肝硬化腹水中医证型与检测指标相关性的临床研究

Clinical study on the correlation between syndrome type and index of liver cirrhotic ascites

目的:探讨肝硬化腹水中医证型与肝纤维化、淤胆、肝功能、并发症的关系。方法:收集157例肝硬化腹水患者,辨证分型为水湿内阻、湿热蕴结、阳虚水盛、阴虚水停共4组,并对其肝纤维化、淤胆、肝功能、并发症进行检查和比较。结果:肝纤维化指标比较:阴虚水停型>阳虚水盛型>湿热内蕴型>气滞湿阻型(P<0.05)。淤胆指标比较:阴虚水停型>阳虚水盛型>湿热内蕴型>气滞湿阻型(P<0.05)。肝功能比较:阴虚水停型<阳虚水盛型<湿热内蕴型<气滞湿阻型(P<0.05)。Child-Pugh A级主要分布在水湿内阻、湿热蕴结证,C级主要分布在阴虚水停证。消化道出血、肝性脑病主要发生在阴虚水停证。结论:肝硬化腹水检测指标与中医辨证分型存在内在联系。

Objective:To explore the relationship between the syndrome type of liver cirrhotic ascites with liver fibrosis,cholestasis,liver synthesis and complications.Methods:157 patients diagnosed as liver cirrhosis ascites were collected,and grouped into 4 groups:Shuisineizu type,Sireyunjie type,Yangxushuisheng type,and Yinxushuiting type.The ascites with liver fibrosis,cholestasis,liver synthesis and complications in groups were tested and compared.Results:Comparison of liver fibrosis index among the 4 groups:Yinxushuiting type was>Yangxushuisheng type>Sireyunjie type>Shuisineizu type(P<0.05).Comparison of cholangiasis index among the 4 groups:Yinxushuiting type was>Yangxushuisheng type>Sireyunjie type>Shuisineizu type(P<0.05).Comparison of liver function indexes among the 4 groups:Yinxushuiting type was<Yangxushuisheng type<Sireyunjie type<Shuisineizu type(P<0.05).Child-pugh grade A was mainly distributed in the groups of Shuisineizu type and Sireyunjie type,and grade C mainly in Yinxushuiting group.The complications of gastrointestinal bleeding and hepatic encephalopathy happened were mainly in Yinxushuiting group.Conclusion:The indexes of liver fibrosis related ascites is closely related to TCM syndrome type.