基于现代文献的肝硬化常见中医证候与肝功能指标相关性的初步分析

Correlation between common TCM syndromes of hepatic cirrhosis and liver function indexes based on modern literature analysis

目的探讨肝硬化不同中医证候与肝功能指标之间的关系。方法以"肝硬化""中医""证"等为主题词,系统检索中国学术期刊网络出版总库、中国博士学位论文全文数据库、中国优秀硕士学位论文全文数据库、中文科技期刊全文数据库与中国生物医学文献数据库近20年来所有相关文献,选取其中肝硬化中医辨证分型下有肝功能指标具体数据的临床研究的文献报道,使用Epi-Data建立肝硬化中医证候与肝功能指标的文献数据库,运用Excel软件对数据进行描述性统计分析。结果符合纳入分析标准的文献有30篇,涉及病例数共计3 172例、中医证候44种、肝功能指标14项,不同中医证候的各项肝功能指标的均值也有所不同,反映不同证候类型的肝硬化患者,其肝脏细胞受损程度也有所差别。结论当肝硬化患者处于肝郁、湿热、血瘀、水停等单一证候时,肝细胞受损较轻,而当肝硬化患者处于肝肾阴虚、脾肾阳虚等复杂证候,病机表现为虚实夹杂时,肝细胞受损较重,肝功能较差。此研究可为进一步探讨肝硬化中医证候与肝功能指标间的关系提供一定依据。

Objective To discuss the relationship between TCM syndromes of hepatic cirrhosis and liver function indexes. Methods Taking hepatic cirrhosis, Chinese medicine and syndrome as subject terms, the databases of China Academic Journal Network Publishing Database （CAJD）, China Doctoral Dissertations Full-text Database （CDFD）, China Master Theses Full-Text Database （CMFD）, China Scientific Journal Database （CSJD） and Chinese Medical Current Contents （CMCC） were systematically retrieved for collecting related literature in last 20 years and selecting the literature reports about clinical studies with specific data of liver function indexes and TCM syndrome types of hepatic cirrhosis. A literature database of TCM syndromes of hepatic cirrhosis and liver function indexes was established by applying EpiData and then all data was given descriptive and statistical analysis by using Excel software. Results There were 30 literature included involving 3172 cases, 44 TCM syndromes and 14 liver function indexes. In different TCM syndromes, the average values of liver function indexes weredifferent, which indicated that the injured degree of liver cells was different in the patients with different syndrome types of hepatic cirrhosis. Conclusion When the patients with single syndrome like liver depression, dampness - heat, blood stasis or water retention, the damage of liver cells is mild. When they have complicated syndromes like liver-kidney yin deficiency or spleen-kidney yang deficiency with pathogenesis of mixture of deficiency and excess, liver cells are damaged severely and liver function is poor. The study will provide some evidences for further analysis on the relationship between TCM syndromes of hepatic cirrhosis and liver function indexes.