重症肝炎肝胆湿热程度与生化指标及预后的关系

The Relationship between the Degree of Dampness-heat ofLiver-gallbladder and the Biochemistry indicate

目的:探讨重症肝炎肝胆湿热程度与生化指标及预后的关系。方法:选择诊断为重症肝炎的患者126例,按中医肝胆湿热诊断标准进行辨证,用肝胆湿热程度分级量化进行积分统计,把肝胆湿热程度分级量化积分与同期肝功能生化指标进行比较。结果:126例重症肝炎患者均符合肝胆湿热证的诊断标准。其中重症肝炎肝胆湿热轻度者5例(4.0%),中度者49例(38.9%),重度者72例(57.1%)。湿热程度不同,其胆红素变化有明显差异(P<0.05),且肝胆湿热积分与总胆红素呈正相关,与患者的预后呈负相关,两者有明显差异(P<0.05)。凝血酶原活动度与预后呈正相关。结论:湿热既是重症肝炎常见症状,又是其重要的病因病机;湿热与胆红素的变化呈正相关;清热利湿解毒是治疗重症肝炎的主要治法。

Objective：Search the relationship between the degree of dampness-heat of liver-gallbladder and the biochemistry indieatero Method：choose 126 cases with seduns hepatitis,and differentiate them according to the diagnosis standard of TCM, then put the symptom into different grades and quantitize them,alter being analized by statistics ,compare them with the biochemistry indieater of liver funtion.Result：all cases of 126 is under the diagnosis standard of liver-gallbladder dampness-heat.among them the slight cases are 5（4.0%）, the midrange are 49 （38.9%）,and the serious are 72 （57.1%）. the result show that with the different degree,the obvious difference of bilirubin exist （P 〈0.05）.And there is a negative link between the symptom score and totel bilirubin as well as prognosis,and distinguish difference come oat （P 〈0.05）.the activity of serozyme has a positive link with the prognosis.Conclusion：dampness-heat is not only the common symptom but the main mechanism,dampness-heat is positively related to the change of jaundice .the way of driving heat dampness and toxin is the major method for serious hepatitis.