome is Xiaoyao San and Danggui Shaoyao San or Chai Ling soup.2 Efficacy observation study about "Shenqi Granule" in the treatment of CAG with spleen-qi deficiency and its correlation with T lymphocyte subsets(1)The efficacy of "Shenqi Granule" in the treatment of CAG with spleen-qi deficiency syndrome:patients with CAG and spleen-qi deficiency syndrome after the treatment of"Shenqi Granule",quantitative score of Qi-deficiency syndrome,CAG disease symptom score,and the spleen-qi deficiency syndrome of CAG were significantly improved(P<0.05),of which the improvement of the quantitative scores of qi deficiency syndrome was mainly related to mental fatigue,fatigue,laziness,and the improvement of the symptoms of CAG disease symptoms was mainly related to discomfort and bloating after meal and middle and upper abdominal pain;the quantitative score improvement of CAG with spleen-qi deficiency syndrome is mainly related to fatigue and laziness and fatigue.(2)Distribution of T-lymphocyte subsets:The difference in Th1,Th2 cell levels and Th1/Th2 ratio between the treatment group before and after treatment and the healthy control group was statistically significant(P<0.05);the difference in Th1,Th2 cell levels and Th1/Th2 ratio between the treatment group before and after treatment was statistically significant(P<0.05);the difference in Th1,Th2 cell levels and Th1/Th2 ratio between the treatment group before treatment and the healthy control group was statistically significant(P<0.05);and there was no statistically significant difference in Th1,Th2 cell levels and Th1/Th2 ratio between the treatment group after treatment and the healthy control group(P>0.05).Conclusion1 Tutor Professor Li Zhenhua’s thinking model and experience in treating CAG(1)Pathogenesis and syndrome differentiation:The instructor believes that the diagnosis of CAG TCM is "gastric pain" and "gastric ruff" at most;the disease is located in the stomach and is related to the liver and spleen.,and Qi-deficiency as the basic pathogenesis throughout(2)Treating CAG from the spleen:the spleen and stomach are related,in the treatment,prescriptions with different effects such as tonifying spleen qi,tonifying spleen yang,and spleen qi are often selected according to the syndrome type.(3)Treating CAG from the liver divided into liver and stomach discordant syndrome,liver and stomach yin deficiency syndrome,liver and stomach stagnation syndrome,liver spleen deficiency syndrome and liver stagnation syndrome.Liver and stomach disharmony take Shu-gan-he-wei as a method;Liver and stomach stagnation syndrome take Qing-gan-xie-re as a method;Liver and stomach yin deficiency take Yang-yin-rou-gan as a method;Liver stagnation and spleen deficiency take Shu-gan-jian-pi as a method.(4)Treating CAG from dampness:divided into spleen deficiency dampness syndrome,spleen deficiency dampness syndrome and spleen stomach dampness syndrome.Spleen deficiency and dampness are based on Jian-pi-hua-shi;yang deficiency drinking is based on Wen-yang-li-shi;spleen and stomach are damp and heat is based on Qing-re-li-shi.(5)The complex syndrome type mainly takes one certificate and takes into account other certificates,and is often used by multiple parties.(6)Pay attention to the compatibility of drugs and symptomatic drugs.2 The correlation between CAG with spleen deficiency syndrome and T lymphocyte subsetsCompared with healthy people,patients with CAG and spleen-qi deficiency syndrome have increased Th1 cell levels,Th2 cell levels are reduced,and Th1/Th2 ratio is increased,indicating that CAG patients with spleen-qi deficiency syndrome have immune dysregulation of Th1/Th2 balance to Th1 drift.After treatment with "Shenqi Granule" for strengthening the spleen and qi,with the improvement of clinical symptoms,the level of Th1 cells decreased,the level of Th2 cells increased,the ratio of Thl/Th2 decreased,and the immune dysregulation state was improved.