目的对幽门螺杆菌(Hp)相关性慢性胃炎的证候、证候要素进行研究,探讨Hp感染的中医证候表达。方法收集非萎缩性胃炎和萎缩性胃炎各200例。应用因子分析和复杂系统熵聚堆2种统计方法对400例患者的四诊信息进行分析。结果Hp阳性慢性胃炎的病位要素有4个:肝、胃、脾、胆(结合临床和专家问卷调查将“胆”舍弃);而Hp阴性慢性胃炎的病位要素有3个:肝、胃、脾。Hp阴性和Hp阳性慢性胃炎的病性要素均为9个:气虚、阴虚、阳虚、气滞、湿、热、瘀血、食积、寒。共得出8个基本证型:类肝胃郁热证、类脾胃虚弱证、类湿热蕴结证、类饮食停滞证、类脾寒胃热证、类胃阴不足证、类肝胃不和证、类瘀阻胃络证。经∥检验,Hp阳性和Hp阴性慢性胃炎的病性要素分布无差异,但基本证型的分布有差异。经两两比较,结果表明Hp感染与证型分布明显相关(P〈0.01),以类胃阴不足证为最密切,其次是类脾胃虚弱证、类湿热蕴结证及类肝胃郁热证。结论Hp感染与湿、热相关,与阴虚关系更为密切。作为一种外来致病因素,Hp的邪气性质与湿、热密切相关,与热关系更大,且具有易伤阴液的特点。
Objective To study the syndromes and syndrome factors of Helicobacter pylori (Hp)-related chronic gastritis, and discuss the expressions of TCM syndromes of Hp infection. Methods The patients with non-atrophic gastritis and atrophic gastritis (each n = 200) were chosen, and their data from TCM four examinations were analyzed by using factor analysis and entropy-reactor of complex system. Results There were 4 syndrome factors related to disease locations of Hp-positive chronic gastritis, including liver, stomach, spleen and gallbladder (gallbladder being given up after clinical and expert questionnaire), and there were 3 of Hp-negative chronic gastritis, including liver, stomach and spleen. There were 9 syndrome factors related to disease nature of Hp-positive or Hp-negative chronic gastritis, including qi deficiency, yin deficiency, yang deficiency, qi stagnation, phlegm, heat, blood stasis, food accumulation and cold. There were 8 basic syndrome types, including para-syndrome of depression-heat in liver and stomach, para-syndrome of spleen-stomach weakness, para-syndrome of damp-heat accumulation, para-syndrome of food stagnation, para-syndrome of spleen cold and stomach heat, para- syndrome of stomach yin deficiency, para-syndrome of liver qi invading stomach and para-syndrome of stasis in stomach collateral. After Chi-square test, the distribution of the syndrome factors related todisease nature had no difference between Hp-positive chronic gastritis and Hp-negative chronic gastritis, but that of basic syndrome types had difference. The results of pairwise comparison showed that Hp infection was significantly correlated to syndrome distribution ( P 〈 0.01 ), and it was most closely related to para-syndrome of stomach yin deficiency and followed by para-syndrome of spleen-stomach weakness, para-syndrome of damp-heat accumulatiorr and para-syndrome of depression-heat in liver and stomach. Conclusion Hp infection is correlated to dampness and heat, especially to yin deficiency. As a kind of exte