摘要
目的:研究胃食管反流病中医证候的分布规律,探讨其主要症状与其他症状间的联系。方法:收集186例胃食管反流病患者的四诊信息,诊断中医证型,采用CONCOR迭代相关收敛法、可视化分析法等对其相对中心度、节点中心度、接近中心度等进行分析,并形成可视化图谱。结果:胃食管反流病患病几率从高到低依次为中年人>年轻人>老年人。186例胃食管反流病患者中,有明显诱因者136例,其中与情绪相关者50例,与饮食相关者58例,与劳累相关者16例,与感受外邪相关者8例,另因手术或药物诱发者4例。186例胃食管反流病患者中,肝胃郁热证38例,胆热犯胃证26例,气郁痰阻证32例,瘀血阻络证10例,脾虚湿阻证29例,痰气交阻证21例,寒热错杂证30例。嗳气、乏力、反酸、胃痛贯穿于各个证型中,与胃食管反流病诊断关系密切,而嗳气在胃食管反流病的证候网络中相对中心度最高。子群2的内部密度数值最大,子群2的症状包括:乏力、反酸、口苦。结论:胃食管反流病的关键病机为"脾胃虚弱,胃虚气逆",嗳气、反酸、乏力、胃痛与胃食管反流病诊断关系密切,乏力、反酸、口苦三症状内部联系最为密切。
Objective:To study the distribution rules of TCM syndromes of gastroesophageal reflux disease(GERD)and the relationship between its main symptoms and other symptoms.Methods:The four pieces of diagnostic information of 186 patients with GERD were collected to diagnose the syndrome type of TCM.The relative centrality,node centrality and proximity centrality were analyzed by CONCOR iterative correlation convergence method and visualization analysis method,and the visualization atlases were formed.Results:The incidences of GERD of the middle-aged were the highest,and those of the young was the second highest followed by those of the elderly.Among the 186 patients with GERD,136 had obvious inducements,including 50 with emotions,58 with diet,16 with fatigue,7 with external pathogens,and 4 with operation or drug inducer.Among the 186 patients with GERD,38 had liver and stomach heat stagnation syndrome,26 had gallbladder heat invading stomach syndrome,32 had qi stagnation and phlegm obstruction syndrome,10 had blood stasis obstructing collaterals syndrome,29 had spleen deficiency and dampness obstruction syndrome,21 had intermingled phlegm-qi obstruction syndrome,and 30 had intermingled cold and heat syndrome.Belching,asthenia,acid regurgitation and stomachache ran through all syndrome types,which were closely related to the diagnosis of GERD,while belching had the highest relative centrality in the syndrome network of GERD.The internal density of subgroup 2 was the highest,and the symptoms of subgroup 2 included:fatigue,acid regurgitation and bitter mouth.Conclusion:The key pathogenesis of GERD is "weakness of the spleen and stomach,deficiency of the stomach and inverse qi".Belching,acid regurgitation,asthenia and stomach pain are closely related to the diagnosis of GERD,and the internal relations of asthenia,acid regurgitation and stomachache are the most closely.
作者
于盼盼
田晶晶
戚经天
YU Pan-pan;TIAN Jing-jing;QI Jing-tian(Nankai Hospital of Tianjin,Tianjin,China,300100)
出处
《河南中医》
2020年第4期593-596,共4页
Henan Traditional Chinese Medicine
基金
天津市卫生健康委员会课题项目(2017046)。
关键词
胃食管反流病
社会网络视角
证候分布
肝胃郁热证
胆热犯胃证
气郁痰阻证
瘀血阻络证
脾虚湿阻证
痰气交阻证
寒热错杂证
gastroesophageal reflux disease(GERD)
the perspective of social network
syndrome distribution
liver and stomach heat stagnation syndrome
gallbladder heat invading stomach syndrome
qi stagnation and phlegm obstruction syndrome
blood stasis obstructing collaterals syndrome
spleen deficiency and dampness obstruction syndrome
intermingled phlegm-qi obstruction syndrome
intermingled cold and heat syndrome
