| ObjectiveBy comparing with gastroesophageal reflux disease(GERD),to explore the characteristics of traditional Chinese medicine(TCM)syndrome distribution of refractory gastroesophageal reflux disease(RGERD),and to explore the relationship between the common factors and the type of syndrome.MethodThe object of study for gastroesophageal reflux disease(GERD),refractory gastroesophageal reflux disease(RGERD)patients,face-to-face interviews with the patients,are basic to the research object,four diagnostic methods,and view the results of gastroscope,the clinical data of patients were collected to determine the clinical syndrome of patients,statistical analysis,draw on the results and data analysis of age,gender,smoking,drinking,drinking coffee,drink carbonated drinks,tea,dietetic habits,Helicobacter pylori(Helicobacter pylori,Hp)and the incidence of the correlation,and explore the treatment of refractory gastroesophageal reflux disease(RGERD)TCM Syndrome Distribution characteristicsResults1 Clinical data:A total of 303 patients,including GERD165 cases,RGERD patients in 138 cases,145 cases of male patients,158 cases of women.The oldest 86 years old,the youngest 18 years old,the averageage of 52.5±11.60 years old.GERD patients with 165 cases,the average age of 50.28 ± 14.067.RGERD patients with 138 cases,the average age of 55.15 ±12.57.The shortest course of 1 month,the longest 50 years.2 syndromes distribution characteristics2.1 patients with syndromes distribution:a total of 303 patients received,of which 83 cases(27.4%)of liver and stomach weakness syndrome>liver and stomach heat syndrome in 76 cases(25.1%)>phlegm resistance syndrome in 59 cases(19.5%)>32 cases(10.6%)of blood stasis syndrome in 30 cases(9.9%)>23 cases(7.6%)of cold and heat syndrome.Chi-square test,P=0.00<0.05.Indicating that the TCM syndromes in the overall composition of the differences.2.2 GERD,RGERD syndromes distribution:a total of 165 cases of GERD patients,syndromes are as follows:50 cases of liver and stomach(30.3%)>liver and stomach heat syndrome in 45 cases(27.3%)>44 cases of phlegm(4.8)= qi deficiency and blood stasis syndrome in 8 cases(4.8%).(23.9%)>31 cases(22.5%)of liver and stomach heat syndrome(24 cases(17.4%))of qi deficiency and blood stasis syndrome in the patients with RGERD 20 cases(14.5%)of phlegm-dampness syndrome in 15 cases(10.9%)= cold and heat syndrome in 15 cases(10.9%).(P = 0.001);GERD<RGERD was statistically significant(P = 0.000<0.01);cold and heat syndrome(GERD)was statistically significant(P = 0.001<0.01)(P ?0.014<0.01).There was no significant difference between GERD and RGERD in other syndromes(P = 0.049<0.05).There was no significant difference between GERD and RGERD P>0.05).2.3 The relationship between sex and syndromes:the distribution of syndromes in male patients:45 cases(31.0%)of liver and stomach disorders,31 cases(21.4%)of liver and stomach heat syndrome,29 cases(20.0%)of phlegm-(10.3%)>14 cases(9.7%)of Qi deficiency and blood stasis syndrome(11 cases(7.6%)).(28.5%)>38 cases(24.1%)>30 cases(19.0%)of phlegm-dampness syndrome>18 cases of qi deficiency and blood stasis syndrome(11.4%)(9.5%)>cold and heat syndrome in 12 cases(7.6%).There was no significant difference between the sexes and the syndromes(P>0.05).2.4 Hp infection and the distribution of the syndrome type characteristics:Hp infection in 52 cases,accounting for 17.1%,105 cases of negative,accounting for 34.7%,146 cases were not investigated,accounting for 48.2%.(34.1%)>12 cases(23.1%)of phlegm-dampness syndrome(23.1%)>deficiency syndrome(7.7%)? 4 cases(7.7%)>qi deficiency and blood stasis syndrome(3.8%);Hp detection of negative syndrome type comparison:39 cases of liver and stomach syndrome(37.1%)>liver and stomach(23.8%)>16 cases(15.2%)of phlegm-dampness syndrome,12 cases(11.4%)of qi deficiency and blood stasis syndrome,8 cases(7.6%)of deficiency syndrome,5 cases(4.8%)of cold and heat syndrome.There was no significant difference between the syndromes and Hp infection(P>0.05).2.5 The relationship between season and morbidity:There were 53 cases(17.5)of the disease in the spring,including 31 cases of GERD(18.8)and RGERD(15.9);There were 63 patients(20.8)in the summer,including 35 patients with GERD(18.8)and 28 patients with RGERD(20.3);There were 79 cases(26.1)in the autumn,including 42 cases(25.5%)of GERD and 37 cases of RGERD(26.8);The incidence of winter in 60 cases(19.8),which GERD 34 cases(20.6),RGERD26 cases(18.8);There were 48 cases(15.8)of the patients all over the year,including 23 cases(13.9%)of GERD and 25 cases of RGERD(18.1).There was no statistically significant difference between the incidence and the seasonal difference,P>0.05.Indicating that the incidence of the disease and the season there is no significant correlation between.2.6The relationship between the factors and the incidence of induced specific distribution:no obvious cause(32.7%),dietary factors(30.4%),psychological factors(20.5%),climate change(9.6%),(4%)postural changes(2.6%)>>hard drugs(0.3%).In the pathogenesis of GERD and RGERD,induced by various factors the proportion of the overall consistent.Among them,no obvious inducement,GERD<RGERD;by dietary factors of the incidence of GERD is less than RGERD;by climate change of the incidence of GERD>RGERD;by fatigue factors Disease,GERD>RGERD;by mental factors of the incidence of GERD>RGERD;by drug factors of the incidence of GERD is less than RGERD;the position change of the incidence of GERD and RGERD;the differences were not statistically significant,P values were greater than that induced by 0.05.and GERD factors in the pathogenesis of RGERD no significant bias.2.7 risk factors:whether to frequent smoking,drinking,drinking tea,coffee,carbonated drinks as a strain,denying 1,accepted as 2,whether or not the disease as an independent variable,the binary logistic regression analysis,The deletion is 0.05 and 0.10 respectively.The results showed that smoking,drinking,coffee,carbonated beverages and tea were positively correlated with the incidence.2.8 The relationship between endoscopic grading and diagnosis:In GERD,LA-A grade 109 cases(66.1)>LA-B grade 32 cases(19.4)>no 23 cases(13.9)>LA-C grade 1 case(0.6)>LA(L),LA-A grade(47.8)>LA-B grade 40 cases(29.1)>LA-C grade 22 cases(15.9)>LA-D grade 9 cases(L)6.5)>does not show 1 case(0.7)cases.(P = 0.000<0.05).In the LA-C grade,the difference was statistically significant(P = 0.000<0.05).In the LA-D grade,the grade was statistically significant(P = 0.000<0.05)The difference was statistically significant(P =0.004<0.05).ConclusionsIn gastroesophageal reflux disease,syndrome of disharmony between liver and stomach,liver and stomach heat syndrome is a common syndrome;followed by phlegm.RGERD with cold and heat syndrome,and deficiency of inverse gas card.Predisposing factors of refractory gastroesophageal reflux disease is the most common diet careless,mental factors,climate change such occurs with smoking,drinking,drinking tea,coffee and carbonated beverages were correlated with the incidence,and the incidence of patients with hi spicy,sweet foods accounted for a higher proportion. |
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