胃脘痛中医辨证与胃镜表现的关联规则分析

目的探索胃脘痛中医辨证特点及其与胃镜表现的关系。方法运用关联规则的数据挖掘方法，对234例胃脘痛患者中医宏观辨证与胃镜检测结果进行分析研究。结果脾胃虚弱（寒）证与胃黏膜苍白，或溃疡浅，红肿不明显相关；肝气犯胃证与胆汁反流相关；湿热中阻证与黏膜红肿明显，或溃疡有黄白苔相关；胃阴亏耗证与黏膜粗糙，血管显露，或黏液稀少相关；瘀血停胃证与黏膜隆起肿胀，糜烂相关；饮食伤胃证与水食物潴留，或可见较多黏液附着黏膜相关。脾胃虚弱（寒）证和湿热中阻证对应的内镜下表现出现的频次最高，而中医宏观辨证以脾胃虚弱（寒）证和肝气犯胃证最高。结论胃脘痛内镜下特征性表现与中医辨证密切相关；通过胃镜等现代腔镜检查手段，可更加客观深入地把握胃脘痛的辨证特点，提高临床辨证准确性。

英文摘要:

Objective To explore Chinese medical syndrome typing features of epigastric pain and its association with gastroscopic manifestations. Methods Using associated rules data mining method， an analysis study was performed in 234 patients with epigastric pain by combining holistic Chinese medical syndrome typing and results of gastroscopic examinations. Results Pi Wei deficiency cold syndrome （PWDCS） was associated with pale gastric mucosa， or superficial ulcers accompained with unobvious redness and swelling. Inversed Gan qi invading Wei syndrome （IGIWS） was associated with bile regurgitation. Damp heat stagnating in the middle jiao syndrome （DSMJS） was associated with obvious redness and swollen mucosa， or ulcers accompanied with yellow and white fur. Wei yin exhaustion syndrome （WYES） was associated with coarse mucosa and exposed blood vessels， or rare mucus. Retention of blood stasis in Wei syndrome was associated with bulged swelling and erosion. Indigestion impairing Wei syndrome （IIWS） was associated with retention of water and food， or more mucus attached. The endoscopic manifestations of PWDCS and DSMJS occurred most frequently， while PWDCS and IGIWS ranked the first place in macroscopic Chinese medical syndrome typing. Conclusions The manifestations of endoscopic features were closely associated with Chinese medical syndrome typing. The syndrome typing features of epigastric pain could be objectively and further grasped by summarizing syndrome typing laws using modern devices such as gastroscopic examinations， thus improving the accuracy of clinical syndrome typing.

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