HBV相关性慢加亚急性肝衰竭中医症候群积分与疾病分期及预后相关性研究

The dependability study on traditional Chinese medicine syndromes integral of hepatitis B virus related acute-on-chronic liver failure for disease stage and prognosis

目的:观察HBV相关性慢加亚急性肝衰竭(HBV-ACLF)患者中医症候群积分与病情分期、预后的相关性。方法:以中医证素研究为理论基础,以湿热、脾虚、血瘀症候群各自中医症候量化表为标准,观察124例HBV-ACLF患者3种症候群积分差异与病情分期及预后的关系。结果:与中/晚期肝衰竭患者比较,早期患者湿热症候群积分较高,血瘀症候群积分较低,差异均有统计学意义(P<0.05);血瘀症候群积分为肝衰竭早期患者预后影响因素(OR>1),脾虚症候群积分为肝衰竭中/晚期患者预后影响因素(OR>1)。结论 HBV-ACLF早期以湿热症候群表现为主,中晚期以血瘀、脾虚症候群表现为主;血瘀、脾虚症候群积分为预后影响因素之一。

Objective： To observe patients with HBV-ACLF on traditional Chinese medicine（ TCM） syndrome integral,correlation with disease stage and prognosis dependability; Methods： Based on traditional Chinese medicine syndrome factor,damp-heat syndrome,spleen deficiency,blood stasis of their respective quantization table as the standard TCM symptoms,observe the relativity of damp-heat integral,spleen deficiency symptom integral,blood stasis symptom integral,total integral differences and disease stage and prognosis of liver disease in 124 cases of patients. Results： Compared with the middle / late stage patients integral of hot and humid symptoms in the early stage patients were higher; integral of blood stasis symptoms were lower,the difference had statistical significance（ P 0. 05）; To the early stage patients,The integral of blood stasis symptoms was the prognostic factors of the prognosis（ OR 1）; To the middle / late stage patients,the integral of spleen deficiency syndrome was the prognostic factors of the HBV-ACLF prognosis（ OR 1）. Conclusions： Symptoms in the HBV-ACLF early stage is mainly of damp heat. In the middle and late stage are mainly of blood stasis and spleen deficiency syndromes; the integral of blood stasis and spleen deficiency syndrome are prognostic factors of the HBV-ACLF prognosis.