Analysis Of The Esophageal Function Characteristics Of Different TCM Syndromes Between Non-erosive Reflux Disease And Functional Esophagus Disease

Objective:Through the comparison of differences in esopHageal functional characte ristics of NERD,RH and FH under different TCM syndromes,to explore the correlation between TCM syndrome differentiation and esopHageal function,so as to better guide the treatment of TCM.Method:Clinical research object for December 2017-December 2019 in the hospital affiliated to the capital university of medical sciences,the digestive internal medicine outpatient and ward patients,according to gastroscope,esopHageal pressure and pH impe dance monitoring results,in line with the diagnostic criteria,inclusion criteria,and by exc lusion standard screening NERD,RH and FH 48 cases,collect the general condition and clinical symptoms,and are collected into liver syndrome and spleen syndrome group.Results:1.General data comparison:The age of NERD patients was significantly hig her than that of RH,and the difference was statistically significant(P<0.05).In FH,femal es were more than nerds,and the difference was statistically significant(P<0.05).The per centage of NERD patients smoking was higher than FH,and the difference was statisti cally significant(P<0.05).There were no statistically significant differences among the th ree groups in terms of occupation,education level,marital status,family economic status,working time,commute time,living,working and learning pressure,weekly times of eating out,eating fast,eating full,drinking and whether there was esopHageal hiatus hernia(P>0.05).2.Comparison of TCM syndrome distribution:24(50%)cases of liver and stomach heat syndrome in NERD patients,7(14.6%)cases of gallbladder heat invading the stom ach syndrome,10(20.8%)cases of qi stagnation in pHlegm,6(12.5%)cases of deficiency syndrome in inverse qi,and 1(2.1%)case of spleen deficiency with dampness and hea t,among which 31(64.6%)cases of liver syndrome and 17(35.4%)cases of spleen synd rome.Among RH patients,there were 18 cases(37.5%)of liver and stomach heat syndr ome,5 cases(10.4%)of gallbladder heat invading the stomach syndrome,22 cases(45.8%)of qi stagnation in pHlegm,2 cases(4.2%)of deficiency syndrome in inverse qi,a nd 1 case(2.1%)of spleen deficiency with dampness and heat.among which 23(47.9%)cases of liver syndrome and 25(52.1%)cases of spleen syndrome.Among the patients with FH,there were 18 cases(37.5%)of liver and stomach heat syndrome,4 cases(83%)of gallbladder heat invading the stomach syndrome,19 cases(39.6%)of qi stagnat ion in pHlegm,1 case(2.1%)of deficiency syndrome in inverse qi,and 6 cases(12.5%)of spleen deficiency with dampness and heat.among which 22(45.8%)cases of liver s yndrome and 26(54.2%)cases of spleen syndrome.There was no significant difference between the three groups in syndrome distribution and the syndrome of liver and sple en system(P>0.05).3.EsopHageal features:?NERD,RH and FH three groups in esopHageal spHincter function(LES length,LES resting pressure,residual pressure,UES LES resting pressure an d residual pressure UES),esopHageal contraction force average(average amplitude,durat ion,invalid swallowing percentage,large creep interrupts percentage,small creep percentag e and DCI),esopHageal movement coordination(synchronous contraction percentage,bim odal swallowing percentage,distal contraction delay,contraction percentage in advance an d rapid contraction percentage)comparative differences had no statistical signifi cance(P>0.05);?The NERD group DeMeester,reflux time and number of reflux,acid reflux ti me percentage,number of long reflux(>5min),the longest duration of reflux,upright acid reflux time(%),supine acid reflux time(%),acid reflux and reflux all event group is si gnificantly higher than RH and FH,statistically significant difference(P<0.05),number of RH group of acid reflux,FH group is significantly higher than total reflux events,stat istically significant difference(P<0.05),However,there was no statistically significant diffe rence between the three groups in the events of weak acid reflux and non-acid reflux,as well as in the proximal esopHageal weak acid reflux and non-acid reflux(P>0.05).4.Comparison of liver syndrome and spleen syndrome in the same disease:?The 1 ength of LES in the NERD spleen syndrome group was significantly greater than that in the liver syndrome group,and the difference was statistically significant(P<0.05).LE S resting pressure in RH liver syndrome group was higher than that in spleen syndro me group,and the difference was statistically significant(P<0.05).There was no significa nt difference in esopHageal motility between hepatic syndrome and splenic syndrome in FH patients(P>0.05).?There was no significant difference between the hepatic syndr ome of NERD,RH and FH and the splenic syndrome in acid reflux(DeMeester,reflux ti me,number of reflux,acid reflux time(%),long reflux times(>5min),the longest duration of reflux,upright acid reflux time(%)and lie on your back acid reflux time(%)),reflux events(acid reflux,weak acid reflux,reflux and reflux all events)and proximal esopHage al reflux(proximal esopHageal acid reflux,weak acid reflux,acid reflux and total reflux)(P>0.05).5.Liver and spleen syndrome under the NERD,RH and FH esopHageal features:?Under the department of liver syndrome NERD,RH and FH three groups in esopHa geal spHincter function,esopHageal contraction force and esopHageal movement coordin ation was no significant difference(P>0.05),while the spleen syndrome,FH group LES r esting pressure significantly higher than the RH group(P<0.05),?While in the rest of the esopHageal function no difference between the three groups(P>0.05).Regardless o f the liver syndrome or the spleen syndrome,the NERD group's DeMeester,reflux time,reflux times,acid reflux time percentage,long reflux times(>5min),longest reflux duratio n,erect acid reflux time(%),and supine acid reflux time(%)were significantly higher th an RH and FH groups(P<0.05).However,there was no significant difference between th e three groups in terms of weak acid reflux events,non-acid reflux events,esopHageal proximal weak acid reflux events and esopHageal proximal non-acid reflux events(P>0.05).The incidence of NERD acid reflux was significantly higher than that of RH and FH(P<0.05).The incidence of acid reflux and all reflux events in the NERD and RH g roups were significantly higher than that in the FH group(P<0.05).The number of RH reflux was significantly higher than that of FH,and the difference was statistically sign ificant(P<0.05).Conclusion:The esophageal function of different TCM syndromes is different.The funct ion of the esophageal sphincter of the liver related syndrome type of NERD is weake r than that of the liver related syndrome type;the function of the esophageal sphincte r of the spleen related syndrome type of RH patients is lower than that of the liver r elated syndrome type;and the function of the esophageal sphincter of RH patients is weaker than that of FH patients with the spleen related syndrome type.