Study On The Correlation Between TCM Syndrome Types Of Functional Dyspepsia And Duodenal Eosinophil

Objective:To investigate the distribution characteristics of TCM syndrome types in functional dyspepsia(FD),analyze the subtype characteristics,anxiety-depression characteristics and duodenal eosinophils(EOS)characteristics of different TCM syndrome types,and also explore the correlation between TCM syndrome types of FD and anxiety-depression and duodenal EOS,so as to provide reference for the TCM accurate diagnosis and treatment of FD.Methods:In this study,patients diagnosed with functional dyspepsia in the Department of Splenic and Gastrointestinal Diseases of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine from October 2021 to March 2023 were used as study subjects,and healthy checkups from the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine Physical Examination Center were used as healthy controls.Age,gender,subtypes,TCM identification information,Hamilton Anxiety Scales(HAMA),Hamilton Depression Scales(HAMD),gastroscopy and duodenal eosinophil pathology results were collected from FD patients and healthy controls,and the differences in clinical indicators among the TCM syndrome types and the correlations were compared.The differences of clinical indices between each TCM syndrome type and the correlation were analyzed.Results:(1)According to the inclusion criteria,126 patients with FD were included,with a minimum age of 19 years and a maximum age of 65 years and a mean age of 45.84 ±10.22 years,including 62 cases(49.21%)in the middle-aged group aged 45 to 59 years,53 cases(42.06%)in the young group aged 44 years and younger,and 11 cases(8.73%)in the elderly group aged 60 years and older.There were 47 cases(37.30%)in males and 79 cases(62.70%)in females,with a male to female ratio of 1:1.68 and more females than males.The 126 FD patients were typed in TCM,and the frequency from highest to lowest was liver-stomach disharmony(40 cases,31.70%),spleen deficiency and qi stagnation(34 cases,27.00%),spleen-stomach damp-heat(24 cases,19.00%),spleen-stomach deficiency-cold(16 cases,12.70%),and cold-heat mixed(12 cases,9.50%).126 FD patients had epigastric pain syndrome(EPS)in 47 cases(37.30%),postprandial distress syndrome(PDS)in 44 cases(34.92%)and EPS+PDS in 35 cases(27.78%).EPS was most common in patients with PDS and EPS+PDS overlapping with spleen deficiency and qi stagnation.(2)The mean HAMA score of 126 FD patients was 18.71±6.89,and the HAMA scores of each TCM syndrome type were,in descending order,liver-stomach disharmony group(24.08 ± 5.06)>spleen-deficiency qi-stagnation group(19.29±6.79)>cold-heat mismatch group(16.25 ± 5.38)>spleen-stomach damp-heat group(14.92 ± 4.47)>spleen-stomach deficiency-cold group(11.63±4.05).The difference in HAMA scores between different TCM syndrome types was statistically significant(P<0.01).The HAMA scores in the liver-stomach disharmony group were significantly higher than those in the spleen-deficiency qi-stagnation group,the spleen-stomach damp-heat group,the spleen-stomach deficiency-cold group and the cold-heat mismatch group(P<0.01),and the HAMA scores in the spleen-deficiency qi-stagnation group were significantly higher than those in the spleen-stomach damp-heat group and the spleen-stomach deficiency-cold group(P<0.01).The results of correlation analysis showed that liver-stomach disharmony and spleen-stomach damp-heat were positively correlated with HAMA score(correlation coefficient=0.411,correlation coefficient=0.600).(3)The mean HAMD score of 126 FD patients was 17.93±6.21,and the HAMD scores of each TCM syndrome type were,in descending order,liver-stomach disharmony group(21.38 ± 4.71)>spleen-deficiency qi-stagnation group(20.85 ± 4.89)>cold-heat mismatch group(18.42 ± 4.06)>spleen-stomach deficiency-cold group(12.25 ± 4.14)>spleen-stomach damp-heat group(11.58±4.58).The difference in HAMD scores between the different TCM syndrome types was statistically significant(P<0.01).The HAMD score in the liver-stomach disharmony group was significantly higher than that in the spleen-stomach damp-heat and spleen-stomach deficiency-cold groups(P<0.01),the HAMD score in the spleen-deficiency qi-stagnation group was significantly higher than that in the spleen-stomach damp-heat and spleen-stomach deficiency-cold groups(P<0.01),the HAMD score in the cold-heat mismatch group was significantly higher than that in the spleen-stomach damp-heat and spleen-stomach deficiency-cold groups(P<0.05).The results of correlation analysis showed that spleen-deficiency qi-stagnation and liver-stomach disharmony and cold-heat mismatch were positively correlated with HAMD scores(correlation coefficient=0.476,correlation coefficient=0.436,correlation coefficient=0.707).(4)The mean duodenal EOS count of 126 FD patients was 23.75 ± 6.49,and the EOS counts of each TCM syndrome type in descending order were spleen-stomach damp-heat group(27.04 ± 6.38)>liver-stomach disharmony group(24.85 ± 5.77)>cold-heat mismatch group(23.67 ± 6.14)>spleen-stomach deficiency-cold group(21.38 ± 7.21)>spleen-deficiency qi-stagnation group(21.26 ± 6.12).The difference in the number of EOS between the different TCM syndrome types was statistically significant(P<0.01).The number of EOS in the spleen-stomach damp-heat group was significantly higher than that in the spleen-deficiency qi-stagnation group and the spleen-stomach deficiency-cold group(P<0.01),and the number of EOS in the liver-stomach disharmony group was significantly higher than that in the spleen-deficiency qi-stagnation group(P<0.05).The results of correlation analysis showed that spleen-stomach damp-heat and liver-stomach disharmony were positively correlated with the number of duodenal EOS(correlation coefficient=0.585,correlation coefficient=0.467),and HAMA score was positively correlated with the number of duodenal EOS(correlation coefficient=0.677).Conclusions:(1)FD patients are predominantly middle-aged and female-dominated.(2)Among the different subtypes of FD,EPS accounted for the most,followed by PDS,and EPS+PDS accounted for the least,and EPS was most commonly associated with liver-stomach disharmony,while PDS and EPS+PDS overlapping patients were most commonly associated with spleen-deficiency qi-stagnation.(3)Among the different TCM syndrome types of FD,liver-stomach disharmony,spleen-deficiency qi-stagnation and spleen-stomach damp-heat were more common,and spleen-stomach deficiency-cold and cold-heat mismatch were less common.(4)Patients with FD are generally anxious and may be depressed,with differences among TCM syndrome types,and the degree of anxiety and depression is most severe in the case of liver-stomach disharmony.(5)The number of duodenal EOS was increased in FD patients,and there were differences among TCM syndrome types,with the most pronounced in the spleen-stomach damp-heat and liver-stomach disharmony.(6)There was a correlation between the anxiety-depression state,duodenal EOS level and some TCM syndrome types in FD.There was also a correlation between anxiety state and duodenal EOS level.The anxiety state was correlated with liver-stomach disharmony and spleen-stomach damp-heat;the depression state was correlated with spleen-deficiency qi-stagnation,liver-stomach disharmony and cold-heat mismatch;the duodenal EOS level was correlated with liver-stomach disharmony and spleen-stomach damp-heat.