摘要
目的 探讨肝炎后肝硬化中医证候特点。方法 临床系统采集 2 2 3例肝炎后肝硬化患者中医四诊信息和相关实验室指标 ,运用SAS 6.11软件进行系统聚类、主成分分析、逐步判别和方差分析等多元统计。结果 多元分析提示 3类证候特点 :第 1类为湿热内蕴、血瘀阻络、肝脾气虚的 13 4例 ;第 2类为气阴两虚 ,气虚重于阴虚 ,湿热内蕴 ,湿重于热 ,兼有血瘀的 62例 ;第 3类为气阴两虚 ,阴虚重于气虚、瘀热内蕴 ,兼有湿邪内停的 2 7例。分析相关实验室指标在 3类证候间的变化显示 ,邪实为主、兼有正虚的的第 1类 ,其血天冬氨酸转移酶 (AST)、丙氨酸转移酶 (ALT)、γ 谷氨酰转移酶 (GGT)活性显著高于正虚为主、兼有邪实的其它两类 ;阴虚为重的第 3类 ,其血纤维结合蛋白 (FN)、血浆凝血因子Ⅴ (FⅤ )、血浆凝血因子Ⅶ (FⅦ )、白蛋白 (Alb)、血小板计数 (PLT)、血小板压积 (PCT)值均显著低于气虚重于阴虚的第 2类及邪实为主的第 1类。结论 多元统计方法在较大程度上能体现出肝炎后肝硬化中医证候的特点及规律性 ,3类中医证候特点基本符合临床。证候分类与实验室指标结果提示 ,肝组织炎症是湿热内蕴的病理基础 ,肝功能障碍。
ObjectiveTo explore the characteristic s of traditional Chinese medical syndrome (TCM syndrome) of hepatocirrhosis. MethodsClinical information from the four diagnosis methods of traditional Chinese medicine (TCM) and related laboratorial indexes were sys tematically collected from 223 hepatocirrhosis cases, and the multi-statistical methods including systematic cluster analysis, principal component analysis, st epwise discrimination and variance analysis were made with the software SAS 6.11 . ResultsMulti-analysis showed that there were 3 cate gories of syndrome characteristics. Type 1 (134 cases): damp heat, blood stasis, deficiency of liver and spleen Qi; Type 2 (62 cases): deficiency of both Qi and Yin with severe deficiency of Qi, heat with severe dampness, blood stasis; Type 3 (27 cases): deficiency of both Qi and Yin with severe deficiency of Yin, stas is and heat or dampness. Analysis of the changes of the related laboratorial ind exes among the three types of syndrome showed that Type 1 mainly manifested asth enia syndrome with sthenia syndrome , and its indexes of AST、ALT、GGT levels we re markedly higher than those of Type 2 and Type 3, both of which mainly showed sthenia syndrome with asthenia syndrome, and that Type 3 was in active inflammat ion, deficiency of both Qi and Yin(deficiency of Yin > deficiency of Qi), and its FN、Alb、FⅤ、FⅦ、PLT、PCT levels were obviously reduced. Conclusion The multi-statistical methods can reveal the characteristic s and regularity of TCM syndrome of hepatocirrhosis, and the 3 categories of syn drome characteristics basically conform to clinical manifestations. The result o f TCM syndrome distribution and laboratorial indexes infer that damp heat is the pathological basis of hepatocirrhosis, and the degree of liver function disorde r and liver damage may be the pathological basis of deficiency of Yin of both li ver and kidney.
出处
《中西医结合学报》
CAS
2003年第2期108-112,共5页
Journal of Chinese Integrative Medicine
关键词
肝炎后肝硬化
中医证候
临床调查
中医药疗法
hepatocirrhosis
traditional Chinese medi cal syndrome
multi-analysis
