Differences In The Distribution Of Syndrome Elements Based On Pathology In Chronic Atrophic Gastritis With Different Cancer Risks

ObjectiveChronic atrophic gastritis(CAG)is associated with the occurrence of gastric cancer(GC).TCM syndrome differentiation has advantages in identifying complex clinical syndromes.Therefore,this study is based on the operative link for gastritis assessment(OLGA)and operative link gastritis intestinal metaplasia assessment(OLGIM),combined with TCM syndrome differentiation,to explore different the distribution characteristics and differences of syndrome elements in chronic atrophic gastritis with cancer risk,in order to provide a certain supplement and reference for refining the diagnosis and treatment of chronic atrophic gastritis.MethodsA total of 138 patients with clinical symptoms diagnosed by gastroscope and pathology were collected.According to the OLGA and OLGIM criteria,the patients who both belonged to stages 0-II were classified into the low-risk group,and those who belonged to stages III and IV were classified into the high-risk group.There were 87 people in the low-risk group and 51 people in the high-risk group.In the form of face-to-face questionnaires,information such as gender,age,four diagnostic data,and related auxiliary examinations are collected,and input into the syndrome differentiation software(Traditional Chinese Medicine Health Status Identification and Consultation System),and the syndrome and element data are derived to obtain the overall disease nature of CAG patients,the distribution characteristics of disease location syndrome elements,and compare the disease location,disease syndrome element distribution characteristics and differences of low-risk group and high-risk group CAG patients.Results1.There are more males than females in this study,with a male-to-female ratio of 1.30:1.The age distribution is dominated by middle-aged and elderly people,and the young population is the least.There was no significant difference in age and gender composition between the high-risk group and the low-risk group(all P >0.05).2.138 cases of chronic atrophic gastritis(low-risk group and high-risk group)were mainly located in the stomach and spleen,involving liver,mind and gallbladder.Qi stagnation,yin deficiency,and qi deficiency can lead to pathological changes such as yang deficiency,phlegm stasis,stagnation of heat,food accumulation,and yang hyperactivity.3.Comparison of syndrome elements between the two groups: there were statistically significant differences in the distribution of syndrome elements in the spleen,gallbladder,large intestine,and kidney between the low-risk group and the high-risk group(all P<0.05),which were all risk factors for the occurrence of CAG of high-risk(all P <0.05,all OR >1).There were statistical differences between the low-risk group and the high-risk group in the distribution of disease-related syndromes of dampness,qi deficiency,phlegm,yang deficiency,and blood stasis(all P < 0.05),and phlegm and blood stasis were the risk factors for the occurrence of CAG of high-risk(all P < 0.05,all OR > 1).Conclusion1.The lesion site of chronic atrophic gastritis involves a wide range,and the disease is mixed with deficiency and excess.2.Low-risk and high-risk CAGs have common features in disease location and syndrome.3.The syndrome elements,spleen,kidney,gallbladder,and large intestine phlegm and blood stasis may aggravate the CAG cancer risk.