Study On The Correlation Between The Distribution Of TCM Syndromes,Gastroscopic Manifestations And Pathological Classification Of Chronic Atrophic Gastritis

Objective:By observing the gastroscopic images and pathological results of patients with different syndrome types of chronic atrophic gastritis(CAG),to explore the correlation between the distribution of TCM syndrome types of CAG and gastroscopic and pathological manifestations,so as to provide objective basis for TCM syndrome differentiation of CAG.Methods:A total of 122 patients diagnosed with CAG were selected as the research object.The TCM syndrome types were determined according to the patients’ symptoms and tongue and pulse images,and the distribution of TCM syndrome types and their correlation with Helicobacter pylori,gastroscopic manifestations,inflammatory activity,atrophy and intestinal metaplasia,atrophy range,OLGA and OLGIM stages were analyzed.Results:The distribution of TCM syndrome types:spleen-stomach weakness syndrome>spleen-stomach damp-heat syndrome>liver-stomach qi stagnation syndrome>stomach yin deficiency syndrome>liver-stomach stagnation-heat syndrome>stomach collateral stasis syndrome.Under gastroscope,the white phase and flattening of mucosal folds were most common in the syndrome of weakness of spleen and stomach,and the nodular shape of mucosal granules was the most common in the syndrome of damp-heat of spleen and stomach.Simple atrophy is mainly seen in the syndrome of weakness of spleen and stomach,and mucosal erosion is mainly seen in the syndrome of damp-heat of spleen and stomach.The syndrome of weakness of spleen and stomach is mainly manifested as inactive inflammation,while the syndrome of damp-heat of spleen and stomach is mainly characterized by moderate inflammation.The syndromes of stomach collaterals showed moderate and severe atrophy,while the syndrome of qi stagnation of liver and stomach and weakness of spleen and stomach mainly showed mild atrophy.The most common syndromes of spleen and stomach weakness is no intestinal metaplasia,and the most common syndromes of stomach yin deficiency and stomach collateral stasis is moderate intestinal metaplasia.In OLGA stage,the syndrome of weakness of spleen and stomach and syndrome of qi stagnation of liver and stomach were mainly in stage Ⅰ,and the syndrome of stasis in stomach collaterals was mainly in stage Ⅲ.In OLGIM staging,stage 0 was the main syndrome of weakness of spleen and stomach,and stage Ⅲ was the syndrome of deficiency of stomach yin and stasis of stomach collaterals.Conclusion:The syndrome of weakness of spleen and stomach is the most common in CAG.There is no significant difference among different TCM syndrome types in age,sex,course of disease,HP,range of atrophy and so on.There were significant differences in the distribution of some syndrome types in gastroscopic mucosal manifestations,mucosal morphology,inflammatory activity,atrophy and intestinal metaplasia,OLGA and OLGIM stages.Under gastroscope,the white phase and flattening of mucosal folds were most common in the syndrome of weakness of spleen and stomach,and the nodular shape of mucosal granules was the most common in the syndrome of damp-heat of spleen and stomach.Simple atrophy is mainly seen in the syndrome of weakness of spleen and stomach,and mucosal erosion is mainly seen in the syndrome of damp-heat of spleen and stomach.The degree of inflammation of spleen-stomach damp-heat syndrome is more serious than that of spleen-stomach weakness syndrome,and the degree of atrophy and the risk of atrophy cancer of stomach collateral stasis syndrome is higher than that of liver-stomach qi stagnation syndrome and spleen-stomach weakness syndrome.The degree of intestinal metaplasia of stomach yin deficiency and stomach collateral stasis syndrome is more severe and the risk of intestinal metaplasia is higher than that of spleen and stomach weakness syndrome.