【作者】 潘琳；

【导师】 陆为民；

【作者基本信息】 南京中医药大学 ， 中医学， 2009， 硕士

【摘要】 目的:通过调查幽门螺杆菌(H.pylori)相关性胃炎患者中医体质类型的分布特点,探讨H.pylori相关性胃炎与中医体质类型的关系,为中医药防治H.pylori提供可以借鉴的依据。方法:采用问卷调查的方法,收集H.pylori相关性胃炎患者365例,按中医体质量表分别判定为平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、瘀血质、气郁质、特禀质等9种体质类型。采用Microsoft Excel建立数据库,使用SPSS13.0统计软件,分析患者的年龄、性别、职业、居住地、胃镜征象及组织病理学表现与中医体质类型的关系。结果:1、H.pylori相关性胃炎患者中医体质类型出现的频率依次为阳虚质(20.3%)＞气郁质(17.3%)＞气虚质(14.5%)＞湿热质(13.7%)＞平和质(13.4%)＞瘀血质(11.2%)＞痰湿质(5.5%)＞阴虚质(3.8%)＞特禀质(0.3%)。2、性别、年龄与中医体质类型密切相关:湿热质、平和质、痰湿质多见于男性,气郁质、瘀血质多见于女性;湿热质多见于青年,阴虚质多见于中年,气虚质多见于老年。3、未发现H.pylori相关性胃炎患者的居住地及职业与中医体质类型的相关性。4、胃镜征象、组织病理学表现与中医体质类型有一定的关系:充血红斑、水肿多见于气虚质;胆汁反流多见于湿热质、气郁质;慢性炎症在痰湿质、湿热质、气郁质、瘀血质中程度较重;气虚质、瘀血质、平和质、阳虚质的萎缩程度较重;气虚质、阳虚质、瘀血质伴肠化多见。结论:H.pylori相关性胃炎与中医体质存在一定的相关性,多见于阳虚质、气郁质、气虚质、湿热质,与H.pylori相关性胃炎的病机基本一致,即脾胃虚弱为本,湿热中阻为标。不同体质类型的患者胃粘膜病变程度也存在一定的差异性。本研究从体质角度启示中医药治疗H.pylori相关性胃炎,不能局限于H.pylori的根除,而应从邪正两方面入手,通过扶助正气,调整体质,也是H.pylori相关性胃炎治疗的关键。更多还原

【Abstract】 Objective:to investigate distribution of TCM Constitution in H.pylori-related Gastritis patients, explore the relationship between H.pylori-related Gastritis and TCM Constitution, and hence to provide a referable data for prevention and treatment of H.pylori (Helicobacter Pylori) infection.Methods:By means of question investigation,365 patients with Hp-related Gastritis are gathered.They are categorized into nine constitution types,namely,gentleness type, gentleness type,qi-deficiency type,qi-depression type,wetness-heat type,phlegm-wet type, special inherited type,yang-deficiency type,yin-deficiency type and blood-stasis type.Data base was established,the relationship of TCM constitution with age,gender, occupation,residence,gastroscopic manifestation and biopsy were analyzed by SPSS statistical software.Results:1.The frequency of TCM Constitution types in H.pylori-related Gastritis in descending order is:yang-deficiency type(20.3%)＞qi-depression type(17.3%)＞qi-deficiency type(14.5%)＞wetness-heat type(13.7%)＞gentleness type(13.4%)＞(17.3%)＞blood-stasis type(11.2%)＞phlegm-wet type(5.5%)＞yin-deficiency type(3.8%)＞special inherited type (0.3%).2.There is a close relationship between TCM Constitution types with age and sex, wetness-heat type,gentleness type and phlegm-wet type are more common seen in male, while qi-depression type and blood-stasis type have a high frequency in female,wetness-heat type is common in youngsters,yin-deficiency type is most observed in middle-aged people and qi-deficiency type is frequent in the elderly.3.No correlation is found between TCM Constitution types in H.pylori-related Gastritis and the patients’ residence and occupation.4.Gastroscopoic and pathological manifestations have a bearing on TCM Constitution types.Congestion,erythema and edema are common in qi-deficiency type,bile reflux is common in wetness-heat type and qi-depression type,chronic inflammation is frequent in phlegm-wet type,wetness-heat type,qi-depression and blood-stasis type.Severe atrophy is seen in qi-deficiency type,blood-stasis type,gentleness type and yang-deficiency type,and intestinal metaplasia is seen in Qi-deficiency type,yang-deficiency type and blood-stasis type.Conclusion:H.pylori-related Gastritis is correlated with TCM Constitution types,abnormal constitution is common in Yang-deficiency type,qi-depression type,qi-deficiency type and wetness-heat type,which conforms to the pathogenesis of H.pylori-related Gastritis.There is also difference between different TCM Constitution types and the degree of gastric mucosa pathological changes.It is indicative by this study that treatment of H.pylori-related Gastritis should not be localized only by eradication of H.pylori,but intervention be given through removing evil-qi and invigorating genuine-qi by readjusting abnormal constitution.It is key to treat H.pylori -related Gastritis.更多还原