Study On Syndrome Differentiation Of Gastroesophageal Reflux Disease Based On Tongue Diagnosis

Objective:This article mainly compares the TCM syndrome types of Gastroesophageal reflux disease based on TCM four diagnostic methods and Tongue diagnosis,and initially explores the reference value of tongue in the syndrome differentiation of Gastroesophageal reflux disease,and further analysis of gender,age,endoscopic findings and other factors and the relationship between the incidence and TCM syndrome type,in order to provide accurate reference for the clinical diagnosis of GERD and prescription medication.Methods:Read the literature,summarize the common syndromes and their clinical diagnostic criteria,and develop a personal information registration form(Including:personal information such as name,sex,and age,Gerd Q rating scale,gastroscopy diagnosis,HP infection status,clinical symptoms,tongue pulse and TCM syndrome type comparison table,etc.).Collecting the real information from the cases of gastroenterology clinics and wards that meet the diagnostic criteria from the hospital of Jiangsu Provincial Hospital,and obtaining tongue images and gastroscopy report,outpatients make clinical judgments based on TCM four diagnostic methods,and three other experienced Chinese medicine practitioners make a judgment of the same patient base on Tongue diagnosis.Each data was entered into the database,statistical analysis of the data using the SPSS21.0 system,and compared with the results of the syndrome type obtained from the two different dialectical criteria of the same patient,to analyze the reference value of tongue in the TCM syndrome differentiation of GERD.Results:From October 2016 to March 2018,140 cases of GERD diagnostic criteria are collected from the outpatient or spleen and gastroenterology department of the Jiangsu Provincial Hospital of Nanjing University of Traditional Chinese Medicine,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,including 77 males and 63 females.The oldest is 79 years old,and the youngest is 26 years old,with an average age of 49.78 ± 12.16.There are 22 cases diagnosed by Gerd Q scale and 118 cases diagnosed by endoscopy.There are 23 cases of endoscopic NERD,63 cases of grade A,28 cases of grade B,3 cases of BE,1 case of C,and no grade D.HP infection is negative in 79 cases and positive in 39 cases.The proportion of TCM syndromes in 140 patients from high to low is the syndrome of Qi deficiency and Qi reversal,Spleen dampness and heat syndrome,the syndrome of Qi depression and phlegm,the sydrome of stagnancy heat of the liver and stomach,the syndrome of disharmony between liver and stomach,the sydrome of insufficiency of stomach yin.By comparing the syndrome results of syndrome differentiation and tongue image differentiation obtained from the four diagnostic syndromes,the overall coincidence rate of the two syndromes is 89.3%.The coincidence rates of the two diagnostic methods for each syndrome is:the sydrome of insufficiency of stomach yin>the sydrome of stagnancy heat of the liver and stomach>Spleen dampness and heat syndrome>the syndrome of Qi deficiency and Qi reversal>the syndrome of Qi depression and phlegm>the syndrome of disharmony between liver and stomach,their coincidence rate is 100%,91.9%,91.2%,90.1%,88.5%,and 74.0%,respectively.Conclusions:1.The incidence of the disease is slightly higher in men than in women.There is no statistical difference between men and women.Occurs in middle-aged people and may be related to work and life stress.Negative Hp infection is higher than positive,with statistical significance,indicating that Hp infection may have protective effects on the esophagus.2.There is no significant difference in gender,age,endoscopic findings,and Hp infection among the TCM syndromes.3.The ratio of TCM syndromes of GERD in 140 patients is as follows:the syndrome of Qi deficiency and Qi reversal,Spleen dampness and heat syndrome,the syndrome of Qi depression and phlegm,the sydrome of stagnancy heat of the liver and stomach,the syndrome of disharmony between liver and stomach,the sydrome of insufficiency of stomach yin.There is no significant difference between Tongue syndrome differentiation and TCM four diagnostic methods.The coincidence rates of the two diagnostic methods for each syndrome are as follows:the sydrome of insufficiency of stomach yin>the sydrome of stagnancy heat of the liver and stomach>Spleen dampness and heat syndrome>the syndrome of Qi deficiency and Qi reversal>the syndrome of Qi depression and phlegm>the syndrome of disharmony between liver and stomach.The overall compliance rate is 89.3%,and the compliance rate for each type of certification is:100%,91.9%,91.2%,90.1%,88.5%,and 74.0%.From the results,we can see that the basic pathogenesis of the disease is weak coke,abnormal movements and rises.The main pathological factors are wetness,heat,phlegm,and gas.4.The reddish tongue and red tongue are more common in patients with GERD,and the greasy moss and thin moss are more common.The degree of tongue thickness in patients with spleen deficiency dampness and heat syndrome may be related to the degree of mucosal damage under endoscopy and the severity of subjective symptoms.In summary,tongue images have important reference value in GERD differentiation,and changes in tongue images can accurately reflect the nature of disease and progression of disease.