The Study On Regulation Of TCM Type And Treatment In Duodenal Ulcer Disease In South Of Mountain Range

Onjective:According to the epidemiologic survey of the TCMtype of duodenal ulcer(DU) in south of mountain range(mainly in Guangdong)and the modern metadata technique,we research the regulation of the TCM(traditional Chinese medicine) type of DU,study its etiology and pathogenesis,sum up its medication characteristics of TCM treatment,so that provide evidence to determination of treatment,medication and scientific research in south of mountain range.Method:1.Literature ResearchAccording to the sumarize of research status and analysis of modern work, we found that,now though many doctors put forward their own views on the determination of treatment of DU,they have not yet concerd that the obvious geographical distribution in the etiology,pathogenesis,syndrome differentiation and treatment of DU.2.Clinic ResearchThrough questionnaire investigation,we analysed the distribution of syndrome of TCM from two kinds data:applyed retrospective studies methods to analysing the medical record(TMR)including out-patient clinic and hospital cases patients in the TCM hospital of Guangdong province during2004-2007.2, and applyed prospective studies methods to analysing the cases including out-patient clinic and hospital cases patients in the TCM hospital of Guangdong province during2007.3-2008.2.In the end,analysed and disposaled all the data through SPSS13.0 statistical package. Results:1.TMR retrospective studies1.1 Constituent of syndromes Total collected 75 cases.Among all these cases, the weakness of the spleen and stomach type(21 cases)occupied the most part, secondly were the splennic asthenia and moist heat type(16 cases),damp-heat in spleen type(12 cases),liver and stomach stagnated heat type(10 cases), incoordination between the liver and stomach type(8 cases),other syndromes such as sathenic yin of stomach type(3 cases),obstruction of collaterals by stasis blood type(4 cases)are less,all below 5%.1.2 Sthenia syndrome is at most(45.3%),asthenia syndrome is the next(32.0%), inclusion of asthenia and sthenia syndrome is the least one(21.3%).Damp-heat in spleen type is the principal type in sthenia.Weakness of the spleen and stomach type is the principal type in asthenia.Splennic asthenia and moist heat type is the principal type in the inclusion of asthenia and sthenia syndrome.1.3 TCM symptom-sign of DU have dependability to diversity of Hp infection settings,but not for gender,age and gastroscop period.The damp-heat in spleen type is the principal type in Hp positive.The weakness of the spleen and stomach type is the principal type in Hp negative.2.Prospective studies of clinical cases2.1 Constituent of syndromes Total collected 112 cases.Among all these cases, the splennic asthenia and moist heat type(34 cases)occupied the most part, secondly were the weakness of the spleen and stomach type(22 cases),damp-heat in spleen type(20 cases),liver and stomach stagnated heat type(16 cases), incoordination between the liver and stomach type(14 cases),other syndromes such as sathenic yin of stomach type(4 cases),obstruction of collaterals by stasis blood type(2 cases)are less,all below 5%.2.2 Sthenia syndrome is at most(46.8%),inclusion of asthenia and sthenia syndrome is the next(30.4%),asthenia syndrome is the least one(23.2%). Damp-heat in spleen type is the principal type in sthenia.Weakness of the spleen and stomach type is the principal type in asthenia.Splennic asthenia and moist heat type is the principal type in the inclusion of asthenia and sthenia.2.3 TCM symptom-sign of DU have dependability to age and diversity of Hp infection settings,but not for gender and gastroscop period.The patients of the weakness of the spleen and stomach type are older than the other type. The patients of the damp-heat in spleen type and the splennic asthenia and moist heat type are younger than the other type.The damp-heat in spleen type is the principal type in Hp positive.The weakness of the spleen and stomach type is the principal type in Hp negative.Conclusion:1.Constituent of syndromes The very common syndromes of DU in south area of mountains are profuse of the splennic asthenia and moist heat type,the weakness of the spleen and stomach type,damp-heat in spleen type,liver and stomach stagnated heat type,incoordination between the liver and stomach type. The base pathogenesis in.all these syndromes are weakness of the spleen and stomach,and damp-heat is the particular character of DU' s etiology and pathogenesis or pathological factors in south area of mountains.2.Constituent of the nature of the disease Sthenia syndrome is at most.The proportion of asthenia syndrome,inclusion of asthenia and sthenia syndrome are almost the same.Compared with the TMR retrospective studies,the proportion of asthenia syndrome is smaller in the prospective studies.It points out that,sthenia syndrome of DU is gradually increased with the climate change,improvement of living conditions and living habits change.3.The relation between TCMsymptom-sign and gender,age and gastroscop period, diversity of Hp infection settings TCM symptom-sign of DU have dependability to age and diversity of Hp infection settings,but not for gender and gastroscop period.The patients of the weakness of the spleen and stomach type are old. The patients of the damp-heat in spleen type and the splennic asthenia and moist heat type are young.The damp-heat in spleen type is the principal type in Hp positive.The weakness of the spleen and stomach type is the principal type in Hp negative.4.Treatment We should differentiation of syndromes and diseases together when diagnose and treat DU with TCM in clinical.We should also attention to treatment of the moist heat.We usually choose sijunzitang added other drugs to treat DU.Banxiaxiexintang is chose to treat the splennic asthenia and moist heat type.Sinisan added on houpu,foshou,muxiang,yujin,etc.is chose to treat liver and stomach stagnated heat type and incoordination between the liver and stomach type.For the common clinical symptoms,such as ructus,acid regurgitation,etc.we can adjust the fundamental treatment.Using local herb is also the particular character of DU' s treatment in south area of mountains.