Reflux Esophagitis And Bile Reflux Gastritis, Gastric Mirror Image Analysis And TCM Syndrome Type Research

Objective:To analyze the past gastroscopic data of patients with reflux esophagitis(RE)or bile reflux gastritis(BRG)for exploring the relationships between the gastroscopic characteristics and diseases,as well as the correlation between the attack time of both diseases and Wuyun Liuqi(five evolutive phases and six climatic factors);To statistically analyze TCM syndrome types of the patients for exploring TCM syndrome type between both diseases and the rules of grading and microscopic syndrome differentiation under gastroscopy,further,to provide better clinical medication guidance and a theoretical framework for thinking and system construction.Method:1.Subjects:The retrospective study was conducted from January 01,2015 to December 31,2017 at the Endoscopy Center of the Hospital,and the patients were diagnosed with either RE or BRG.The cross-sectional study was to collect patient information from the Gastrointestinology&Hepatology.Department of the Hospital from January 01,2018 to December 31,2018.2.Data collection:A retrospective study was conducted to collect and count the incidence of gender,age,examination time,grade,bile reflux,Hp infection,atrophic gastritis,duodenal ulcer,and esophageal hiatal hernia in patients with RE or BRG.The cross-sectional study was to collect information on the general situation of patients with RE or BRG,information on four clinics of Chinese medicine,and gastroscopic results.3.Statistical method:The statistical analysis of the data in this study used Excel 2011 software and SPSS19.0 statistical software,P<0.05 for the difference was statistically significant.Research result:1.The retrospective study?Included 3922 patients with RE,accounting for 14.12%of gastroscopy in the same period,2592 cases of grade A,948 cases of grade B,234 cases of grade C,and 148 cases of grade D,after chi-square test P=0.001,the grade difference were statistically significant.The average age of RE patients was 53.59±14.34(13,91),the ratio of male to female was 1.33:1,and the positive rate of Hp was 20.76%.A total of 2,48 patients with BRG were enrolled in the study,accounting for 8.93%of the gastroscope in the same period,555 in grade 1,1325 in grade ?,and 603 in grade ?,after chi-square test P= 0.001,the grade difference were statistically significant.The average age of BRG patients was 47.94±16.23(15,89),the ratio of male to female was 1:1.55,and the positive rate of Hp was 19.77%.? Compared with patients with mild RE,the incidence of esophageal ulcer,esophageal hiatus hernia,gastric ulcer,gastric cancer and esophageal cancer was higher in patients with moderate to severe RE,which was statistically significant(P<0.05).Compared with patients with grade I bile reflux,the incidence of atrophic gastritis,gastric polyps,reflux esophagitis,duodenal ulcer and compound ulcer was higher in patients with grade III bile reflux,which was statistically significant(P<0.05).?The high-incidence period of RE and BRG patients was in the spring and the summer,the corresponding host evolutive phase being the wood phase,the host climatic qi being the Jueyin wind wood.In the high-risk period of RE patients,the guest evolutive phase is mainly based on wood and the guest climatic qi is mainly Taiyin damp earth.During high-risk BRG periods guest evolutive phase is wood and the guest climatic qi is mainly based on Jueyin wind wood.2.The cross-sectional study?In 60 patients with RE in the cross-sectional study,the ratio of male to female was 1.8:1.The ratio of male to female in mild RE was 1:1:1.The ratio of male to female was 1.2:1.In 60 patients with BRG,the ratio of male to female was 1:1.125.About 70%of RE patients were induced by dietary and emotional factors.In BRG patients,about 60%incidence was accountable to emotional dysfunction and dietary irregularities.?Among RE patients,spleen and stomach qi deficiency accounted for the highest proportion,accounting for 43%,followed by liver and stomach disharmony,qi stagnation and stagnation,and the proportion of gastric yin deficiency was the lowest;grades A and B were more common in spleen and stomach qi deficiency,liver and stomach disharmony and C and D grades were more common in stagnation of qi and blood stasis and spleen and stomach qi deficiency syndrome.Among the BRG patients,the proportion of liver and stomach disharmony was the highest,accounting for 26%,followed by spleen and stomach qi deficiency,spleen and stomach deficiency,and the lowest proportion of gastric collateral blood stasis.Analysis conclusion:1.The severity of RE is positively correlated with age,esophageal hiatus hernia,esophageal ulcer,gastric ulcer,gastric cancer and esophageal cancer.The severity of bile reflux is positively correlated with the incidence of atrophic gastritis,gastric polyps,reflux esophagitis,duodenal ulcer and compound ulcer.The relationship between bile reflux and the incidence of RE is temporarily undetermined and has no effect on the severity of RE,but it is a common complication of RE.2.The RE high-risk period is mainly in the first climatic qi,and the BRG high-incidence period is mainly in the second climatic qi.The two pathogenesis is closely related to the liver and spleen.3.The distribution of TCM syndrome types in RE is mainly spleen and stomach qi deficiency.The distribution of TCM syndromes in BRG is mainly caused by liver and stomach disharmony.The TCM syndrome differentiation of microscopic mucosain BRG is mainly caused by liver and stomach stagnation.