Clinical Study On The Law Of TCM The Differentiation Of Syndromes And Differential Treatment Of Peptic Ulcer

Objective:To discuss the TCM syndrome classification, differentiation standards and laws syndromes of peptic ulcer; Evaluate the efficacy of TCM syndrome differentiation treatment of peptic ulcer.Methods:1. Literature study:Systematically study on ancient and modern literature of PU and to know its card-type distribution and research progress.2. Clinical epidemiological study:Using cluster random sampling method to collect appropriate sample size of PU patients at Jiangxi Province Chinese medicine hospital, for the clinical epidemiological investigation of TCM syndrome classification, differentiation standard and syndrome laws.3. Clinical Efficacy:198 cases which were diagnosed PU according to gastroscopy were randomly divided into A group, B group and C group. A group was the Chinese medicine differentiation treatment group, according to syndrome differentiation prescriptions were given different treatment; B group was the western medicine group, to give enteric-coated capsules of omeprazole treatment; C group was the Chinese and Western combined group, to give Chinese medicine differentiation treatment, at the same time give Omeprazole enteric-coated capsules treatment. Observe the patients with symptom score, syndromes of the efficacy, endoscopic efficacy and HP eradication rate before and after 6 weeks course of treatment. Results:1. Literature study:After general past studies of the related literature of PU, it is found that more types of differentiation syndromes, syndromes of the majority of scholars are based on experience to carry out the classification of the existing evidence-based diagnostic criteria for syndromes, mainly from some experts to discuss and collective research, Therefore, there is no differentiation of this disease in a standardized, unified not recognize its overall macro-distribution and evolution of the grasp is still not comprehensive enough.2. Clinical epidemiological study:(1) The syndromes of PU patients can be divided into five symptom syndromes groups according to the results of Variable clustering.(2) The statistically significant main symptoms for syndrome differentiation diagnosis can be drawn after the use of principal component analysis and multiple logistic regression analysis.(3) Syndromes distribution of PU can be drawn through factor analysis, the proportion of the order of syndromes is followed as the spleen and stomach deficiency cold syndrome, the liver and stomach qi stagnation syndrome, stagnant exuberant stomach heart syndrome, stomach yin deficiency syndrome and syndrome of stasis in the stomach collateral.(4) There was no significant difference on the distribution of 5 TCM syndromes at the respects of sex, age, alcohol consumption, smoking, eating fried Anopheles, Anopheles drinking strong tea, Anopheles thick and greasy food, dietary irregularities, climate factors, superficial gastritis, and atrophic gastritis (P> 0.05) (5) Pathogenesis, clinical classification, Anopheles spicy food, emotions upset, overworked, the merger of bile reflux, endoscopic staging, HP infection at 5 TCM Syndromes distribution there was a significant difference on statistical significance (P<0.01)3. Clinical Efficacy:(1) Clinical evaluation of gastroscopic, TCM Syndrome Evaluation:A better efficacy of the treatment of PU is found on each test groups. Traditional Chinese medicine group and western medicine group considerable effect, no significant differences in efficacy is found (P>0.05). Chinese and Western combined group was superior to traditional Chinese medicine group and western medicine group, there is significant difference (P<0.05)(2) Significant effects can be drawn from the Test of the 5 types of treatment programs for PU Syndromes., which combines Chinese and Western Group of the spleen and stomach deficiency cold syndrome, stomach yin deficiency syndrome, stagnant exuberant stomach heart syndrome, syndrome of stasis in the stomach collateral, the liver and stomach qi stagnation syndrome permit improvement was superior to traditional Chinese medicine and western medicine group (p<0.05). Test the treatment on the syndrome of stasis in the stomach collateral was no significant difference (p>0.05).(3) HP eradication rate evaluation:Tests of the treatment program have a better efficacy of the treatment of PU, Chinese medicine group HP eradication rate is 67.19%, western medicine group of HP eradication rate is 71.43%, Chinese and Western combined group for the HP eradication rate is 89.23%, Chinese and Western combined group HP eradication was significantly better than the Chinese medicine group and western medicine group (P<0.01); Chinese medicine group and western medicine group the eradication rate of HP is considerable.Conclusions:(1) According to the results of statistical analysis PU common syndrome type can be put into the following 5 categories:the spleen and stomach deficiency cold syndrome, the liver and stomach qi stagnation syndrome, syndrome of stasis in the stomach collateral, stagnant exuberant stomach heart syndrome, stomach yin deficiency syndrome.(2) Combining the results of previous studies, literature studies and the preliminary findings of clinical epidemiology, PU common 5 syndromes of differentiation standards can be initial set up.(3) Syndromes distribution can be drawn through factor analysis.(4) Statistical methods such as cluster analysis, principal component analysis, multiple logistic regression analysis and factor analysis are helpful in the studies on TCM Syndrome classification, differentiation standards and laws of syndrome.(5) Test of the treatment program has a better efficacy of the treatment of PU. Chinese medicine group and western medicine group effect considerable, Chinese and Western combined group have the best therapeutic effect.