Clinical Investigation On Gastric Polyps Of TCM Physique

ObjectivesThe thesis is aim to introduce TCM Constitution Theory to the research of gastric polyp and make a survey of gastric polyps patients, to find out internal relation between human constitution and this disease, which justifies gastric polyp diagnosis, treatment and prevention.MethodOn the basis of "TCM physique classification and judgments self-test table", Gastric polyps TCM physique questionnaire is designed. The author employs Clinical Epidemiology survey research methods. Firstly, collect gastric polyps patients'stomachoscopy results and physique questionnaires. Second of all, evaluate and confirm patients'physical characteristics and classification according to certain standards. Thirdly, build database and apply Statistical Methods such as Descriptives, Chi-Square, Rank sum test and so on to analysis relation between human constitution distribution and gastric polyp.ResultThere were 3564 patients who had taken stomachoscopy in Guangdong hospital of TCM from Jun.2010 to Jan.2011,160 cases of which were diagnosed as gastric polyp, indicating that gastric polyp morbidity is 4.48%. In those 160 cases, there were 116 clinic patients (72.5%) and 44 inpatients (27.5%).1. Statistical analysis of Gastric polyps patients'general Information: There are 46 male cases(28.75%),114 female cases(71.25%) and the ratio is 1:2.48. Among these patients, the youngest one is only 16, and the oldest is 89, with an average of54.58±15.95 years old. There are 15 cases under the age of 30(9.4%),12 cases at the age of 30-39(7.5%),32 cases at the age of 40-49 (20.0%),42 cases at the age of 50-59 (26.3%),27 cases at the age of 60-69 (16.9%),23 cases at the age of 70-79 (14.4%) and 9 cases of 80 years(5.6%).2. Analysis of gastric polyp amount, location, size and shape according to stomachoscopy results:The growth amount of stomach polyps:104 sporadic cases (65%),56 multiple cases (35%). Location:54 cases of the fundus (33.8%), 50 cases of gastric body (25.0%),23 cases including two parts above (14.4 %),17 cases of gastric antrum (10.6%),9 cases of cardia(5.6%),5 cases of bottom body border (3.1%),1 case of stomach angle (0.6%),1 case of sinus body border(0.6%). Size:the minimum is 2mm, the maximum is 25mm and the average size is 4.98±3.06 mm, including 108 cases of 3mm-5mm polyps. Shape:81 cases of yamada I (50.6%),52 cases of yamadaII (32.5%),22 cases of yamadaIII(13.8%), 5 cases of yamadaIV (3.1%).3. The situation of gastric polyps patients infected with H pylori (helicobacter pylori):With the HPUT of 145 patients, there are 63 cases of HP negative(39.4%),16 cases of HP weak positive (10%),58 cases of HP positive(36.3%) and 8 cases of strong positive(5%).4 Cases similar of gastric polyps patients:94 cases of fund gland polyps (28.1%),45 cases of inflammatory polyps (28.1%),7 cases of hyperplastic polyps(4.4%),1 case of P-J polyps(0.6%).5. Therapies for gastric polyps patients:Out of 112 cases having microscopically treatment, including endoscopic direct removal by forceps in 64 cases(40%), argon plasma coagulation in 30 cases(18.8%), high frequency electric coagulation and cut method in 11 cases(6.9%) and compound treatment in 7 cases(4.4%).6. Distribution of gastric polyps patients'TCM physique:qi asthenia physique or with tendency to qi asthenia physique (39.4%), wetness-heat physique or with tendency to wetness-heat physique(18.8%), phlegm-dampness type or with tendency to phlegm-dampness type (14.20%), qi depression type or with tendency to qi depression type(13.1%), yin deficiency or with tendency to yin deficiency (8.1%), Yang deficiency or with tendency to yang deficiency (5%), blood stasis or with tendency to blood stasis(1.3%).7. Distribution difference of TCM physique is significant between the male and female patients. Qi asthenia or with tendency to qi asthenia and qi depression or with tendency to qi depression physique are frequently in female, while qi asthenia or with tendency to qi asthenia and wetness-heat or with tendency to wetness-heat physique are more frequently in male.8. Distribution difference of TCM physique is also significant at different age groups (P<0.01). Qi asthenia or with tendency to qi asthenia physique patients are mainly over 50 years old; qi depression or with tendency to qi depression physique are frequently in 40~49 age group; wetness-heat physique or with tendency to wetness-heat physique patients are mainly under 40 years old.9. There's no significant difference in gastric polyps patients'TCM physique between cases of different type, growth number, shape and the HP infection (P>0.05).Conclusion1. The detection rate of this disease is 4.48%, and the rate of female is higher than male. The usual age of onset is over 50.2. The study suggests:There are more sporadic cases when it comes to gastric polyps. Areas where gastric polyps grow:gastric fundus>gastric body > gastric antrum> cardia> bottom body border> sinus body border. Gastric polyp is common in size 3mm to 5mm. The shape of gastric polyps is mostly seen as yamadaⅠand yamadaⅡ. It suggests that most cases of this disease are types of fund gland polyps and inflammatory polyps according to the result of pathological examination taken by patients. The rate of HP positive and HP negative is close to 1:1 with patients who have taken HPUT. At present, main therapy for this disease is microscopically treatment about gastric polyps treatments mainly for endoscopic treatment, and the most common way is endoscopic direct removal by biopsy forceps, then is argon plasma coagulation or high frequency electric coagulation and cut method.3. Rules of the distribution of gastric polyps patients'TCM physique: Qi asthenia or with tendency to qi asthenia physique(39.4%)> wetness-heat physique or with tendency to wetness-heat physique(18.8%)> phlegm-dampness or with tendency to phlegm-dampness physique(14.4%)> qi depression or with tendency to qi depression physique(13.1%)> yin deficiency or with tendency to yin deficiency physique (8.1%)> Yang deficiency or with tendency to yang deficiency physique (5%)> blood stasis or with tendency to blood stasis(1.3%).It tells us gastric polyps patients'TCM physique is mostly the type of qi asthenia or with tendency to qi asthenia. 4. Gastric polyps patients of different gender and different age group are correlated with their type of TCM physique. Most of female patients have qi asthenia physique, or have tendency to qi asthenia physique; qi depression or have tendency to qi depression physique. And most of male patients have qi asthenia physique, or have tendency to qi asthenia physique; wetness-heat physique or have tendency to wetness-heat physique. Patients over the age of 50 mainly have qi asthenia physique or have tendency to qi asthenia and patients under the age of 40 mainly have wetness-heat physique or have tendency to wetness-heat physique.5. No association could be detected between gastric polyps patients'TCM physique and their type of polyps, growth number, shape and the HP infection.