511例胃食管反流病患者不同亚型临床特征与中医证型的相关性研究
Study on the correlation between clinical characteristics of different subtypes and traditional Chinese medicine syndrome types in 511 patients with gastroesophageal reflux disease
- 北京中医药 2023年42卷第8期 页码：892-896
- 作者机构：
1.中国中医科学院西苑医院脾胃科，北京 100091
- 作者简介：
胡佳艳，女，24岁，硕士研究生。研究方向：中医药治疗脾胃病。
王凤云，E-mail：wfy811@163.com
- 基金信息：国家自然科学基金青年项目(82104850);中国中医科学院科技创新工程项目(CI2021A01001)
DOI：10.16025/j.1674-1307.2023.08.020
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胡佳艳，张坤漓，吕咪，等.511例胃食管反流病患者不同亚型临床特征与中医证型的相关性研究［J］.北京中医药，2023，42（8）：892-896.
HU Jia-yan,ZHANG Kun-li,LYU Mi,et al.Study on the correlation between clinical characteristics of different subtypes and traditional Chinese medicine syndrome types in 511 patients with gastroesophageal reflux disease[J]. Beijing Journal of Traditional Chinese Medicine,2023,42(08):892-896.
胡佳艳，张坤漓，吕咪，等.511例胃食管反流病患者不同亚型临床特征与中医证型的相关性研究［J］.北京中医药，2023，42（8）：892-896. DOI： 10.16025/j.1674-1307.2023.08.020.
HU Jia-yan,ZHANG Kun-li,LYU Mi,et al.Study on the correlation between clinical characteristics of different subtypes and traditional Chinese medicine syndrome types in 511 patients with gastroesophageal reflux disease[J]. Beijing Journal of Traditional Chinese Medicine,2023,42(08):892-896. DOI： 10.16025/j.1674-1307.2023.08.020.
摘要
目的,2,探讨511例不同亚型胃食管反流病（GERD）患者的临床特征及中医证型分布特点。,方法,2,采集2017年1月—2021年12月中国中医科学院西苑医院门诊病历系统中诊断为GERD的511例患者临床资料，根据其亚型分为非糜烂性胃食管反流病（non-erosive reflux diseases，NERD）组362例，反流性食管炎（reflux esophagitis，RE）组149例。分析不同亚型患者的临床特征、不同亚型重叠功能性消化不良（FD）及其亚型的发生率；运用多因素二元Logistic回归探索GERD患者食管黏膜病变的影响因素，运用卡方检验分析不同临床特征GERD患者的中医证型分布特点。,结果,2,RE组男性患者及合并食管裂孔疝比例更高（,P,<,0.05），2组年龄、情绪障碍、伴随食管外症状及便秘症状比较差异均无统计学意义（,P,>,0.05）。年龄、性别、食管裂孔疝是GERD患者食管黏膜病变的危险因素，年龄大、男性及合并食管裂孔疝的患者更易发生食管黏膜病变，而重叠餐后不适综合征（postprandial distress syndrome，PDS）是食管黏膜病变的保护因素（,P,<,0.05）。GERD重叠FD的患者352例，重叠发生率为68.9%。NERD组、RE组重叠FD、重叠上腹疼痛综合征（epigastric pain syndrome，EPS）发生率比较差异无统计学意义（,P,>,0.05），但NERD组重叠PDS发生率高于RE组（,P,<,0.05）。511例患者中最常见的4种证型是肝胃郁热证（48.3%）、脾虚湿热证（19.6%）、胆热犯胃证（17.0%）以及气郁痰阻证（5.3%）。与无食管外症状相比，有食管外症状的患者脾虚湿热证更少而气郁痰阻证更多（,P,<,0.05）；与无便秘症状、无情绪障碍的患者相比，有便秘症状、有情绪障碍的患者肝胃郁热证更多而脾虚湿热证更少（,P,<,0.05）；与未重叠EPS患者相比，重叠EPS的患者胆热犯胃证更多而脾虚湿热证更少，差异均有统计学意义（,P,<,0.05）。中医证型分布在性别、年龄、是否重叠PDS以及亚型分组中分布差异无统计学意义（,P,>,0.05）。与肝胃郁热证相比，重叠便秘症状以及情绪障碍是脾虚湿热证的危险因素（,P,<,0.05），食管外症状是气郁痰阻证的保护因素（,P,<,0.05）。,结论,2,NERD与RE临床特征存在差异。与RE相比，NERD更易重叠FD，尤其是PDS；中医证型分布因重叠其他症状或疾病而有区别。
Abstract
关键词
胃食管反流病非糜烂性反流病反流性食管炎功能性消化不良中医证型
Keywords
references
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