摘要
目的对常规实验室检查、肝病理、FibroTouch与中医证候的相关性进行探讨。方法收集95例进行肝组织活检肝病患者,进行中医证候分型,进行临床和实验室常规检查,包括年龄、性别、血常规、生化、血清纤维化四项、FibroTouch等参数,计算APRI、FIB4评分,根据中医证候分为肝气郁结、湿热蕴结、肝脾两虚、肝肾阴虚四组,分析血清纤维化、APRI、FIB4评分、肝病理炎症、纤维程度及FibroTouch肝弹性程度与中医证候的相关性,计算四种中医证候肝脏硬度值的受试者工作特征曲线(ROC),计算曲线下面积(AUC)。结果各组间年龄、ALT、AST、GGT、BMI、TG、CHOL、Glu、APRI指数、LN、HA无显著差异(P>0.05),但白蛋白水平有差异(P<0.05),FIB4、LSM值及PCIII、IVC差异非常显著(P<0.01),ROC曲线分析显示LSM对肝气郁结、肝脾两虚、肝肾阴虚体现很好的预测,AUC分别为0.883、0.790、0.790,均大于0.7,但对湿热蕴结型预测准确性欠佳。结论肝病理、肝脏弹性测定对中医证候分型有一定的诊断价值,可便于临床更精确的辨证分析,但难以体现中医的整体性。
Objective To assessment the correlation of routine examination of clinical laboratory with TCM syndrome in chronic hepatiitis. Methods 95 patients were divided into groups according to the TCM syndrome： stagnation of liver-qi syndrome, damp and hot accumulate knot, deficiency of liver and spleen and deficiency of liver-yin and kidney-yin. During the same period, each patient was made the assessment of serum liver fibrosis indexes, APRI, Fib-4, hepatic histopathology and LSM of Fibrotouch. The correlation of invasive diagnosis model and TCM syndrome was compared. Results There were no differences in ages, ALT, AST, GGT, BMI, TG, CHOL, Glu, APRI index, LN and HA, but the difference existed in Alb, and there were significant differences in FIBg, LSM, PCIII and IVC. The analysis of ROC the areas under the ROC curve （AUCs） of Fibro Touch in stagnation of liver-qi syndrome, deficiency of liver and spleen and deficiency of liver-yin and kidney-yin were O. 883, 0. 790 and 0. 790, but it was O. 573 in damp and hot accumulate knot. Conclusion Fibrotouch and hepatic histopathology have comparable diagnostic values for TCM syndrome. It can be more accurate syndrome differentiation analysis, but it is difficult to reflect the integrity of traditional Chinese medicine.
作者
杨秀珍
肖丽
王蔚
张丽丽
于立新
咸建春
YANG Xiuzhen;XIAO Li;WANG Wei;ZHANG Lili;YU Lixin;XIAN Jianchun(Hepatology Department,Taizhou People＇s Hospital,Jiangsu Province,Taizhou 225300,China)
出处
《光明中医》
2018年第16期2307-2310,共4页
GUANGMING JOURNAL OF CHINESE MEDICINE
基金
江苏省干部保健科研项目(No.BJ14032)
关键词
证候
慢性肝病
瞬时弹性波检测
肝病理
Syndrome
Chronic hepatitis
Fibrotouch
Hepatic histopathology
