摘要
目的:探讨慢性乙型肝炎肝纤维化患者中医证型与肝脏组织病理分级(G)、分期(S)的关系及对肝纤维化无创性诊断的意义。方法:对符合诊断标准的106例慢性乙型肝炎肝纤维化患者均进行中医辨证分型,同时行肝组织活检,对肝组织进行病理炎症分级、纤维化分期,分析中医证型与肝组织病理分级、分期的相关性。结果:不同证型之间肝组织病理分级、分期有明显差异,肝郁脾虚型S1、G1、G2较多,湿热中阻型S2、G2、G3较多,肝肾阴虚型及脾肾阳虚型S3、G2、G3较多,瘀血阻络型S4、G3、G4较多。结论:慢性乙型肝炎肝纤维化病理分级、分期与中医证型有良好的相关性。随着肝脏病理炎症活动度的逐渐加剧,纤维化程度的不断加重,中医证型由实至虚,由气及血,久病入血入络是其最终的病理转归。
Objective： To study the correlation between traditional Chinese medicine（TCM） syndrome types and pathological grades（G） and stages（S） of the liver in chronic hepatitis B patients with hepatic fibrosis and its significance for noninvasive diagnosis of hepatic fibrosis.Methods： TCM syndrome differentiation was performed on 106 chronic hepatitis B patients with hepatic fibrosis,and liver biopsy was also performed on the patients,with a grading and staging system for assessing the inflammation and fibrosis of the liver tissue.The correlation between TCM syndrome types and pathological grades and stages of the liver was analyzed.Results： There were significant differences among patients with various syndrome types in terms of pathological grades and stages of the liver.S1,G1,and G2 were seen more in patients with hepatic stagnation and spleen deficiency,S2,G2,and G3 were seen more in patients with damp-heat retention,S3,G2,and G3 were seen more in patients with liver-kidney Yin deficiency and spleen-kidney Yang deficiency,and S4,G3,and G4 were seen more in patients with blood stasis obstructing the collaterals.Conclusion： There is a good correlation between TCM syndrome types and pathological grades and stages of the liver in chronic hepatitis B patients with hepatic fibrosis.Fibrosis worsens as the inflammation grade of the liver increases,and the blood and collaterals were affected as the disease progresses.
出处
《湖南中医杂志》
2012年第3期10-12,共3页
Hunan Journal of Traditional Chinese Medicine
基金
广西壮族自治区研究生教育创新计划资助项目(编号:2011106001006M20)
广西壮族自治区自然科学基金(桂科自0832174)
关键词
慢性乙型肝炎
中医证型
肝纤维化
病理
chronic hepatitis B； traditional Chinese medicine syndrome types； hepatic fibrosis； pathological grades and types
