运用中医气分证和血分证判断慢性肝炎肝脏病理程度的研究

Discussion about differential pathologic by the analysis of Qi syndrome and Xue syndrome of chronic hepatitis

目的:研究运用中医证型来判断慢性肝炎肝脏病理程度。方法:对286例慢性肝炎患者行中医辨证和肝活检肝组织病理分级分期,按气分证和血分证分组,将肝组织炎症分为G0-2、G3-4两个级度,纤维化分为S0-2、S3-4两个级度,比较气分证与血分证的差异,采用诊断性试验四格表法评价气分证和血分证判断G0-2或G3-4和S0-2或S3-4的价值。结果:气分证组与血分证组各在G0-2、G3-4和S0-2、S3-4的差异均P<0.01,气分证判断G0-2和S0-2的敏感性、特异性、准确性分别为81.03%、87.50%、83.57%和92.53%、87.50%、90.56%,血分证判断G3-4和S3-4的敏感性、特异性、准确性分别为87.50%、81.03%、83.57%和87.50%、92.53%、90.56%。结论:慢性肝炎气分证与血分证有显著不同的肝脏病理状态,可以通过辨别气分证和血分证来判断慢性肝炎肝组织炎症及纤维化程度。

Objective： To decide the pathologic grade and stage of chronic hepatitis with TCM syndrome types. Methods： The patients with chronic hepatitis were studied by Chinese medical dialectics and biopsy of liver. The liver inflammation and fibrosis were divided into two groups respectively （ G0-2 and G3-4, S0-2 and S3 -4 ）. And used diagnostic test four-frame table methods to evaluate the value of the judgment of different pathologic with Qi syndrome and Xue syndrome. Results： The judgment of G0-2 and S0-2, with Qi Syndrome in sensitivity, peculiarity, accuracy were respectively 81.03%, 87.50%, 83.57% and 92. 53% , 87. 50%, 90. 56%. The judgment of G3 -4 and S3-4 with Xue syndrome in sensitivity, peculiarity, accuracy were respectively 87. 50%, 81.03%, 83. 57% and 87. 50%, 92. 53%, 90. 56%. And their differences were P 〈 0. 01. Conclusion： There are significantly differents in pathologic of chronic hepatitis by analysis of Qi syndrome and Xue syndrome.