| ObjectiveWe chose reflux esophagitis as the pointcut of the research, referencing to the method of evidence-based medicine (EBM) and advanced mathematical and statistical models, to probe into distribution characteristics of TCM syndromes and syndrome factors of the disease. On this basis,we drew up reflux esophagitis syndrome factor diagnose scale. With the help of the scale,we discussed the correlation relationship of the endoscopic grading of esophageal, psycho-mental factors, and HP infection with syndrome key factors of RE.All of the researches were to acquaint this disease of TCM more,to objectify and standardize the TCM differentiation types more.It would contribute to differentiation standard of RE of TCM.then would supply guidance in clinic prevention and treatment of this disease.Method1Literature studyAn extensive search including CBM.CNKI.Wanfang and VIP databases was performed up to September2011for literatures about reflux esophagitis of TCM.to summarize and extract syndrome factors and the four diagnostic methods information of it.And we evaluated the literatures included.2Clinical researches were made up of three parts①200patients with reflux esophagitis were investigated, and factor analysis and complex network technique were used to study the distribution of Chinese syndromes and syndrome factors.②We drew up reflux esophagitis factor diagnose scale using the theory of scale.Many methods were used for item selection,such as discrete tendency,concentrated trend analysis(frequence distribution),factor analysis, complex network technique, complex system entropy and Chronbach’s α. Complex system entropy was used in extraction and classification of the items,and giving sores to items according to the contribution of the item to the syndrome. The critical diagnostic score was given through ROC curve.We evaluated the sensitivity, specificity and coincidence rate of the scale we had drawn up by diagnostic test.'pearman’s rank correlation coefficient and Kendall coefficient were used in analyzing the correlation relationship of the endoscopic grading of esophageal, psycho-mental factors, HP infection with syndrome factors of RE.Results1Literature study①37documents were included in this review of TCM syndromes of RE,3078cases were reported and26syndrome types were related to RE.most common syndrome types were stagnated heat of liver and stomach and incoordination between liver and stomach;the main location factors were stomach,liver and spleen;heat,qi stagnation,phlegm and dampness were the main excess factors;the frequency of yang deficiency and yin deficiency was higher in deficiency factors.②151documents were included in this review of distribution of four diagnostic methods information of RE.177four diagnostic methods information were reported after standardizing.And there were66of them which frequencies were more than5%. Among the four diagnostic methods information, the frequencies of heat syndromes and excess syndromes were higher than cold syndromes and deficiency syndromes.2Clinical researches①In the study of TCM syndromes and syndrome factors of RE,8syndrome factors were extracted by both factor analysis and complex network technique.The location factors were stomach,liver and spleen;the syndrome factors of the nature were heat,qi stagnation,phlegm and dampness, yang deficiency and qi deficiency.②We had drawn up reflux esophagitis factor diagnose scale which was made up of6syndrome subsets.There were9items in the qi stagnation syndrome subset.8items in the heat syndrome subset.4items in the phlegm and dampness syndrome subset.5items in the qi deficiency syndrome subset,2items in the yang deficiency syndrome subset.2items in the blood stasis syndrome subset. The syndrome subsets we had drawn up proved good value on diagnosis by the way of giving scores through ROC curve. The diagnostic tests of6syndrome subsets showed high sensitivity, specificity and coincidence rate.③In the200patients of RE,the relationship of many syndrome factors was extensive and complex. We found obvious positive correlations on the following syndrome factors:qi stagnation with phlegm and dampness, yang deficiency and qi deficiency. phlegm and dampness with qi stagnation. yang deficiency,qi deficiency and blood stasis, qi deficiency with qi stagnation, phlegm and dampness,yang deficiency and blood stasis.58patients of had no anxiety and depression,and142patients had anxiety or depeession.A obvious positive correlation between anxiety and depression, and a obvious negative correlation between heat syndrome and anxiety were found.HP infection had a obvious positive correlation with heat syndrome and qi deficiency;It could not think that HP infection had a obvious correlation with the endoscopic grading of esophageal, anxiety and depression.And It could not think that the endoscopic grading of esophageal had a obvious correlation with6syndrome factors,anxiety and depression.ConclusionIt seemed better to unveil the Chinese syndrome characteristics of RE.if we used a combination of statistical methods. Complex network technique was better on unveiling TCM syndrome characteristics than factor analysis. Complex system entropy had more advantages on the extraction and separation of four diagnostic methods information and syndrome factors than other two methods.Also, complex system entropy was good at drawing up scale. With the help of scale, combinating vary statistical methods to study TCM syndromes, syndrome diagnosis would be more rapid, standard and be able to copy. |
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