The Correlation Analysis Between The Endoscopy Manifeston And The Syndrome Differentiation Of Traditional Chinese Medicine Of Peptic Ulcer Bleeding

ObjectivesTo discuss the Correlation between the endoscopy manifeston and the syndrome differentiation of Traditional Chinese Medicine of peptic ulcer bleeding, in the purpose of provide some Clinical theoretical support for the application of the combination of the syndrome differentiation of Traditional Chinese Medicine and endoscopy in the diagnosis of the peptic ulcer bleeding.MethodsCollated and retrospectively analyzed the clinical data of288patients who met the inclusion criteria and had been admitted to the Guangdong Provincial Hospital(Dade Road General Hospital, Er Sha and Fang Cun Branch included)from June2009to June2011. Filled out the observation forms, codes and clinical data entry, SPSS17.0application software for statistical analysis. The descriptive analysis method was used to calculate the frequency and composition; the variance and t-test methods were used for measurement data groups; count data groups were analyzed by using the chi-square test and Rank sum test. Bivariate correlation is used for the relationship between the various parameters. To investigate the correlation between the TCM Syndrome and the bleeding sites, the endoscopic staging, the Forrest classification, the bile reflux, the degree of bleeding, the Rockall classification and some predisposing factors (Hp infection, alcohol, smoking, fatigue), the correlation between the tongue image of TCM and the endoscopic staging, the Forrest classification, the degree of bleeding, the Rockall classification, and the distribution law of the disease in season, age and genderResult1. TCM syndrome distribution:By frequency in descending order:Heat Injuring Vascular, Qi and Blood Deficiency Syndrome(44.1%)>Heat Injuring Vascular Syndrome(26.5%)>Failure Of Qi to Control Blood Syndrome(24.3%)>Liver Fire Invading Stomach Syndrome (5.1%).2. Incidence:(1) The distribution law in season:winter (28.1%)>spring(25.3%)> autumn(24.4%)>summer(22.2%).(2) The distribution law in age:middle-aged(42.3%)> youth (37.6%)> oldly(20.1%).(3) The distribution law in gender:male(76.0%)>female(24.0%).(4) The bleeding sites:227cases of DU bleeding(78.8%),25cases of GU bleeding(8.7%),36cases of Complex Ulcer bleeding(12.5%).(5) The endoscopic staging:A1for221cases (76.8%), A2for67cases (23.2%).(6) The incidence of bile reflux:62cases of bile reflux(21.5%),226cases of non-bile reflux(78.5%).(7) The Forrest classification:5cases of Ⅰ a class (1.7%),48cases of Ⅰ b class (16.7%),19cases of Ⅱa class (6.6%),27cases of Ⅱb class (9.4%),32cases of Ⅱc class (11.1%),157cases of Ⅲ class (54.5%)(8) The degree of bleeding:238cases of low-grade(82.6%),44cases of middle-grade(15.2%),6cases of high-grade(2.1%).(9) The Rockall classification:106cases of low-grade(36.8%),150cases of middle-grade (52.1%),32cases of high-grade (11.1%).(10) The colour of tongue in TCM:26cases of light white(9.0%),58cases of light red(20.1%),185cases of red(64.2%),19cases of purple(6.6%).(11) The mossiness of tongue in TCM:24cases of thin and white(8.3%),52cases of thin and yellow(18.1%),28cases of thick and white(9.7%),148cases of thick and yellow(51.4%),36cases of little mossiness (12.5%).3. The instance of evocative factors:210cases of Hp infection(72.9%),66cases of overeating(22.9%),68cases of drinking(23.6%),159cases of fatigue(55.2%). 4. The correlative analysis of TCM syndrome:(1) The correlation between TCM syndrome and the bleeding sites, the endoscopic staging, the Forrest classification, the Rockall classification, and smoking rates had no statistical meaning (P>0.05)(2) The correlation between TCM syndrome and bile reflux:It had statistical meaning (X2=15.81, P=0.01, P<0.05), and the cases of Liver Fire Invading Stomach Syndrome had the most high ratio of bile reflux (60.0%).(3) The correlation between TCM syndrome and the degree of bleeding:It had statistical meaning (R=0.72, P=0.03, P<0.05), and the cases of the Failure Of Qi to Control Blood Syndrome had the highest degree of bleeding.(4) The correlation between TCM syndrome and drinking:It had statistical meaning (X2=22.94, P=0.01, P<0.05), and the cases of Liver Fire Invading Stomach Syndrome had the most high ratio of drinking.(5) The correlation between TCM syndrome and fatigue:It had statistical meaning (X2=19.16, P=0.01, P<0.05), and the cases of the Failure Of Qi to Control Blood Syndrome had the most high ratio of fatigue.5. The correlative analysis of the image of tongue in TCM:(1) The correlation between the color of tongue in TCM and endoscopic staging had no statistical meaning (R=-0.22, P=0.61, P>0.05)(2) The correlation between the color of tongue in TCM and Forrest classification had no statistical meaning (R=-0.32, P=0.44, P>0.05)(3) The correlation between the color of tongue in TCM and the degree of bleeding had statistical meaning (R=0.78, P=0.02, P<0.05), and cases of light white tongue had the highest degree of bleeding.(4) The correlation between the color of tongue in TCM and the Rockall classification had statistical meaning (R=0.63, P=0.04, P<0.05), and cases of light white tongue had the highest degree of Rockall classification.(5) The correlation between the mossiness of tongue in TCM and endoscopic staging, Forrest classification, the Rockall classification had no statistical meaning (all P>0.05)(6) The correlation between the mossiness of tongue in TCM and the degree of bleeding had statistical meaning (R=0.57, P=0.03, P<0.05), and cases with thick yellow mossiness had the highest degree of bleeding.Conc l us ion Peptic ulcer bleeding often take place in winter and spring. Most patients were youth and middle-aged, and male had bigger proportion than female. llp infection, alcohol, smoking and fatigue was important evocative factor. The cases of Liver Fire Invading Stomach Syndrome had the highest ratio of bile reflux. The cases of the Failure Of Qi to Control Blood Syndrome had the most high degree of bleeding. The cases of Liver Fire Invading Stomach Syndrome had the highest ratio of drinking. The cases of the Failure Of Qi to Control Blood Syndrome had the most high, ratio of fatigue. The cases of light white tongue had the highest degree of bleeding. The cases of light white tongue had the highest degree of Rockall classification. The cases with thick yellow mossiness had the highest degree of bleeding.