218例肝硬化患者中医证型、肝功能分级及食管静脉曲张分析

Analysis of TCM Pattern,Liver Function Grading and Esophageal Varices of 218 Cases of Cirrhosis

目的探讨中医不同证型肝硬化患者的肝功能分级及食管静脉曲张的相关性,为临床应用中医药辨证治疗肝硬化提供临床依据。方法对218例肝硬化患者进行中医辨证分型,按Child-pugh评分分级,并进行胃镜及彩超检查,记录患者的食管静脉曲张的宽度、部位、条数、形态及颜色等相关指标及门静脉宽度。结果中医不同证型肝硬化患者肝功能分级存在显著性差异(P<0.01)。中医不同证型肝硬化患者的食管静脉曲张程度及宽度存在显著性差异(P<0.05)。各证型之间门静脉宽度无显著性差异(P>0.05)。肝功能A级与C级的食管静脉曲张程度相比,差异有显著性意义(P<0.01)。肝功能A级与C级的食管静脉宽度相比,差异有显著性意义(P<0.05)。结论随着肝硬化患者中医证型的演变,其肝功能分级、食管静脉曲张有加重趋势。

Objective To discuss correlations of liver function grading of cirrhotic patients with different TCM patterns and the esophageal varices to provide evidence for the clinical application of traditional Chinese medicine to treat cirrhosis based on syndrome differentiation.Methods218 cases of cirrhosis were divided into different groups according to different TCM patterns;child-pugh was used to grade;gastroscope and color ultrasonography were employed to inspect;relevant index such as width,location,number of branches,shape and color of esophageal varices and the width of portal vein were recorded.ResultsLiver function grades of cirrhotic patients with different TCM patterns were significantly different from each other（P〈0.01）.The degree and width of esophageal varices of cirrhotic patients with different TCM patterns were obviously different（P〈0.05）.The width of the portal vein is basically the same（P〉0.05）.Differences of the degree of esophageal varices between Child-pugh A and C were significantly meaningful（P〈0.01）.Differences of the width of esophageal vein between Child-pugh A and C were significantly meaningful（P〈0.05）.Conclusion： Varying with different TCM patterns,liver function grading and esophageal varices are tending to worsen.