慢性丙型肝炎中医证型与瘦素及胰岛素抵抗的相关性

Correlation between Syndromes Differentiation Typing with Leptin and Insulin Resistance in Chronic Hepatitis C

目的:探讨慢性丙型肝炎中医证型的分布特点及其与血清瘦素、胰岛素抵抗的相关性。方法:筛选慢性丙型肝炎患者160例,归纳其中医证型,分别测定其血清瘦素水平、空腹血糖及胰岛素含量,设健康对照50例,并将上述指标与中医辨证分型作多因素回归分析。结果:慢性丙型肝炎湿热中阻型所占比例最高,其次为肝郁脾虚、瘀血阻络型、肝肾阴虚型、脾肾阳虚型;与健康对照组比较,除脾肾阳虚外,其余证型均存在明显的高瘦素血症及胰岛素抵抗,其水平依次为脾肾阳虚、肝郁脾虚、肝肾阴虚、湿热中阻、瘀血阻络,其中湿热中阻型及瘀血阻络型患者更易于脂肪变。结论:湿热中阻是慢性丙肝的主要证型,高瘦素血症及胰岛素抵抗可以作为慢性丙型肝炎中医辨证分型的客观指标。

Objective：To investigate correlation between syndromes differentiation typing（SDT） with leptin and insulin resistance in chronic hepatitis C.Method： Screened One handre and sirty cases of chronic hepatitis C patients and Smmarized its syndromes differentiation typing.Serum leptin levels,fasting blood glucose and insulin levels were measured,fifty cases in healthy control group and make the regression analysis with the above indicators and SDT.Result：The type of shi-re stasis is highest proportion in chronic hepatitis C,followed by liver stagnation and spleen deficiency,blood stasis,deficiency in liver-kidney,deficiency in spleen and kidney,compared with the healthy control group,in addition to spleen-kidney deficiency,The remaining syndromes are obvious hyperleptinemia and insulin resistance,followed by spleen-kidney deficiency,liver stagnation and spleen deficiency,shi-re stasisl blood stasis,in which shi-re stasis and blood stasis type is easier to steatosis.Conclusion： The type of shi-re stasis is the main syndromes of chronic hepatitis C,hyperleptinemia and insulin resistance is the indicators in SDT of chronic hepatitis C.