1042例上海地区胆石病辨证分型

TCM Syndrome Types of 1042 Cases of Cholelithiasis in Shanghai Area

目的探讨上海地区胆石病患者的诱发因素和辨证规律,为确立上海地区胆石病辨证分型和辨证标准提供依据。方法胆石病诱发因素和辨证规律采用前瞻性临床流行病学调查方法。结果共调查上海地区1042例胆石病患者,饮食不规律者202例(占19.39%),不或偶尔进食早餐者共219例(占21.02%),晚餐饱食者共435例(占41.75%),每日运动1h以上者80例(占7.68%),胆石病伴发脂肪肝或高脂血症、糖尿病、高血压者218例(占20.92%),有家族史者共41例(占3.93%)。1042例胆石病患者中肝胆湿热证患者313例(占30.04%),肝气郁结证患者228例(占21.88%),气阴不足证患者56例(占5.37%),肝阴亏虚证患者381例(占36.56%),其他类型证候64例(占6.14%)。结论胆囊结石伴急性胆囊炎和胆囊结石合并肝胆管结石患者中肝胆湿热证占较高的比例;胆囊结石伴慢性胆囊炎中肝阴亏虚证和肝气郁结证占较高的比例;肝胆管结石中肝阴亏虚证和肝胆湿热证占较高的比例。

Objective To study the inducing factors and syndrome differentiation regulations of cholelithiasis in Shanghai area in order to establish the criteria of syndrome differentiation. Methods A prospective clinical epidemiological study was carried out to observe the inducing factors and syndrome differentiation regulations of cholelithiasis. Results Of the 1042 cases, there were 202 （19.39%） with irregular food intake, 219 （21.02%） with a habit of not taking or only occasionally taking breakfast, 435 （41.750%） with dinner-overeating, 80 （7.68 %） having exercise more than one hour per day, 218 （20. 92%） accompanied with fatty liver or hyperlipidemia or diabetes or hypertension, and 41 （3.93 %） having family history. Totally 313 cases （30.04%） were suffering from the liver and gallbladder damp heat syndrome, 228 cases （21.88%） suffering from the liver-qi stagnation syndrome, 56 cases （5.37%） suffering from the qi and yin deficiency syndrome, 381 cases （36.56%） suffering from liver yin deficiency syndrome, and 64 cases （6, 14%） involved in other syndromes. Conclusion In cholelithiasis cases with acute cholecystitis or complicated with hepatolith, the liver and gallbladder damp heat syndrome is high in percentage. In cholelithiasis cases with chronic cholecystitis, liver yin deficiency and liver qi stagnation syndromes are hitgh in percentage. In hepatolith cases, liver yin deficiency and liver and gallbladder damp heat syndromes are high in percentage.