酒精性肝病患者中医证型与无创肝纤维化诊断模型、凝血功能的相关性研究

Correlation Study of TCM Syndrome Types with Non-invasive Liver Fibrosis Diagnosis Model and Blood Coagulation Function in Patients with Alcoholic Liver Disease

目的:探讨酒精性肝病患者中医证型与无创肝纤维化诊断模型及凝血功能之间的相关性。方法:收集159例酒精性肝病患者的临床资料,完善各患者外周血细胞、肝功能及凝血功能等指标检测,并对其进行中医证候辨证分型,分为肝胃气滞型、肝胆湿热型、肝肾阴虚型、脾肾阳虚型、痰瘀阻滞型5种证型。依据文献建立天冬氨酸氨基转移酶和血小板比率指数(APRI评分)、基于4项因素的肝纤维化指数(FEIB-4)2种无创肝纤维化模型。采用SPSS 17.0统计软件分析数据。结果:APRI模型结合凝血功能评估痰瘀阻滞型的诊断价值更优于FIB-4模型,FIB-4模型评估ALD患者肝肾阴虚型诊断价值高于APRI模型。结论:APRI、FIB-4肝纤维化无创诊断模型及凝血功能与酒精性肝病患者的中医证型具有一定相关性,可为病情评估、治疗提供参考依据。

Objective:The study aims to investigate the relationship between Traditional Chinese Medicine(TCM)syndromes of patients with alcoholic liver disease,non-invasive liver fibrosis diagnosis models,and blood coagulation function.Methods:Clinical data from 159 patients with alcoholic liver disease were collected,including peripheral blood cell counts,liver function,and blood coagulation function.Patients were classified into 5 TCM syndromes:liver and stomach Qi-stagnation type,liver and gallbladder damp-heat type,liver and kidney Yin deficiency type,spleen and kidney Yang deficiency type,and phlegm-stasis block type.Based on the literature,two non-invasive liver fibrosis models were established using the aspartate aminotransferase and platelet ratio index(APRI score)and the liver fibrosis index(FEIB-4)based on 4 factors.The data were analyzed using SPSS 17.0 statistical software.Results:The APRI model combined with blood coagulation function had a better diagnostic value in evaluating phlegm and blood stasis block type than the FIB-4 model.The FIB-4 model was more valuable than the APRI model in evaluating liver and kidney Yin deficiency type in patients with alcoholic liver disease.Conclusion:The APRI and FIB-4 non-invasive diagnosis models of liver fibrosis and blood coagulation function are correlated with the TCM syndromes of patients with alcoholic liver disease,which can provide a reference for disease evaluation and treatment.