食管裂孔疝患者中医体质分布规律与中医证型、胃镜下表现的相关性

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目的:探讨食管裂孔疝(HH)患者中医体质分布规律及其与中医证型、胃镜下表现的相关性。方法:收集2016年1月至2018年12月山东中医药大学第二附属医院消化中心确诊的HH患者300例为研究对象,采集临床信息,完成中医体质、中医证型判定及胃镜下表现分类,进行分析。结果:300例HH患者中医体质类型构成比不完全相同(χn 2=88.140,n P<0.05),由高到低依次为气郁质(58例)、气虚质(56例)、湿热质(51例)、痰湿质(45例)、阳虚质(27例)、阴虚质(21例)、平和质(17例)、血瘀质(17例)、特禀质(8例);中医证型与中医体质分型存在明显的属性关联(χn 2=129.753,n P<0.05),其中肝胃郁热证与湿热质、阴虚质对应;脾胃湿热证与痰湿质对应;脾胃虚寒证与阳虚质、气虚质对应;气郁痰阻证与血瘀质、气郁质对应;气虚血瘀证与气虚质对应;胃镜下表现与中医体质存在明显的属性关联(χn 2=123.189,n P<0.05),其中无食管炎与阳虚质、气虚质、平和质、痰湿质对应;反流性食管炎A级与湿热质、气郁质对应,B级与湿热质、气郁质对应,C级无明显对应关系,D级与阴虚质对应。n 结论:HH患者的中医体质以气郁质、气虚质、湿热质、痰湿质为多见,且体质类型与中医证型、胃镜下表现有明显相关性。“,”Objective:To investigate the correlation between the distribution of traditional Chinese Medicine (TCM) constitution and the syndrome of TCM and the performance under gastroscope in patients with hiatal hernia(HH).Methods:A total of 300 HH patients diagnosed in the Department of Gastroenterology, the Second Affiliated Hospital of Shandong University of TCM from January 2016 to December 2018 were enrolled in this study.The clinical information was collected to complete TCM constitution, TCM syndrome type and gastroscopic performance classification.Results:The composition ratio of TCM constitution in 300 patients with HH was not exactly the same(χn 2=88.140, n P<0.05). From high to low, the order was: Qi stagnation(58 cases), Qi deficiency(56 cases), damp heat(51 cases), phlegm dampness(45 cases), Yang deficiency(27 cases), Yin deficiency(21 cases), peace(17 cases), blood quality(17 cases), special quality(8 cases). There was a significant attribute association between TCM syndrome type and TCM constitution classification(χn 2=129.753, n P<0.05), among which: the syndrome of liver and stomach stagnation heat corresponded to damp heat and Yin deficiency; the syndrome of spleen and stomach dampness heat corresponded to phlegm dampness syndrome; the syndrome of spleen and stomach deficiency cold corresponded to Yang deficiency and Qi deficiency; the syndrome of Qi stagnation and phlegm corresponded to blood sputum and Qi stagnation; Qi deficiency and blood stasis syndrome corresponded to Qi deficiency.There was significant attribute association between gastroscopic performance and TCM constitution(χn 2=123.189, n P<0.05), among which: no esophagitis corresponded to Yang deficiency, Qi deficiency, peace and phlegm dampness; the grade A reflux esophagitis corresponded to the dampness heat and the Qi stagnation; the grade B corresponded to the dampness heat and the Qi stagnation, the grade C had no obvious correspondence, the grade D corresponded to the Yin deficiency.n Conclusion:The TCM constitution of HH patients is mainly characterized by Qi stagnation, Qi deficiency, damp heat and phlegm dampness, and there is a significant correlation between constitution classification and TCM syndromes type and gastroscopic performance.
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