慢性重型肝炎发病特点及与中医证型相关性的临床分析

Clinical Analysis of the Correlation about Clinical Features of Chronic Severe Hepatitis and Its Syndromes of TCM

目的:分析慢性重型肝炎(慢重肝)的临床发病特点。方法:对257例慢重肝患者的发病过程进行回顾性分析。结果:慢性肝病发展成慢重肝的时间以<2周、2～4周、4周至半年来统计发生率分别为18.1%、17.1%及64.8%;有40.0%以上的患者无明确诱因,但30.0%以上的患者有1～3种以上诱因,合并感染的发生率最高,差异有非常显著性(P<0.01);有50.0%以上患者发生于肝硬化;有50.0%以上患者无肝性脑病,而腹水发生率均在75.0%以上;<2周起病的慢重肝患者中医证型以血瘀血热证为主(58.3%),4周至半年起病的慢重肝患者以肝肾阴虚证、脾肾阳虚证为主(85.1%),而2～4周起病的慢重肝患者各种证型分布较为均衡(P>0.05)。结论:慢重肝均是在慢性肝病的基础上发展而成;其发病诱因、并发症发生率及出现时间、合并症等因素均影响预后。

Objective：To analyze the clinical features of the chronic severe hepatitis.Method：This article analyzed the pathogenesis of 257 cases with chronic severe hepatitis retrospectively.Result：The incidence rates of2 weeks,2 to 4 weeks,4 weeks to 6 months were 18.1%,17.1% and 64.8% according to the time of that chronic liver disease developed into chronic hepatitis;more than 40.0% of patients had no clear incentive,however,more than 30.0% of patients had more than 1 to 3 incentives,had the highest incidence of infection,the difference was significant（P0.01）;more than 50.0% of patients had cirrhosis;more than 50.0% of patients have no hepatic encephalopathy,and the incidence rate of ascites were more than 75.0 %;the syndromes of TCM of patients with chronic severe hepatitis in 2 weeks were blood stasis-heat mainly（58.3%）,the syndromes of TCM of patients with chronic severe hepatitis in 4 weeks to 6 months were liver-kidney Yin deficiency,spleen-kidney yang deficiency mainly（85.1%）,and the syndromes of TCM of patients with chronic severe hepatitis in 2 to 4 weeks had more balanced distribution（P0.05）. Conclusions：Chronic liver disease is the basis of the occurrence of chronic severe hepatitis;the incentives,the incidence of complications,the time of occurrence of complications can affect the prognosis.