594例轻度慢性乙型肝炎中医证候分布规律调查研究

Investigation of TCM syndrome distribution law in 594 patients with mild chronic hepatitis B

目的:探讨轻度慢性乙型肝炎(CHB)患者的中医证候分布规律,为规范化治疗CHB提供参考依据。方法:运用中医证候量表对594例轻度CHB患者进行中医证候调查,采用聚类分析的方法对纳入的患者进行聚类,并结合变量频数分析对证型归属进行判定。结果:收集的轻度CHB病例均以肝郁脾虚为主要证型,在此基础上合并有6个兼证,分别为肝郁脾虚兼湿热阴虚血瘀证型(62.80%)、肝郁脾虚兼肝肾阴虚证型(24.24%)、肝郁脾虚兼肝郁化火证型(5.05%)、肝郁脾虚兼肝胃不和证型(3.70%)、肝郁脾虚兼中气亏虚证型(2.53%)和肝郁脾虚兼瘀血阻络证型(1.68%)。肝郁脾虚兼湿热阴虚血瘀证型又进一步分为5个亚型,分别为脾虚为主型(45.30%)、普通型(22.52%)、气滞为主型(17.70%)、湿热为主型(10.46%)、肾虚为主型(4.02%)。结论:肝郁脾虚证型为轻度CHB的基本证型。

Objeclive： To discuss the distribution law of the traditional Chinese medicine （TCM） syndrome in mild chronic hep- atitis B, and provide the evidence to standardize treatment of chronic hepatitis B. Methods： Five hundred ninety-four patients with chronic hepatitis B were collected, the TCM syndrome was judged by the scale of the TCM syndrome, and the identification patterns were determine by the distribution of variables using duster analysis. Results： The main identification pattern of mild chronic hepatitis B was liver stagnation and spleen deficiency. There were six accompanying syndromes within the main pattern, damp heat - Yin defi- ciency and blood stasis syndrome （62. 80% ）, Yin deficiency of liver and kidney syndrome （24. 24% ）, depressed liver Qi transfor- ming into fire syndrome （5. 05% ）, liver and stomach incoordination syndrome （3. 70% ）, Qi deficiency syndrome （2. 53% ）, blood stasis syndrome （ I. 68% ）, and the liver stagnation and spleen deficiency accompanying damp heat - Yin deficiency and blood stasis syndrome also included five subtypes, spleen deficiency syndrome （45. 30% ）, usual syndrome （22. 52% ）, Qi stagnation syndrome （ 17. 70% ）, damp heat syndrome （ 10. 46% ）, kidney deficiency syndrome （4. 02% ） . Conclusion： The main identification pattern of mild chronic hepatitis B is liver stagnation and spleen deficiency.