Study On The Correlation Between TCM Syndromes And Pathology,Hexosamine,Epidermal Growth Factor And HP In Chronic Atrophic Gastritis

Objective:By collecting the clinical data of chronic atrophic gastritis(CAG)patients with traditional Chinese medicine and Western medicine,the correlation between TCM syndrome differentiation and pathology,hexosamine,epidermal growth factor(EGF),Helicobacter pylori(HP)was analyzed to assist TCM clinicians to conduct microcosmic analysis through advanced western medicine methods.TCM syndrome differentiation,in order to more accurately apply TCM to the treatment,slow down or reverse the process of chronic atrophic gastritis.Method:The patients diagnosed as CAG in the Department of integrated traditional Chinese and Western medicine,digestive outpatient department and inpatient department of Affiliated Hospital of Qinghai University were selected.Four diagnostic data of TCM syndromes,pathological and HP data of CAG patients were collected.The content of hexosamine was determined in each patient,and the epidermal growth factor was immunohistochemically stained in each case.Statistics and analysis of patients' general information,TCM syndrome differentiation and pathological correlation;correlation between TCM syndrome differentiation and hexosamine;correlation between TCM syndrome differentiation and epidermal growth factor;correlation between TCM syndrome differentiation and HP,and correlation between TCM syndrome differentiation and other related factors;correlation between TCM syndrome differentiation and gastroscopic performance.The results are summarized and discussed in depth.Result:1.A total of 112 cases of CAG were collected in this study.The ratio of male to female was 1.04:1.Age distribution: middle-aged patients(52.7%),elderly patients(36.6%)and young patients(10.7%).Ethnic distribution: Han 62.5%,Tibetan 20.5%,Hui 8.0%,Mongolian 3.6%,Salar 2.7%,Tu 2.7%.Improper diet accounted for 39.3% of the pathogenic factors.The detection rate of mucosal erosion,polyps and bile reflux under endoscopy was 59.8%,12.5% and 25.9%,respectively.2.The distribution of TCM syndromes is: 39 cases of spleen deficiency and qi stagnation(34.8%),36 cases of liver-stomach disharmony(32.1%),22 cases of Stomach-yin deficiency(19.6%)and 15 cases of qi deficiency and blood stasis(13.4%).3.Among the pathogenic factors,there was only significant difference between emotional factors and syndrome differentiation(P < 0.01).There was no significant difference between CAG with polyp,CAG with bile reflux,CAG with erosion under gastroscope and TCM syndromes(P > 0.05).4.The rank sum test showed that there was significant difference between TCM syndrome differentiation and intestinal metaplasia in 112 CAG patients(P=0.014,P<0.05).Among them,mild intestinal metaplasia accounted for 32.1%,moderate intestinal metaplasia 29.5%,and severe intestinal metaplasia 1.8%.Among the spleen deficiency and Qi stagnation syndrome group,46.2% had intestinal anaplasia,30.8% had mild intestinal metaplasia,23.1% had moderate intestinal metaplasia,27.3% had mild intestinal metaplasia,36.4% had mild intestinal metaplasia,31.8% had moderate intestinal metaplasia,4.5% had severe intestinal metaplasia,13.3% had no intestinal metaplasia,20.0% had mild intestinal metaplasia,66.7% had moderate intestinal metaplasia and 0% had severe intestinal metaplasia.5.The degree of atrophy in TCM syndrome differentiation and pathological manifestations of CAG patients was tested by rank sum test(P=0.263,P>0.05),suggesting that there was no significant difference.Among the gastric mucosal gland atrophy,53.6% was mild atrophy,42.9% was moderate atrophy,and 3.6% was severe atrophy.The proportion of mild atrophy in each syndrome type was liver-stomach disharmony group(63.9%),spleen deficiency and qi stagnation group(56.4%),stomach yin deficiency group(45.5%)and Qi deficiency and blood stasis group(33.3%).Moderate atrophy accounted for 66.7% in each syndrome type,50.0% in deficiency of Stomach-yin group,38.5% in deficiency of spleen-qi group,and 33.3% in disharmony between liver and stomach group.6.The TCM syndrome differentiation and the content of hexosamine in CAG patients were tested by rank sum test(P=0.047,P < 0.05),suggesting a significant difference.The contents of hexosamine were lower to higher in the order of insufficient stomach yin group,liver-stomach disharmony group,spleen deficiency and qi stagnation group,Qi deficiency and blood stasis group.7.There was no significant difference between TCM syndrome differentiation and epidermal growth factor expression in CAG patients by rank sum test(P = 0.376,P > 0.05).However,there is a certain degree of correlation between the distribution of TCM syndromes and EGF,the column connection number is 0.371,and its P value is 0.006.8.There was no significant difference between TCM syndrome differentiation and HP infection in CAG patients by Chi-square test(P=0.109,P > 0.05).The positive rate of HP infection was 53.6%.The proportion of HP infection in TCM syndromes was: Qi deficiency and blood stasis(80.0%),disharmony between liver and stomach(55.6%),spleen deficiency and qi stagnation(48.7%)and stomach yin deficiency(40.9%).Conclusion:1.Chronic atrophic gastritis patients are mostly middle-aged and elderly people,syndrome type is mainly spleen deficiency and Qi stagnation.2.There were significant differences between TCM syndrome differentiation and emotional factors,intestinal metaplasia of gastric mucosa and the content of hexosamine in patients with chronic atrophic gastritis.3.There was no significant difference between TCM syndrome differentiation and gastric mucosal atrophy,epidermal growth factor expression,HP infection and gastroscopic manifestations in patients with chronic atrophic gastritis.