本文選題：慢性萎縮性胃炎 + 胃黏膜糜爛��； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究目的:本研究旨在探討慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型分布規(guī)律,并研究其與血型、飲食、季節(jié)、幽門螺旋桿菌感染、黏膜萎縮等因素的相關(guān)性,為本病在臨床的預(yù)防和治療提供參考依據(jù),也可以為社區(qū)全科醫(yī)生對(duì)居民進(jìn)行本病的健康宣傳教育提供借鑒。研究方法:在導(dǎo)師的指導(dǎo)與幫助下,通過(guò)閱讀學(xué)習(xí)大量的文獻(xiàn)資料,設(shè)計(jì)該研究病種的臨床調(diào)查表,在亞運(yùn)村社區(qū)、東方醫(yī)院及北京中醫(yī)藥大學(xué)第三附屬醫(yī)院收集165例慢性萎縮性胃炎并胃黏膜糜爛患者的臨床資料,參考2011年《慢性胃炎中西醫(yī)結(jié)合診療共識(shí)意見(jiàn)》提供的標(biāo)準(zhǔn)進(jìn)行辨證分型,運(yùn)用SPSS軟件統(tǒng)計(jì)分析數(shù)據(jù),總結(jié)探討慢性萎縮性胃炎并胃黏膜糜爛的證型分布規(guī)律,并初步分析該分布規(guī)律與季節(jié),飲食,血型,幽門螺旋桿菌感染、黏膜萎縮等因素的關(guān)系。研究結(jié)果:1.本次研究共納入病例樣本量為165例,其中男性78例,女性87例,女性多于男性,男女構(gòu)成比為:1:1.2。經(jīng)卡方檢驗(yàn)P=0.4840.05,說(shuō)明慢性萎縮性胃炎并胃黏膜糜爛的患者男女性別差異無(wú)統(tǒng)計(jì)學(xué)意義。2.在納入本次研究的165例患者中,年齡最小者28歲,年齡最大者89歲,平均年齡59.00±11.03歲。年齡在50-79歲之間的人們得本病的多,共占85.4%。3.在慢性萎縮性胃炎并胃黏膜糜爛的發(fā)病人群中,0型血的人數(shù)最多,共77例,其次是B型血的患者51例,AB型和A型分別為24例和13例。經(jīng)過(guò)卡方檢驗(yàn),P0.05,表明慢性萎縮性胃炎并胃黏膜糜爛的患者的血型差異有統(tǒng)計(jì)學(xué)意義。4.根據(jù)胃鏡及病理報(bào)告,本次收集的165例患者中,單純胃竇部存在糜爛的有102例,單純胃角處存在糜爛的有1例,單純胃底部存在糜爛的有4例,單純胃體部存在糜爛的有7例,剩下的51例患者均存在兩個(gè)部位或多個(gè)部位散在的糜爛,且多部位的糜爛以胃角、胃竇部散在糜爛的居多。經(jīng)卡方檢驗(yàn),P=0.0000.05,說(shuō)明慢性萎縮性胃炎并胃黏膜糜爛的患者糜爛部位的差異有統(tǒng)計(jì)學(xué)意義。5.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)各證型分布,通過(guò)卡方檢驗(yàn),P=0.0000.05,說(shuō)明慢性萎縮性胃炎并胃黏膜糜爛的各個(gè)證型間存在統(tǒng)計(jì)學(xué)差異。6.飲食方面,飲食過(guò)燙者脾胃濕熱型比較多見(jiàn);飲食辛辣者胃絡(luò)瘀血型比較多見(jiàn);食速過(guò)快者脾胃濕熱、肝胃郁熱以及肝郁氣滯型比較多見(jiàn);三餐不規(guī)律者肝胃郁熱和肝郁氣滯型比較多見(jiàn)。7.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型與性別的關(guān)系:經(jīng)卡方檢驗(yàn),P=0.0850.05,說(shuō)明慢性萎縮性胃炎并胃黏膜糜爛的患者中醫(yī)證型分布與性別無(wú)顯著性差異。8.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型與年齡段的關(guān)系:以年齡段為分組標(biāo)準(zhǔn),經(jīng)卡方檢驗(yàn),P=0.1730.05,差異沒(méi)有統(tǒng)計(jì)學(xué)意義,表明各年齡段患者的中醫(yī)證型分布無(wú)顯著性差異。以中醫(yī)證型為分組標(biāo)準(zhǔn),經(jīng)Kruskal-Wallis H檢驗(yàn),P=0.2420.05,說(shuō)明中醫(yī)各證型的年齡段分布無(wú)統(tǒng)計(jì)學(xué)差異。9.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型與季節(jié)的關(guān)系:經(jīng)卡方檢驗(yàn),P=0.0010.05,說(shuō)明中醫(yī)證型的分布與季節(jié)有顯著性差異。10.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型與血型的關(guān)系:經(jīng)卡方檢驗(yàn),P=0.0700.05,說(shuō)明中醫(yī)證型分布與血型無(wú)顯著性差異。11.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型與Hp感染的關(guān)系:以中醫(yī)證型為分組標(biāo)準(zhǔn),經(jīng)Kruskal-Wallis H檢驗(yàn),P=0.1810.05,表明慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)各證型的Hp感染分級(jí)無(wú)顯著性差異。以Hp感染分級(jí)為分組標(biāo)準(zhǔn),進(jìn)行卡方檢驗(yàn),P=0.0370.05,說(shuō)明Hp感染的程度不同會(huì)影響中醫(yī)證型的分布,Hp感染分級(jí)不同的患者中醫(yī)證型的分布有顯著性差異。12.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型與黏膜萎縮程度的關(guān)系:以證型為分組標(biāo)準(zhǔn),經(jīng)Kruskal-Wallis H檢驗(yàn),P=0.0260.05,說(shuō)明慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)各證型的黏膜萎縮程度有顯著性差異。以胃黏膜萎縮程度為分組標(biāo)準(zhǔn),進(jìn)行卡方檢驗(yàn),P=0.04960.05,說(shuō)明黏膜萎縮程度不同的各組間中醫(yī)證型的分布有顯著性差異。研究結(jié)論:1.慢性萎縮性胃炎并胃黏膜糜爛的各個(gè)證型間有統(tǒng)計(jì)學(xué)差異,其證型出現(xiàn)的頻次由高到低依次為脾胃濕熱型、肝胃郁熱型、肝郁氣滯型、胃絡(luò)瘀血型、胃陰不足型和脾胃虛寒型。2.慢性萎縮性胃炎并胃黏膜糜爛的糜爛部位有統(tǒng)計(jì)學(xué)差異,糜爛部位以胃竇部最為多見(jiàn)。3.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型分布與性別及年齡段沒(méi)有相關(guān)性。4.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型分布與季節(jié)有相關(guān)性。5.慢性萎縮性胃炎并胃黏膜糜爛的患者的血型有統(tǒng)計(jì)學(xué)差異,但是血型和本病的中醫(yī)證型分布沒(méi)有相關(guān)性。6.慢性萎縮性胃炎并胃黏膜糜爛中醫(yī)證型與Hp感染有相關(guān)性,Hp感染的程度不同會(huì)影響中醫(yī)證型的分布。7.慢性萎縮性胃炎并胃黏膜糜爛的中醫(yī)證型與黏膜萎縮程度有相關(guān)性。
[Abstract]:The purpose of this study is to investigate the distribution of TCM syndrome types of chronic atrophic gastritis and gastric mucosal erosion, and to study the correlation of the factors such as blood group, diet, season, Helicobacter pylori infection and atrophy of mucous membrane, and provide the basis for the prevention and treatment of this disease and the community general practitioner. Health publicity and education of the disease provide reference. Research methods: under the guidance and help of the tutor, through reading and learning a large number of documents, design the clinical questionnaire of the disease type, collect 165 cases of chronic atrophic gastritis and gastric mucosa erosion in the Asian Sports Village community, the Oriental Hospital and the Third Affiliated Hospital of Beijing University of Chinese Medicine. Bed data, referring to the standard for diagnosis and treatment of chronic gastritis in 2011, the standard for diagnosis and treatment of traditional Chinese and Western medicine provided by the standard for differentiation, using SPSS software statistical analysis data to summarize and discuss the pattern distribution of chronic atrophic gastritis and gastric mucosa erosion, and preliminarily analyze the distribution rule and season, diet, blood type, Helicobacter pylori infection, mucous membrane The relationship between atrophy and other factors. 1. a total of 165 cases were included in this study, including 78 men, 87 women and more women than men. The ratio of male and female to male and female was 1:1.2. by chi square test P=0.4840.05. The sex difference between men and women in chronic atrophic gastritis and gastric mucosal erosion was not statistically significant.2. was included in the study Among the 165 patients, the youngest was 28 years old, the oldest was 89 years old, and the average age was 59 + 11.03 years. The people aged 50-79 years were more likely to have the disease. Among the patients with chronic atrophic gastritis and gastric mucosal erosion, the number of 0 type of blood was the largest, 77 cases, and the next of the patients with type B blood, and the AB type and the A type respectively. 24 cases and 13 cases. After the chi square test, P0.05, the difference of blood type of the patients with chronic atrophic gastritis and gastric mucosa erosion was statistically significant.4. according to the gastroscopy and pathological report. Among the 165 cases of this collection, there were 102 cases of erosion in the Dan Chunwei sinus, 1 cases of erosion in the simple gastric corner, and the erosion in the bottom of the stomach. In 4 cases, there were 7 cases of erosion in the body of the stomach, and the remaining 51 cases had two parts or many parts of the erosion, and the erosion of the gastric antrum in the multiple parts of the stomach and the gastric antrum scattered in the most erosive. P=0.0000.05, the difference between the chronic atrophic gastritis and the gastric mucous erosion of the patients with chronic atrophic gastritis was statistically significant. 5. the distribution of TCM syndrome types of chronic atrophic gastritis and gastric mucosa erosion through chi square test, P=0.0000.05, indicating that there are statistical differences in.6. diet between the various syndromes of chronic atrophic gastritis and gastric mucosa erosion. The spleen and stomach damp heat, liver and stomach depression and stagnation of liver qi stagnation are more common. The relationship between the liver and stomach depression and the stagnation of liver qi stagnation in the irregular three meals is more common in the.7. chronic atrophic gastritis and the relationship between the TCM syndrome type and the sex of the gastric mucosa erosion: through the chi square test, P=0.0850.05, the TCM syndrome distribution of the patients with chronic atrophic gastritis and gastric mucosa erosion There is no significant difference between sex and age in.8. chronic atrophic gastritis and gastric mucosa erosion: the age group is the standard, the chi square test and the P=0.1730.05 are not statistically significant, indicating that there is no significant difference in the distribution of TCM Syndrome Types in the patients of all ages. The standard of TCM Syndrome type as the standard of group, Kruskal-Wallis H test, P=0.2420.05, indicating that there is no statistical difference in the age distribution of each type of TCM syndrome, the relationship between the TCM syndrome type of chronic atrophic gastritis and gastric mucosa erosion in.9. and the season: P=0.0010.05, the distribution of TCM syndrome type and the seasonal variation of TCM syndrome type.10. chronic atrophic gastritis and gastric mucosa erosion Relationship of blood type: P=0.0700.05, the relationship between TCM Syndrome Distribution and blood type, the relationship between TCM syndrome type of chronic atrophic gastritis and gastric mucosa erosion and Hp infection in.11. chronic atrophic gastritis and gastric mucosal erosion: TCM syndrome type as group standard, Kruskal-Wallis H test and P=0.1810.05, the TCM syndrome of chronic atrophic gastritis and gastric mucosa erosion There was no significant difference in the classification of Hp infection in each type. Hp infection classification was divided into grouping criteria, chi square test, P=0.0370.05, indicating that the degree of Hp infection would affect the distribution of TCM syndrome type. The distribution of TCM syndrome types with different Hp infection classification had significant difference in the TCM Syndrome type of chronic atrophic gastritis and gastric mucosa erosion in.12. The relationship between the degree of atrophy of mucous membrane: the degree of atrophy of mucous membrane in the TCM syndrome types of chronic atrophic gastritis and gastric mucosa erosion by Kruskal-Wallis H test and P=0.0260.05, with the syndrome type as the standard of grouping, with the standard of gastric mucosa atrophy as the grouping standard, the chi square test, and P=0.04960.05, indicating that the degree of atrophy of mucous membrane is different. There were significant differences in the distribution of TCM syndrome types between each group. Conclusions: 1. there are statistical differences between the various syndromes of chronic atrophic gastritis and gastric mucosa erosion. The frequency of the syndrome is from high to low to spleen and stomach damp heat, liver and stomach depression, stagnation of liver qi, stomach and collateral blood stasis, gastric Yin deficiency and spleen stomach deficiency cold type.2. atrophy. There were statistical differences in the erosive sites of erosive gastric mucosa and gastric mucosal erosion. The most common.3. chronic atrophic gastritis in the antrum and the erosion of gastric mucosa in the erosive part of the erosive region was not related to the sex and age of.4.. The distribution of TCM syndrome in chronic atrophic gastritis and the erosion of gastric mucosa was associated with the chronic atrophy of.5. in the season. The blood types of patients with gastritis and gastric mucosal erosion were statistically different, but there was no correlation between the distribution of TCM syndrome of.6. chronic atrophic gastritis and the TCM syndrome type of gastric mucosa erosion and Hp infection. The different degree of Hp infection could affect the distribution of TCM syndrome type of chronic atrophic gastritis of.7. and the erosion of gastric mucosa. There is a correlation between the type of medical syndrome and the degree of atrophy of mucous membrane.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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2 馮瑤 德寧;中醫(yī)可防止慢性萎縮性胃炎“變壞”[N];新華日?qǐng)?bào);2006年

3 大兵;慢性萎縮性胃炎患者的自我保護(hù)[N];中國(guó)石油報(bào);2002年

4 王振嶺 周文平 范俊利;中藥可有效治療慢性萎縮性胃炎癌前病變[N];中國(guó)中醫(yī)藥報(bào);2006年

5 南昌市第一醫(yī)院消化科 副主任醫(yī)師 熊鋒寶;正確對(duì)待慢性萎縮性胃炎[N];家庭醫(yī)生報(bào);2004年

6 ;治慢性萎縮性胃炎方[N];農(nóng)村醫(yī)藥報(bào)（漢）;2004年

7 石磊;治療慢性萎縮性胃炎藥對(duì)[N];中國(guó)醫(yī)藥報(bào);2005年

8 ;胃靈湯治療慢性萎縮性胃炎[N];中國(guó)中醫(yī)藥報(bào);2004年

9 文羊;慢性萎縮性胃炎患者的飲食調(diào)節(jié)[N];中國(guó)消費(fèi)者報(bào);2000年

10 南京中醫(yī)藥大學(xué) 劉舟 張衛(wèi)華 駱殊;孟景春:慢性萎縮性胃炎三治[N];中國(guó)中醫(yī)藥報(bào);2013年

相關(guān)博士學(xué)位論文 前10條

1 阮氏秋河;胃炎Ⅰ號(hào)對(duì)慢性萎縮性胃炎癌前病變的干預(yù)作用[D];廣州中醫(yī)藥大學(xué);2009年

2 郭紅梅;曾斌芳學(xué)術(shù)思想與臨床經(jīng)驗(yàn)及扶正消萎湯治療脾胃虛弱型慢性萎縮性胃炎臨床研究[D];北京中醫(yī)藥大學(xué);2016年

3 郭琳;慢性萎縮性胃炎證治規(guī)律的探討[D];南京中醫(yī)藥大學(xué);2004年

4 魏玉霞;慢性萎縮性胃炎近10年中醫(yī)文獻(xiàn)研究[D];北京中醫(yī)藥大學(xué);2012年

5 梅惠文;單兆偉教授治療慢性萎縮性胃炎的學(xué)術(shù)思想與臨床經(jīng)驗(yàn)研究[D];南京中醫(yī)藥大學(xué);2012年

6 陳國(guó)忠;周德麗教授治療慢性萎縮性胃炎學(xué)術(shù)經(jīng)驗(yàn)研究[D];廣州中醫(yī)藥大學(xué);2011年

7 韋玉娜;胃炎Ⅰ號(hào)對(duì)慢性萎縮性胃炎的治療作用及其實(shí)驗(yàn)研究[D];廣州中醫(yī)藥大學(xué);2014年

8 張倫;萎胃湯治療慢性萎縮性胃炎的臨床觀察與實(shí)驗(yàn)研究[D];廣州中醫(yī)藥大學(xué);2010年

9 杜琳;單兆偉教授慢性萎縮性胃炎證治經(jīng)驗(yàn)輯要[D];南京中醫(yī)藥大學(xué);2005年

10 鐘e，

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