辨别瘀血证判断慢性肝炎肝病理程度的研究

Study on stasis blood syndrome of TCM judging pathology degree of chronic hepatitis liver

目的探索以中医辨证无创伤性评估慢性肝炎患者肝病理程度的方法,试图建立中医模式的肝病理程度评估系统。方法对364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,按瘀血证与非瘀血证分组,以肝病理分级分期为标准诊断,采用诊断性试验四格表测算瘀血证在G3—4级度和S3—4、S4级度的敏感性、特异性、准确性。结果瘀血证在G3—4、S3—4、S4级度的敏感性分别为81.35%,93.34%和94.34%,特异性分别为88.30%,89.80%和76.16%,准确性分别84.62%,91.21%和77.20%。结论辨别慢性肝炎瘀血证和非瘀血证对判断肝病理程度具有良好的诊断价值。

Objective It is to approach the non-invasive method to evaluate the pathologic grade and stage of chronic hepatitis by syndrome differentiation, and try to establish the TCM mode of evaluation of the liver pathologic degree. Methods 364 patients with chronic hepatitis was diagnosed by syndrome differentiation and liver biopsy, and divided into two groups of the stasis blood syndrome and other type. And used diagnostic test four-frame table methods to evaluate the sensitivity, pecu-liarity and accuracy of the stasis blood syndrome at the grade G3-4 ,stage S3-4 and S4 respectively. Results The judgment in- dexes of the stasis blood syndrome at degree of, G3-4, S3-4 and S4 were respectively 81.35 % , 93.34 % and 94.34 % in sen- sitivity, that were 88.30 %, 89.80 % and 76.16 % in peculiarity and that were 84.62 % , 91.21% and 77.20 % in accuracy. Conclusion There was significantly value of diagnosis for the degree of liver pathology to differ chronic hepatitis with the stasis blood syndrome from that without it.