| Objective: By collating and retrospectively analyzing the case data of peptic ulcer patients in our hospital in recent 5 years,to summarize the regularity of the disease and the distribution characteristics of syndromes,to study the internal relationship between microscopic endoscopy and macroscopic differentiation of TCM syndromes,to evaluate the curative effect,to explore the mechanism of improving the healing quality of ulcer by combining traditional Chinese and western medicine and to summarize the clinical experience,in order to provide certain guiding value for the prevention and intervention of peptic ulcer.Methods: Collected in our hospital from 2015 to 2020 of spleen and stomach department in hospital and clinic diagnosis of Chinese and western medicine treatment of peptic ulcer patients,according to include and exclude criteria to select the research object,the reference to the 2017 consensus "peptic ulcer combine traditional Chinese and western medicine diagnosis and treatment," the object of study is divided into seven card type,fill a report on the cases,information extraction generally,gastroscope and TCM syndrome,treatment and so on,to excel raw data management and description statistics,from the gender,age,season,risk factors and so on the research on the rules of the onset of the disease,summarize the syndrome distribution characteristics,curative effect evaluation,to explore the internal relationship between microscopic endoscopic images and macroscopic TCM syndromes,and to select typical cases from the aspects of improving the healing quality of ulcers by combining traditional Chinese and western medicine to summarize the experience and discuss the theory.Results:1.Gender and age distribution: Among 100 cases of PU,there were 69 males and 31 females,male: female ≈ 2.2:1.The overall age of the patients ranged from 18 to 81 years,with an average age of 50.36 years.The males ranged in age from 18 to 79 years,with an average age of 49.01 years.The female age range was 27-81 years old,with an average age of 53.35 years old.The average onset age of male was 4 years earlier than that of female.There was no statistical difference in the distribution of male and female in different age groups(P>0.05).2.Ulcers type and age distribution: The incidence rates of DU,GU and CU were 60%,34% and 6%,respectively,with a ratio of about 10:5.7:1.The age distribution of DU was as follows: young > old > Middle-aged;The age distribution of GU was:old > Middle-aged >young;CU age distribution: Middle-aged > old > young.There was significant difference in the population distribution of DU and GU(P<0.05),but there was no significant difference in the population distribution of CU and other ulcer types(P>0.05).3.The incidence of PU patients in different seasons was: spring(30.0%)> winter(27.0%)> summer(24.0%)> autumn(19.0%).The second half of spring(vernal equinox-grain rain)and the first half of winter(beginning of winter-heavy snow)are the peak,the first half of autumn(beginning of autumn-white dew)is the trough period.4.The frequency distribution of PU risk factors was: smoking(67.0%)> fast eating(59.0%)> drinking(51.0%)> irregular meals(45.0%)> anxious(39.0%)> NSAIDs(20.0%)> depression(12.0%)> tension(10.0%).5.The positive rate of HP was 58%,and the negative rate was 40%.The distribution of TCM syndrome types in 100 cases of PU was as follows: liver-stomach disharmony type >spleen and stomach qi deficiency type > deficient cold of spleen and stomach type > stasis blocking channels type > cold-heat jumble type > spleen-stomach damp-heat type > lack of stomach yin type.The positive rate of Hp was the highest in dampness-heat type of spleen and stomach and mixed cold-heat type,both of which were 80.0%.The positive rate of Hp in blood stasis type was the lowest,about 33.3%.There was no significant difference in the distribution of Hp infection among different syndromes(P>0.05).6.DU was more common in liver-stomach disharmony type and deficient cold of spleen and stomach type,while GU was more common in liver-stomach disharmony type and stasis blocking channels type.There was no statistical difference in the number of TCM syndrome types among different types of ulcers(P>0.05).Liver-stomach disharmony type were the most common in the active and healing stages,Spleen and stomach qi deficiency type and deficient cold of spleen and stomach type were the most common in the scar stage.There were significant differences in the distribution of TCM syndrome types in different ulcer stages(P<0.01).Ulceration white moss is commonly seen in liver-stomach disharmony type and deficient cold of spleen and stomach type,yellow moss is more commonly seen in liver-stomach disharmony type and spleen-stomach damp-heat type,no moss is more commonly seen in spleen and stomach qi deficiency type and deficient cold of spleen and stomach type,the distribution of TCM syndrome types of different base moss is very significant(P<0.01).Liver-stomach disharmony type mucosa more seen congestion,edema,bulge,red,slow peristalsis.Cold-heat jumble type and spleen-stomach damp-heat type mucosa erosion,bleeding,red obvious.Stasis blocking channels type see bleeding,color red,deformity more.Lack of stomach yin type mucosa color red,occasionally see uplift congestion.In the type of spleen and stomach qi deficiency,mucosal erosion,bleeding and eminence,red and white are common.The mucosa of deficient cold of spleen and stomach type is characterized by swelling,edema and whiteness,both of which are often accompanied by weakened peristalsis and deformity.There were significant differences in mucosal properties and color among different syndromes(P<0.01),and no significant differences in mucosal activity among different syndromes(P>0.05).7.The total effective rate of this disease was 97.0%.The obvious efficiency of DU was48.3% and the effective rate was 41.7%,while the obvious efficiency of GU was 67.6% and the effective rate was 26.5%.There were significant differences in significant efficiency and effective rate between the two(P<0.05).The cure rate and significant efficiency of CU were significantly lower than those of DU and GU(P<0.01).Conclusion:1.The male-to-female ratio of PU is 2.2:1.The average age of onset of PU in males is 4years earlier than that in females,showing a younger trend.DU:GU:CU=10:5.7:1.The high incidence of DU was found in young people,while GU was more common in middle-aged and elderly people.2.The incidence of PU is high in winter and spring,and lowest at the turn of summer and autumn.In the season of high incidence,attention should be paid to "cure the disease".Smoking is the most common risk factor of this disease.Anxiety is the most common emotional factor,and poor diet is also an important factor.3.Hp positive patients were more than negative patients.The most common type of PU was the disharmony between liver and stomach,followed by the deficiency of spleen and stomach qi and deficiency of spleen and stomach cold.The positive rate of HP was the highest in dampness-heat type and cold-heat mixed type,and the lowest in blood stasis and collateral-obstruction type.4.The TCM syndrome differentiation and classification of this disease has certain regularity with microscopic mirror features,and the combination of disease and syndrome can improve the curative effect.5.Gastric abscess disease is characterized by spleen deficiency and heat depression,and gastric collaterals block throughout.High healing rate,but easy to relapse.Clinical syndrome should be combined with TCM syndrome differentiation and microscopic disease differentiation.In the active stage,it mainly focuses on clearing away heat,clearing away turbidity and relieving depression,and adding the products of acid collecting sores and fixing pain to promote the selection of swelling and dissipation.During the healing period,the combination of tonifying and tonifying the liver,activating collaterals and invigorating the spleen can accelerate the healing of the selected surface and prevent lesions from deformities and stenosis.Scar stage is mainly to nourish qi and strengthen zheng,giving attention to promoting blood circulation and removing blood stasis,improving the healing quality of ulcer and reducing recurrence. |
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