慢性乙型肝炎常见中医证候及证候要素的分析

Analysis on common syndrome manifestations and syndrome factors of chronic hepatitis B

目的探讨慢性乙型肝炎的证候分布规律和证候内部特征,从而为证候的规范化研究提供依据。方法遵循循证医学原则,对符合选择标准的文献中证候及证候要素进行分析。结果认为慢性乙型肝炎最常见证候依次为肝郁脾虚、肝肾阴虚、湿热(蕴结)、脾肾阳虚、瘀血阻络、肝胆湿热、气滞血瘀、肝气郁结、肝郁血瘀、血瘀证、脾肾两虚。证候要素有:病位方面为肝、胆、脾、肾、胃、中焦、络;病性方面为阴虚、阳虚、气虚、血虚、湿、热、气郁、血瘀、毒、寒、水、痰。结论通过总结本病的常见证候分布规律及证候要素,为慢性乙型肝炎证候的标准化研究提供依据。

Objective To discuss the distribution law and internal characteristics of syndrome manifestations of chronic hepatitis B, and to provide a base for standardized study of syndrome manifestations. Method According to the principles of evidence - based medicine, the syndrome manifestations and syndrome factors in documents over the past ten years qualified to the selection standard were analyzed. Results The result showed that the most common syndrome manifestations successively were stagnancy in the liver leading to spleen - deficiency, insufficiency of liver - yin and kidney - yin, accumulation of damp - heat, deficiency of spleen - yang and kidney - yang, obstruction of blood stasis in collaterals, damp -heat in liver and gallbladder, qi stagnation and blood stasis, stagnation of liver - qi, liver depression and blood stasis, stasis of blood, deficiency of both spleen and kidney. The syndrome factors consisted of disease location and disease characters. The location included liver, gallbladder, spleen, kidney, stomach, Zhongjiao and collaterals. The characters included yin insufficiency, yang deficiency, qi deficiency, blood insufficiency, dampness, heat, qi stagnation, blood stasis, toxin, cold, water and phlegm. Conclusion This paper summed up the distribution law of common syndrome manifestations and syndrome factors and provided a base for standardized study on symptoms and signs of chronic hepatitis B.