本文關(guān)鍵詞： 慢性糜爛性胃炎(CEG) 窄帶成像內(nèi)鏡(NBI) 中醫(yī)體質(zhì)　出處：《廣西中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:基于窄帶成像內(nèi)鏡(Narrow-band imaging,NBI)對于病變胃黏膜微結(jié)構(gòu)的診斷價(jià)值,探索NBI技術(shù)下的慢性糜爛性胃炎中醫(yī)體質(zhì)的分布特點(diǎn),及與NBI鏡下像表現(xiàn)的關(guān)系。方法:采用文獻(xiàn)綜述和臨床問卷調(diào)查相結(jié)合的方法。收集100例確診為慢性糜爛性胃炎的病例,按王琦教授的《中醫(yī)體質(zhì)分類判斷》對體質(zhì)進(jìn)行分類判定,同時(shí)觀察患者一般資料、NBI鏡下表現(xiàn)及組織病理學(xué)等資料,通過Microsoft Excel建立數(shù)據(jù)庫,采用SPSS21.0統(tǒng)計(jì)分析軟件,分析糜爛性胃炎患者中醫(yī)體質(zhì)分布及與相關(guān)因素的關(guān)系。結(jié)果:(1)本研究中慢性糜爛性胃炎患者中偏頗體質(zhì)分布依頻次由多到少為:濕熱質(zhì)(25%),氣郁質(zhì)(18%),陽虛質(zhì)(15%),氣虛質(zhì)(9%),陰虛質(zhì)(8%),痰濕質(zhì)(6%),血瘀質(zhì)(2%),特稟質(zhì)(1%)。偏頗體質(zhì)占84%;平和質(zhì)占16%。(2)體質(zhì)類型在性別上的分布無統(tǒng)計(jì)學(xué)差異;本病集中分布于40-59歲年齡段,占60%,平均年齡46.50±10.878歲。在不同年齡段的分布上有統(tǒng)計(jì)學(xué)差異。濕熱質(zhì)在青年組分布居多,占青年組總例數(shù)44.1%。陽虛質(zhì)、氣郁質(zhì)在中年組分布居多,分別占18.9%26.4%。(3)慢性糜爛性胃炎患者中醫(yī)體質(zhì)與胃黏膜糜爛程度:Ⅲ級胃黏膜糜爛以陽虛質(zhì)(28.6%)分布最多,氣虛質(zhì)(17.9%)次之,Ⅱ級糜爛以氣郁質(zhì)(27.0%)、濕熱質(zhì)(24.3%)分布最多,Ⅰ級糜爛以濕熱質(zhì)(34.3%)、平和質(zhì)(25.7%)分布最多。(4)NBI鏡下胃黏膜表面微血管形態(tài)(CP)與體質(zhì)的分布:CP-III型以陽虛質(zhì)(40%)為主,陰虛質(zhì)(24%)次之,CP-II型以濕熱質(zhì)(42.9%)為主,CP-I型以平和質(zhì)(32.5%)、氣郁質(zhì)(30%)為主。(5)NBI鏡下胃小凹分型(PP)與體質(zhì)的分布:Ⅰ型胃小凹占22%,Ⅱ型占41%,Ⅲ型占26%,Ⅳ型占21%,Ⅴ型、Ⅵ型病例缺如。Ⅰ型以平和質(zhì)為主,濕熱質(zhì)次之,Ⅱ型以濕熱質(zhì)為主,氣郁質(zhì)次之。Ⅲ型、Ⅳ型以虛證體質(zhì)為主,其中以陽虛質(zhì)多見。(6)慢性糜爛性胃炎中醫(yī)體質(zhì)在不同病理慢性炎等級上的分布無統(tǒng)計(jì)學(xué)差異;在病理有無活動性炎及萎縮改變方面,活動性炎改變多見于濕熱質(zhì),萎縮改變多見于陽虛質(zhì)。結(jié)論:(1)慢性糜爛性胃炎患者的體質(zhì)主要是:濕熱質(zhì)、平和質(zhì)、氣郁質(zhì)、陽虛質(zhì)。其中最常見的偏頗體質(zhì)是:濕熱質(zhì),其次是氣郁質(zhì)。(2)本病以中青年發(fā)病較多,與性別無明顯相關(guān)性。隨著年齡的增長,平和質(zhì)和濕熱質(zhì)呈減少趨勢,而氣郁質(zhì)、陽虛質(zhì)、氣虛質(zhì)、陰虛質(zhì)呈增多趨勢。青年以濕熱質(zhì)易患,中年以陽虛質(zhì)、氣郁質(zhì)易患。(3)CEG體質(zhì)分布特點(diǎn)與NBI內(nèi)鏡表現(xiàn)、病理類型具有一定相關(guān)性。陽虛質(zhì)患者發(fā)病后鏡下像分級較重,以Ⅲ級糜爛、CP-Ⅲ型、PP-Ⅲ型分布為主,其組織病理學(xué)多伴有萎縮改變。濕熱質(zhì)、氣郁質(zhì)患者發(fā)病后鏡下分級較輕,濕熱質(zhì)患者發(fā)病以Ⅰ級糜爛、CP-Ⅱ型、PP-Ⅱ型為主,組織病理學(xué)多伴活動性炎改變;氣郁質(zhì)患者發(fā)病后以Ⅱ級糜爛、CP-Ⅰ型、PP-Ⅱ型為主,組織病理學(xué)多伴活動性炎改變。
[Abstract]:Objective: based on the diagnostic value of narrow band imaging endoscope Narrow-band imaging (NBI) for pathological gastric mucosal microstructures, to explore the distribution of TCM constitution of chronic erosive gastritis based on NBI technique. Methods: #number0# cases of chronic erosive gastritis were collected by means of literature review and clinical questionnaire survey. According to Professor Wang Qi's TCM Constitution Classification judgment, the constitution was classified and judged, and the general data of the patients were observed under microscope and histopathology. The database was established by Microsoft Excel, and the SPSS21.0 statistical analysis software was used. Analysis of the relationship between TCM physique distribution and related factors in erosive gastritis. Results: in this study, the distribution of partial constitution in patients with chronic erosive gastritis was as follows: dampness and heat 25%, Qi stagnation 18%, Yang deficiency 1515), Qi and Qi. There was no statistical difference in the distribution of physical types in sex between the two groups, and there was no statistical difference in the distribution of the physical types between the two sexes, and there was no statistical difference in the distribution of the types of constitution between the two sexes, and there was no statistical difference in the distribution of the types of constitution between the two sexes, and there was no statistical difference in the distribution of the types of constitution between the two sexes, and there was no statistical difference in the distribution of the physical types. The disease was mainly distributed in the 40-59 age group, accounting for 60 cases, with an average age of 46.50 鹵10.878 years. There were statistical differences in the distribution of dampness and heat in the young group, accounting for 44.1% of the total number of cases in the young group. The proportion of TCM constitution and gastric mucosal erosion in patients with chronic erosive gastritis was 18.9 & .4. 3) the degree of gastric mucosal erosion in grade 鈪，

本文編號：1499358