目的:比较不同可操作的与胃癌风险联系的肠上皮化生评价(operative link for gastric intestinal metaplasia assessment，OLGIM)分期的慢性萎缩性胃炎(chronic atrophic gastritis，CAG)患者中医证素分布特征，探索影响CAG患者病情进展的中医证素。方法:对CAG患者进行问卷调查，采用证素辨证方法，分析其证素分布特征，探讨不同OLGIM证素分布特征与差异。结果:共纳入640例CAG患者，其中OLGIM低危组367例，OLGIM高危组273例。获得中医病位证素5个:胃、脾、肝、心(神)、肾;病性证素8个:气滞、湿阻、气虚、血瘀、热郁、阳虚、食积、阴虚。OLGIM低危组与高危组之间中医病位证素分布差异无统计学意义(P＞0。05);OL-GIM高危组气虚、血瘀、阳虚证素占比较高，与低危组比较差异有统计学意义(P＜0。05)。OLGIM高危组患者复合证素比例显著高于OLGIM低危组(P＜0。05)。结论:CAG的病位主要在胃，与脾、肝、心(神)、肾密切相关;病性上总体呈现"虚实夹杂"的复合证候特点;随着CAG病情加重，虚、瘀的证素占比增加，可能在CAG患者胃癌风险增高中起了推动作用。
Characteristic analysis of Traditional Chinese Medicine syndrome elements of chronic atrophic gastritis based on OLGIM systems
Objective:To investigate and compare the distribution characteristics of Traditional Chinese Medi-cine(TCM)syndrome elements in patients with chronic atrophic gastritis(CAG)with different stages of operative link for gastric intestinal metaplasia assessment(OLGIM)systems associated with the risk of gastric cancer,and to explore the TCM syndrome elements affecting the progression of CAG.Methods:Patients with CAG were in-vestigated by questionnaire,syndrome factor differentiation method was used to analyze the distribution character-istics of syndrome factors,and the distribution characteristics and differences of different OLGIM syndrome fac-tors were discussed.Results:A total of 640 CAG patients were included,including 367 in the OLGIM low risk group and 273 in the OLGIM high risk group.Five TCM syndrome elements were obtained,which were stomach,spleen,liver,heart(spirit),kidney;there are 8 pathogenic syndromes,namely Qi stagnation,dampness,Qi defi-ciency,blood stasis,heat stagnation,Yang deficiency,food accumulation and Yin deficiency.There was no difference in the distribution of TCM disease location syndrome elements between OLGIM low-risk group and high-risk group(P＞0.05),and the proportion of Qi deficiency,blood stasis and Yang deficiency syndrome ele-ments in OLGIM high-risk group was increased,while the difference between low-risk group was statistically sig-nificant(P＜0.05).The proportion of complex syndrome in OLGIM high-risk group was significantly higher than that in OLGIM low-risk group(P＜0.05).Conclusion:The disease position of CAG locates in the stomach,close-ly related to the spleen,liver,heart and kidney.The disease generally presents the characteristics of complex syn-drome with"deficiency and solid inclusion";with the aggravation of CAG,the proportion of syndrome elements of deficiency and stasis increases,which may play a role in promoting the increased risk of gastric cancer in CAG pa-tients.
chronic atrophic gastritisoperative link for gastric intestinal metaplasia assessmentTraditional Chinese Medicine syndrome elementscomplex syndrome elements
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