酒精性肝硬化中医证型与肝功能相关性分析
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R657.3+1

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Correlation Analysis Between Chinese Medicine Syndrome Types of Alcoholic Cirrho⁃ sis and Liver Function
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    摘要:

    目的:研究酒精性肝硬化(AC) 患者中医证型与肝功能的相关性。方法:回顾性分析163 例AC 患者的临床资料,根据证型不同分肝气郁结证组39 例、湿热蕴结证组54 例、瘀血阻络证组28 例、肝肾阴虚 证组27 例和脾肾阳虚证组15 例,比较各组肝功能特征和Child-Turcotte-Pugh(CTP) 分级。结果:AC 中医证 型分布中以湿热蕴结证为主。谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、白蛋 白(Alb)、凝血酶原时间(PT)、胆碱酯酶(CHE)、总胆红素(TBil)、总胆汁酸(TBA) 和CTP 分级在各证 型中的分布,差异均有统计学意义(P<0.05)。两两比较,湿热蕴结证组ALT 高于肝气郁结证组、肝肾阴虚 证组,且AST 高于瘀血阻络证组、肝肾阴虚证组,且GGT 高于其他4 组,差异均有统计学意义(P<0.05); 肝气郁结证组Alb 高于肝肾阴虚证组、脾肾阳虚证组,且CHE 显著高于湿热蕴结证组、脾肾阳虚证组,且PT 较湿热蕴结证组、肝肾阴虚证组和脾肾阳虚证组偏低,差异均有统计学意义(P<0.05);湿热蕴结证组的TBil 高于肝气郁结证组、瘀血阻络证组、肝肾阴虚证,且TBA 高于肝气郁结证组,差异均有统计学意义(P< 0.05)。结论:AC 患者中医证型与肝功能、CTP 分级存在相关性,其证型演变与CTP 分级递增一致,且湿热蕴 结证是本病的主要证型。

    Abstract:

    Abstract:Objective:To study the correlation between traditional Chinese medicine (TCM) syndrome types and liver function in patients with alcoholic cirrhosis (AC). Methods:The clinical data of 163 cases of AC patients were retrospectively analyzed. According to different syndrome types,they were divided into the liver qi depression syndrome group,the damp- heat accumulation syndrome group,the static blood obstructing the collaterals syndrome group, the liver- kidney yin deficiency syndrome group, and the spleen- kidney yang deficiency syndrome group, with 39, 54, 28, 27, and 15 cases in each group respectively. Liver function characteristics and Child- Turcotte- Pugh (CTP) classification were compared among all groups. Results:The main TCM syndrome type of AC was damp-heat accumulation syndrome. There were significant differences being found in the distribution of alanine aminotransferase (ALT), aspartate aminotransferase (AST),glutamyl transpeptidase (GGT),albumin (Alb),prothrombin time (PT), cholinesterase (CHE),total bilirubin (TBil),total bile acid (TBA) and CTP classification in all syndrome types (P<0.05). Pairwise comparison showed that ALT in the damp- heat accumulation syndrome group was higher than those in the liver qi depression syndrome group and liver- kidney yin deficiency syndrome group,AST was higher than those in the static blood obstructing the collaterals syndrome group and the liver- kidney yin deficiency syndrome group, and GGT was higher than those in the other four groups, differences being significant (P<0.05). Alb in the liver qi depression syndrome group was higher than those in the liver-kidney yin deficiency syndrome group and the spleen-kidney yang deficiency syndrome group, CHE was significantly higher than those in the damp- heat accumulation syndrome group and the spleenkidney yang deficiency syndrome group, and PT was lower than those in the damp- heat accumulation syndrome group,the liver- kidney yin deficiency syndrome group and the spleen- kidney yang deficiency syndrome group, differences being significant (P<0.05). TBil in the damp- heat accumulation syndrome group was higher than those in the liver qi depression syndrome group, the static blood obstructing the collaterals syndrome group and the liver-kidney yin deficiency syndrome,and TBA was higher than that in the liver qi depression syndrome group, differences being significant (P<0.05). Conclusion: There is correlation between TCM syndrome types of AC patients and liver function and CTP classification. The evolution of the syndrome types is consistent with the increase of CTP grades, and the damp- heat accumulation syndrome is the main syndrome type of this disease.

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林尚明,刘林华,刘蒙,贺劲松,魏春山.酒精性肝硬化中医证型与肝功能相关性分析[J].新中医,2023,55(22):78-82

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  • 在线发布日期: 2023-11-28
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