肝硬化CT分型与中医证型相关性研究

A study on correlation between CT grouping and syndrome typing of traditional Chinese medicine of liver cirrhosis

目的:探索肝硬化CT分型与中医证型之间的关系及其意义。方法:通过分析142例肝硬化患者CT表现和中医征象,对其进行CT分型和中医辨证分型,并分析两种类型之间的关系。结果:142例肝硬化根据CT征象分为3个类型,均匀型32例(22.54%),节段型21例(14.79%),结节型89例(62.68%)。中医辨证分为6个证型,肝郁脾虚证17例(11.97%),湿热蕴结证18例(12.68%),气滞血瘀证31例(21.83%),水湿内停证41例(28.87%),脾肾阳虚证21例(14.79%),肝肾阴虚证14例(占9.86%)。均匀型和节段型肝硬化病例中大多为肝郁脾虚证和湿热蕴结证,分别占62.49%和47.62%;其次为气滞血瘀证和水湿内停证,分别占28.13%和42.86%;脾肾阳虚证和肝肾阴虚证最少,分别占9.38%和9.52%。而结节型肝硬化病例中以肝郁脾虚证和湿热蕴结证最少,占5.62%;其次为脾肾阳虚证和肝肾阴虚证,占33.71%;气滞血瘀证和水湿内停证最多,占60.67%,与均匀型和节段型具有显著性差异(χ2值分别为49.40和32.06,P值均小于0.001)。结论:肝硬化的CT分型与中医证型之间存在密切的关联,2种分型均与肝硬化肝损害的严重程度相关。

Objective： To study the relationship between CT grouping and syndrome typing of traditional Chinese medicine （TCM） of liver cirrhosis and its significance. Methods：On the basis of CT findings and signs of TCM in 142 cases with liver cirrhosis,CT and syndrome typing of TCM of the cirrhosis were performed. Their relationship was analyzed. Results： There were 3 kinds of CT typing in 142 cases with liver cirrhosis. They were homogeneous group （32 cases, 22.54%）, segmental group （21 cases,14. 79%） and nodal group （89 cases,62.68%）. There were 6 syndrome types of TCM. They were the type of stagnation of liver Qi and deficiency of spleen （17 cases, 11.97 % ）, the type of accumulation of damp-heat in the body （18 cases, 12.68%） ,the type of stagnation of vital energy and blood stasis （31 cases,21.83%） ,the type of water-fluid retention （41 cases,28.87%） ,the type of insufficiency of both spleen and kidney （21 cases, 14.79%） ,the type of syndrome with Yin asthenia of liver and kidney （14 cases, 9.86 % ）. In the cases of homogeneous group and segmental group, the type of stagnation of liver Qi and deficiency of spleen and the type of accumulation of damp-heat in the body were the most,the type of stagnation of vital energy and blood stasis and water-fluid retention type were secondary,and insufficiency of both spleen and kidney type and syndrome with Yin asthenia of liver and kidney type were the least, whereas in the cases of nodal group, the type of stagnation of liver Qi and deficiency of spleen and the type of accumulation of damp-heat in the body were the least, insufficiency of both spleen and kidney type and syndrome with Yin asthenia of liver and kidney type were secondary,the type of stagnation of vital energy and blood stasis and water-fluid retention type were the most. It showed significant difference between the cases of homogeneous group and segmental group and the cases of nodal group （ P 〈0. 001）. Conclusion： There is close relationship between CT grouping and syndrome typing of TCM in liver cirrhosis. Both CT grouping and syndrome typing of TCM correlated with severe degree of liver damage in the cirrhosis.