Traditional Chinese Medical syndromes in 69 patients with autoimmune gastritis: A single-center retrospective cross-sectional study
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摘要: 目的 研究自身免疫性胃炎证候分布规律。方法 采用单中心回顾性横断面调查方法，选取上海市嘉定区中医医院2014—2022年医院信息系统数据，共纳入69例自身免疫性胃炎患者。采集患者胃镜、活检或手术病理、四诊信息(包括症状、舌象和脉象)等数据。采用因子分析、聚类分析方法分析自身免疫性胃炎证候分布规律。结果 共收集到35个症状因子及17个舌脉因子进行分析，排除频率 < 5%的症状因子，共纳入15个症状因子进行因子分析。共提取出6个公因子。将纳入因子分析的15个症状及10个舌脉因子进行系统聚类分析，结合因子分析结果、中医诊疗专家共识意见证候类型，可将本病的证候分为4个类型：脾胃虚弱、脾胃湿热、肝胃不和、阴虚血瘀。在此4个证候类型基础上，将上述因子进行K均值聚类分析，归纳为脾胃虚弱型23例(33.33%)，脾胃湿热型17例(24.64%)，阴虚血瘀型16例(23.19%)，肝胃不和型13例(18.84%)。结论 自身免疫性胃炎的证候可分为脾胃虚弱、脾胃湿热、肝胃不和、阴虚血瘀4型。Abstract: Objective To investigate Traditional Chinese Medical syndromes in patients with autoimmune gastritis.Methods A single-center retrospective cross-sectional study was completed. A total of 69 autoimmune gastritis patients were collected from the hospital information system in Jiading Hospital of Traditional Chinese Medicine in 2014-2022. The data, which include gastroscope, biopsy or surgical pathology, and four diagnostic information were analyzed by factor analysis and cluster analysis.Results Fifty-two pieces of information were collected, including 35 symptoms and 17 data of tongue coating and pulse. A total of 15 symptom factors were included for factor analysis, after symptom factors with a frequency of < 5% were excluded, and six common factors were extracted. 15 symptom factors and 10 tongue and pulse factors included in factor analysis were analyzed by systematic cluster analysis. Combined with the results of factor analysis and the consensus of TCM diagnosis and treatment experts, the syndrome types of this disease can be divided into four types: weakness of spleen and stomach, damp heat of spleen and stomach, disharmony between liver and stomach, Yin deficiency and blood stasis. Based on the four syndrome types, the above factors were analyzed by K-means cluster analysis. There were 23 cases of spleen stomach weakness type(33.33%), 17 cases of spleen stomach damp-heat type(24.64%), 16 cases of Yin deficiency and blood stasis type(23.19%), and 13 cases of liver stomach disharmony type(18.84%).Conclusion The syndromes of autoimmune gastritis can be divided into four types: weakness of spleen and stomach, damp heat of spleen and stomach, disharmony between liver and stomach, Yin deficiency and blood stasis.
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表 1 症状频数分布
症状 频次 频率/% 症状 频次 频率/% 中上腹胀 28 40.58 咽部异物感 2 2.90 中上腹不适 27 39.13 头晕 2 2.90 嗳气 22 31.88 汗出 2 2.90 中上腹痛 20 28.99 腰酸 2 2.90 胃纳差 12 17.39 脐周胀满 1 1.45 大便稀溏 10 14.49 黑便 1 1.45 大便次数增多 8 11.59 小便黄 1 1.45 泛酸 7 10.14 呕吐 1 1.45 大便干结 7 10.14 早饱 1 1.45 烧心 6 8.70 口干 1 1.45 夜寐不安 6 8.70 口腔溃疡 1 1.45 乏力 6 8.70 烦躁易怒 1 1.45 口苦 5 7.25 头痛 1 1.45 恶心 4 5.80 短气 1 1.45 易饥饿 4 5.80 耳鸣 1 1.45 脐周疼痛 3 4.35 口腔异味 1 1.45 中上腹冷 2 2.90 善太息 1 1.45 矢气 2 2.90 
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表 2 舌脉频数分布
舌苔 频次 频率/% 脉象 频次 频率/% 苔腻 31 44.93 脉细 41 59.42 舌淡红 30 43.48 脉弦 22 31.88 舌红 29 42.03 脉滑 17 24.64 苔白 27 39.13 脉沉 3 4.35 薄苔、少苔 18 26.09 脉迟 1 1.45 苔黄 15 21.74 脉浮 1 1.45 舌暗红 10 14.49 脉缓 1 1.45 齿痕舌 2 2.90 花剥苔 1 1.45
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