| Purpose:1.To analyze and summarize the traditional Chinese medicine Syndrome characteristics of chronic atrophic gastritis with low-grade intraepithelial neoplasia,so as to provide ideas for clinical syndrome differentiation and treatment.2.To analyze the selection of treatment methods for patients with chronic atrophic gastritis and low-grade intraepithelial neoplasia,and to compare the differences in efficacy between different groups,so as to provide guidance for the selection of clinical treatment methods.3.To analyze the characteristics of traditional Chinese medicine prescriptions in patients with chronic atrophic gastritis with low-grade intraepithelial neoplasia,summarize the medication rules to provide ideas for clinical prescription and medicationMethods:1.Collection and arrangement of case data:A total of 230 patients who met the inclusion and exclusion criteria for chronic atrophic gastritis with low-grade intraepithelial neoplasia were included,and the patient’s age,gender,treatment method,traditional Chinese medicine syndrome,syndrome type,prescription medication,endoscopy and pathological results were entered into an Excel table,build database2.Data processing:The patients were divided into groups according to their treatment methods and whether they had traditional Chinese medicine interventions,and their traditional Chinese medicine syndrome characteristics,treatment methods,efficacy comparisons,and traditional Chinese medicine prescription rules were statistically processed.Results:1.Characteristics of traditional Chinese medicine syndrome:A total of 230 patients with chronic atrophic gastritis with low-grade intraepithelial neoplasia were included in this study,including 144 male patients and 86 female patients.The youngest was 30 years old and the oldest was 70 years old,with an average age of 58.05±7.99 years old,among which 51-60 years old and 61-70 years old were the most distributed.The distribution of symptoms is mainly based on digestive system symptoms,of which more than 20%of the symptoms are stomach pain(70.9%),abdominal distension(64.3%),belching(44.3%),acid reflux(40.0%),noisy(33.9%),Bad taste in the mouth(32.1%),fullness(23.5%),fatigue(23.5%),poor sleep at night(24.8%),irregular stools(23.0%),heartburn(23.0%),and dry mouth(20.0%).The distribution of tongue quality is mainly red tongue(35.2%)and red tongue(32.6%);the distribution of tongue coating is mainly thin white coating(51.3%)and thin yellow coating(32.2%);the distribution of pulse is mainly thin veins(47.4%)main.The endoscopic manifestations accounted for a higher proportion of mucosal roughness(93.0%),mucosal erosion(81.3%),mucosal red and white(76.1%),mucosal congestion and edema(60.0%),and granular or nodular hyperplasia(53.0%),erythema(48.7%).The proportion of traditional Chinese medicine syndrome types from high to low is:spleen-stomach damp-heat syndrome(24.8%),spleen-stomach deficiency syndrome(22.6%),stomach-collateral stasis syndrome(19.1%),stomach-yin deficiency syndrome(13.0%),liver and stomach disharmony(10.9%),spleen and stomach deficiency-cold syndrome(9.6%).2.Comparison of treatment methods and efficacy:The treatment methods of the 230 patients included in this study were mainly in the traditional Chinese medicine group(32.3%),the combined medication group(27.8%)and the endoscopy group(20.4%),and the western medicine group and follow-up group accounted for a small proportion.By chi-square test,the gender group X2=3.324,P=0.51>0.05,the age group X2=4.764,P=0.31>0.05.Intragroup comparison:comparison of scores before and after treatment of main symptoms:traditional Chinese medicine and combined medication can effectively improve the main symptoms(P<0.01),Western medicine can effectively improve gastric pain(P<0.01),and endoscopic treatment can effectively improve gastric pain,abdominal distension,fullness,and belching(P<0.01).Comparison of scores before and after treatment of minor symptoms:traditional Chinese medicine and combined medication can effectively improve various symptoms(P<0.01),western medicine can effectively improve noise,acid regurgitation,and heartburn,and endoscopic therapy can effectively relieve noise(P<0.01).Comparison between groups:there were significant differences in the scores of the main symptoms before and after treatment in each group(P<0.01);there were significant differences in the scores before and after treatment for acid reflux,heartburn,bad taste in the mouth,poor sleep,and fatigue(P<0.01),noisy.There was a statistically significant difference in the scores before and after treatment of limb dysphoria(P<0.05).There were significant differences between the traditional Chinese medicine intervention group and the non-traditional Chinese medicine intervention group before and after treatment in the main symptom score difference,secondary symptom score difference,and total score difference(P<0.01).The pathological regression rate of patients in the Chinese medicine intervention group was 92.8%higher than that of the non-Chinese medicine intervention group,which was 77.8%,indicating that Chinese medicine can effectively improve the pathological outcome of patients with chronic atrophic gastritis with low-grade intraepithelial neoplasia(Z=-2.206,P=0.03<0.05)3.The characteristics of traditional Chinese medicine prescription:The overall characteristics of traditional Chinese medicine:according to the efficacy of drugs,it can be divided into qi and spleen-boosting categories,heat-clearing dampness detoxification,activating blood and removing blood stasis,nourishes stomach yin,qi-regulating categories,digestive category,nourishing the heart and soothing the nerves and spleen-warming categories etc.There are 26 traditional Chinese medicines with a frequency of use of more than 20%.Among them,the top five are atractylodes(83.33%),dried tangerine peel(77.54%),licorice(64.49%),coix seed(61.59%)and poria(55.07%).Core traditional Chinese medicine combination:Systematic cluster analysis was performed on 26 traditional Chinese medicines with a frequency of use over 20%,and the following 25 core drug pairs were obtained.12 pairs,respectively:coptis chinensis,evodia(0.764),coptis chinensis,octopus(0.318),hedyotis diffusa,curcuma(0.459),hedyotis diffusa,banzhilian(0.291),atractylodes,poria(0.417),radix ginseng,coix seed(0.224),coix seed,agrimony(0.387),codonopsis,Chinese yam(0.367),codonopsis,astragalus(0.232),codonopsis,licorice(0.269),tangerine peel,pinellia(0.365),malt,six divine comedies(0.240).Cluster analysis categories:①coptis chinensis,evodia,ophiopogon japonicus,ophiopogon japonicus;the treatment method is to clear away dampness and heat,and to relieve pain and acid;②tangerine peel.Pinellia,endothelium corneum gigeriae galli;the treatment method is to dry dampness and remove fullness,strengthen the spleen and eliminate food;③scutellaria barbata,agrimony,hedyotis diffusa,curcuma radix,rhizoma coix seed,scutellaria baicalensis;the treatment method is to promote blood circulation and remove blood stasis,clear heat and detoxify;④paeonia lactiflora,citrus aurantium;the treatment method is to regulate qi and invigorate the spleen,promote qi and relieve pain;⑤codonopsis,astragalus,atractylodes,poria,yam,licorice,woody,bletilla striata,malt,six divine comedies;the treatment method is to invigorate qi and spleen,regulate qi and eliminate food.Conclusions:1.The age of onset of chronic atrophic gastritis with low-grade intraepithelial neoplasia is mostly in people over 50 years old,and more men than women.The traditional Chinese medicine syndromes are mainly digestive system symptoms such as stomach pain,abdominal distension,belching,acid regurgitation,noise,and fullness.The tongue is mainly red tongue and red tongue,the tongue coating is mainly thin white coating and thin yellow coating,and the pulse is mainly thin veins.Endoscopic manifestations are mainly mucosal roughness,erosion,congestion and edema.The distribution of traditional Chinese medicine syndrome types is mainly spleen-stomach damp-heat syndrome,spleen-stomach weakness syndrome,and stomach-collateral stasis syndrome.2.The treatment methods of chronic atrophic gastritis with low-grade intraepithelial neoplasia are mainly traditional Chinese medicine,combined medicine and endoscopic therapy.Traditional Chinese medicine and combined medication can effectively improve the clinical symptoms of patients.Endoscopic treatment can effectively improve stomach pain,fullness,belching,and noise.Western medicine can effectively improve stomach pain,acid regurgitation,heartburn,and noise.Traditional Chinese medicine can effectively improve the pathological outcome of chronic atrophic gastritis with low-grade intraepithelial neoplasia,and has a certain reversal effect.3.Atractylodes,tangerine peel,licorice,coix seed and tuckahoe are frequently used in chronic atrophic gastritis with low-grade intraepithelial neoplasia.Commonly used core drug pairs are codonopsis,astragalus;codonopsis,yam;codonopsis,licorice;atractylodes,poria;coptidis,evodia;coptidis,sea lox;hedyotis diffusa,curcumae;coix seed;coix seed,agrimony;tangerine peel,pinellia;malt,six divine comedies.The formula of traditional Chinese medicine is mainly based on invigorating qi and spleen,clearing away dampness and heat,promoting blood circulation and removing blood stasis,and is often combined with anti-cancer and detoxifying products,clearing stomach yin,regulating qi and digestion,and resolving phlegm and dehumidification. |
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