摘要
目的:探讨慢性病毒性乙型肝炎肝纤维化的不同中医证候之间的差异和最常见的中医证型,揭示"证"的实质及其与客观指标的内在规律。方法:采用临床病例观察及实验室检测,收集152例确诊慢性乙型肝炎肝纤维化患者的临床资料,包括病史、症状、辨证分型、辅助检查(如ALT、AST、HBV-DNA、肝纤4项)等数据,应用SPSS13.0软件包建立数据库,进行统计分析。结果:152例患者中肝郁脾虚证112例,占73.68%,湿热中阻证20例,占13.16%,瘀血阻络证16例,占10.53%,肝肾阴虚证3例,占1.97%,脾肾阳虚证1例,占0.66%。肝纤4项各项指标的阳性人数均以肝郁脾虚证患者占大多数,PCⅢ水平高低的次序为肝肾阴虚证>肝郁脾虚证>瘀血阻络证>湿热中阻证;Cl-Ⅳ的次序为瘀血阻络证>肝郁脾虚证>湿热中阻证>肝肾阴虚证;LN的次序为肝郁脾虚证>湿热中阻证>肝肾阴虚证>瘀血阻络证;HA的次序为瘀血阻络证>肝郁脾虚证>肝肾阴虚证>湿热中阻证。但肝纤4项中各项指标中,各证型之间两两比较差异无统计学意义(P>0.05)。结论:慢性病毒性乙型肝炎肝纤维化以肝郁脾虚证最常见,肝郁脾虚、湿热中阻、瘀血阻络、肝肾阴虚、脾肾阳虚是慢性病毒性乙型肝炎肝纤维化由浅入深、由轻到重发展过程中的不同阶段,随着病情的加重,肝纤维化的程度逐渐增高,肝纤4项的阳性人数随着中医病机演变而逐渐减少,但PCⅢ、Cl-Ⅳ、LN、HA的水平随着中医病机演变逐渐增高。
Objectives:to investigate into differences among various sign-syndrome type of hepatic fibrosis following chronic hepatitis B virus(HBV),and the most common type to bring to light internal relations between nature of sign-syndrome and objective indices.Methods:By case observation and lab detection,152 confirmed patients' clinical information,(i.e.,case history,symptoms,syndrome differentiation,assisted tests-ALT,AST,HBV-DNA,HA,type Ⅲprecollagen,type Ⅴcollagen,and LN)were collected and processed with SPSS13.0 software.Results:152 cases were categorized into different sign-syndrome types:112 cases(73.68%)into the type of liver depression and spleen deficiency(a);20 cases(13.16%)into damp-heat obstruction(b);16 cases(10.53%)into blood stasis and collateral obstruction(c);3 cases(1.97%)into yin deficiency of liver and kidney(d);1 cases(0.66%)into yang deficiency of spleen and kidney(e).Cases with positive results in hepatic fibrosis tests mostly belonged to type a;PCIII level:d>a>c>b;C1-IV:c>a>b>d;LN:a>b>d>c;HA:c>a>d>b.However,any two types were not significantly different in fibrosis tests(P>0.05).Conclusions:liver depression and spleen deficiency(a)is most common in chronic HBV caused hepatic fibrosis.Types of a,b,c,d,e in order were different illness developing phases.As illness aggravates,hepatic fibrosis increases,while number of positive cases in HF tests declines,in the same time,the levels of PCIII,C1-IV,LN,HA rise gradually.
出处
《世界中医药》
CAS
2007年第4期211-213,共3页
World Chinese Medicine
关键词
慢性乙型肝炎
肝纤维化/中医证型
Chronic hepatitis B,Hepatic fibrosis/Sign-syndrome of Chinese medicine
