乙肝后肝硬化辨证分型与胃底静脉血液动力学关系探讨

Relationship Between Chinese Medical Syndromes of Posthepatitic Cirrhosis and Venous Hemodynamics of Fundus of Stomach

目的探讨乙肝后肝硬化的辨证分型与胃底静脉血液动力学的相关性。方法将86例乙肝后肝硬化患者辨证分为肝郁脾虚证(23例)、水湿内阻证(21例)、湿热内蕴证(22例)、肝肾阴虚证(20例);另选健康成人30名作正常对照组。采用激光多谱勒血流仪检测受试者胃底静脉的血流灌注量和流速及血液流变学变化。结果湿热内蕴证及肝肾阴虚证患者胃底静脉的血流灌注量和流速明显低于正常对照组(P<0.05);全血高切、低切黏度及血浆黏度也明显低于正常对照组(P<0.05)。结论乙肝后肝硬化的辨证分型与胃底静脉血液动力学变化有一定相关性,可作为其微观辨证参考指标之一。

Objective To study the relationship between Chinese medical syndromes of posthepatitic cirrhosis and venous hemodynamics of fundus of stomach. Methods Eighty-six subjects were differentiated into liver depression and spleen deficiency syndrome （23 cases）, dampness retention syndrome （21 cases）, dampness heat accumulation syndrome （22 cases）, and liver-kidney yin deficiency syndrome（20 cases）. Thirty healthy people were enrolled as control group. The stomach perfusion unit, blood velocity and rheology were detected. Results The stomach perfusion unit and blood velocity were significantly lower in the latter two syndromes than in the healthy people（P 〈 0.05）; the blood high shear, low shear and plasma viscosity were significantly lower in the latter two syndromes than in the healthy people （P〈 0.05）. Conclusion The Chinese medical syndromes of posthepatitic cirrhosis were related with venous hemodynamics of fundus of stomach, which can be used as an evidence for micro-differential diagnosis.