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1、提要目的：运用临床流行病学的方法，研究CAG癌前病变中医临床证候规律，以期规范证候宏观标准，提高辨证水平。方法：临床选择符合纳入标准的慢性萎缩性胃炎癌前病变156例患者进行问卷调查，所有病例均进行胃镜检查，对所采集到的数据整理后，运用卡方检验以及因子分析法进行统计分析。结果：经因子分析统计方法得出156例慢性萎缩性胃炎癌前病变患者，存在脾胃虚弱兼有肾气不足，气滞血瘀，脾胃气滞，肝气郁结，肝火旺盛，肝气犯胃六种证型。结论：中医宏观辨证、胃镜下黏膜病变状态、Hp病原学结果都多见综合、重叠、交叉的变化，绝少整齐单一，符合CAG癌前病变病机复杂，病性多变的特征。统计结果表明，CAG癌前病变病
2、性虚实夹杂，虚证以气阴两虚为主，另有脾胃虚弱、肾气不足；实证以气滞血瘀为主，另有肝胃郁热。关键词慢性萎缩性胃炎癌前病变；宏观辨证；胃镜象；幽门螺杆菌；因子分析StudyonTraditionalChineseMedicalSyndromeofPrecancerousLesionsofChronicAtrophicGastritisSpeciality：DigestiveSystemDiseaseInternalMedicineofTCMAthour：HuWanjingTutor：ProfessorLuGuangchaoAbstractObjective：Throughinvestig
3、ationmethodsofclinicepidemiology,tostudythetraditionalChinesemedical(TCMforshort)syndromeofprecancerouslesionsofChronicAtrophicGastritis(CAGforshort),soastoguidethepractice,improvetheclinicalefficacyandthetreatmentlevel.Methods：Collecttheclinicalandendoscopicdataof156patientswithprecancerousles
4、ionsofCAG,introduce“GastroscoPicsigns”intothesyndromedifferentiationofTCM,summarizethecollecteddata,andmakestatisticalanalysisbychi-squaretestandfactoranalysis.Results：Throughthestatisticsbyfactoranalysis,theresultshowsthatthe156subjectswhoisinthecourseofprecancerouslesionsofCAGexistsixpatterns
5、,theyarePi-wei-xu-ruo，withShen-qi-buzu，Qi-zhi-xu-yu,Pi-wei-qi-zhi,Gan-qi-yu-jie,Gan-huo-wang-cheng,Gan-qi-fan-wei.Conclusions：Comprehensive,crossedandoverlappingchangeswereofenseeninmacroscopicsyndromedifferentiationofTCM,gastroscopicobservationofmucosallesions,andetiologicdiagnosisofHp,whereas
6、tidyandunitarychangeswereveryrare,whichwasinaccordancewiththecharacteristicofprecancerouslesionsofCAG——complicatedpathogenesisandvariablepathologicalnature.ThestatisticalresultsshowedthatthepathologicalnatureofprecancerouslesionsofCAGwasdeficiencyaccompaniedwithexcess.Themaindeficiencysyndromes
7、ofprecancerouslesionsofCAGwerePi-wei-xu-ruo,aswellasShen-xu;themainexcessivesyndromesofprecancerouslesionsofCAGwereQi-zhi-xue-yu.KeyWordsPrecancerouslesionsofCAG；macroscopicsyndromedifferentiation；GastroscoPicsigns；Helicobacterpyl
