The Research On Distribution Regularity Of TCM Syndromes Of RE And The Correlations Between Syndromes And Endoscopic Characteristics

The regurgitation of contents of stomach and duodenum cause reflux esophagitis(RE).It leads to esophageal mucosa damaged and makes the esopbageal mucosa in the state of inflammation,erosion,ulcers and other diseases.The common symptoms are burning heart,pantothenic acid, retrosternal pain or difficulty swallowing.Reflux esophagitis, non-erosive gastroesophageal reflux and Barrett's esophagus are collectively known as gastroesophageal reflux disease.The cause of reflux esophagitis is considered to be a multi-factor role.It is believed that the breakdown of anti-reflux defense mechanism and the aggression of regurgitation contributed to the disease.It also can be caused by the infection of Helicobacter pylori(Hp),visceral hypersensitivity and psychological factors.In light of the clinical manifestations of the disease,RE belongs to the categories of "sour regurgitation","gastric distention","cardiac spasm" in traditional Chinese medicine(TCM).The traditional Chinese physicians already have generally understanding to RE,and they have already summaried many important experience of treatment of RE.But now there is not a unified standard about syndromes of RE in TCM.Purpose:Traditional Chinese medicine has a good curative effect to RE while there are some problems in modern medicine like having a long treatment cycle or easy to relapse.Now our country still lacks unified standards of diagnosis and syndromes of RE in TCM.So our research is based on the literature research and clinical observation,to find out some rules about the syndromes in TCM,and the correlations between syndromes and endoscopic characteristics.In this way,we can provide scientific basis for clinical diagnosis and treatment.Methods:Base on the literature research about syndromes of RE from the year 1997 to 2007,a survey questionnaire of syndromes in Chinese medicine for RE can be setup,we can find out some rules about the syndromes by clinical observation with the survey questionnaire for 108 patients,and we also can find out the correlations with the syndromes and endoscopic characteristics.Result:1.Literature research:There are 15 syndromes of RE in the literature research.The mainly ten syndromes and their distributions are:the syndrome of incoordination between the liver and stomach(37.64%),the syndrome of heat evil in the liver and stomach(17.63%),the syndrome of weakness of the spleen and stomach with heat and cold(7.66%),the syndrome of insufficiency of spleen-YANG(6.29%),the syndrome of weakness of the spleen and stomach(5.76%),the syndrome of splenogastric hygropyrexia (5.31%),the syndrome of combination of phlegm and heat(5.05%),the syndrome of stagnation of phlegm and QI(3.68%),the syndrome of asthenia of splenogastroyin(3.10%),the syndrome of obstruction of collaterals by blood stasis(1.77%).2.Clinical observation(1)In the incidence of gender there is no significant difference. Patients aged 40-50 account for the largest proportion.Patients aged 40-50 account for the second largest proportion.(2)There are 10 syndromes of RE in clinical observation.Their distributions are:the syndrome of incoordination between the liver and stomach(26.85%),the syndrome of heat evil in the liver and stomach(25.93%),the syndrome of splenogastric hygropyrexia(14.81%),the syndrome of weakness of the spleen and stomach with heat and cold (9.26%),the syndrome of weakness of the spleen and stomach(5.56%),the syndrome of stagnation of phlegm and QI(5.56%),the syndrome of insufficiency of spleen-YANG(4.63%),the syndrome of asthenia of splenogastroyin(2.78%),the syndrome of obstruction of collaterals by blood stasis(2.78%),the syndrome of combination of phlegm and heat (1.85%).(3)The most common symptoms of RE are:belching,sour regurgitation, bitter taste of mouth,burning feeling of the breast bone and so on.It reveals RE has close relationship with liver,spleen,and stomach.(4)The top three tongues are:the red tongues,the light red tongue and the light white tongue.The top three tongue coatings are:the light white tongue coating,the light yellow tongue coating and the yellowish greasy tongue coating.The top three pulses are:angry pulse,angry and frequent pulse and slippery and frequent pulse.It reveals RE has close relationship with stagnation of liver-QI and humid heat.(5)In the literature research and clinical observation,we found that the specific distribution of Syndromes have difference(P＜0.01).The distribution of sthenia syndrome,asthenia syndromea,the syndrome with asthenia and sthenia have no significant difference(P＞0.05).(6)The distributions of the syndromes have significant difference between all grade(A,B,C,D)in gastroscopy(P＜0.01).Grade A and B mainly include the syndrome of incoordination between the liver and stomach,the syndrome of heat evil in the liver and stomach,the syndrome of splenogastric hygropyrexia.Grade C mainly include the syndrome of insufficiency of spleen-YANG,the syndrome of weakness of the spleen and stomach,the syndrome of asthenia of splenogastroyin,the syndrome of obstruction of collaterals by blood stasis.Grade D only include the syndrome of syndrome of insufficiency of spleen-YANG,the syndrome of asthenia of splenogastroyin,the syndrome of obstruction of collaterals by blood stasis.Grade A and B maily include sthenia syndrome,Grade C and D maily include asthenia syndrome.Conclusion:1.The main syndromes in the literature research is the same with the result of clinical observation.But the specific distribution of some syndromes are different.The distribution regularity of syndromes of RE in clinical observation are:the syndrome of incoordination between the liver and stomach＞the syndrome of heat evil in the liver and stomach＞the syndrome of splenogastric hygropyrexia＞the syndrome of weakness of the spleen and stomach with heat and cold＞the syndrome of weakness of the spleen and stomach＞the syndrome of stagnation of phlegm and QI＞the syndrome of insufficiency of spleen-YANG＞the syndrome of asthenia of splenogastroyin＞the syndrome of obstruction of collaterals by blood stasis＞the syndrome of combination of phlegm and heat.2.The syndromes' distribution of RE are syndromes mainly in state of evil domination,the second are syndromes mainly in state of asthenia of healthy energy,the third are syndromes mainly in state of deficiency and excess with the same severity occurring at the same time.the syndrome of incoordination between the liver and Stomach and the syndrome of heat evil in the liver and stomach have the largest proportion.The most common symptoms of RE have close relationship with liver,spleen and stomach.The tongues and pulses about RE reveal the disease have close relationship with stagnation of liver-QI and humid heat.3.The rule of the syndromes' distribution of RE according to gastroscopy reveals how the disease occur and develop in TCM.At the early stage of disease,there are syndromes mainly in state of evil domination.At the development stage of tbe disease,there are syndromes mainly in state of deficiency and excess with the same severity occurring at the same time.With the further development of illness,there are syndromes mainly in state of asthenia of healthy energy.