慢性病毒性肝炎肝功能指标辅助判断中医辨证分型浅析

A brief analysis of chronic viral hepatitis liver function index guiding TCM syndrome differentiation

目的:探讨慢性病毒性肝炎患者肝功能指标与中医辨证分型之间的关系,分析肝功能指标升高某一值域的各证型出现概率并总结规律,以指导于临床。方法:门诊收集270例临床症状显著的慢性病毒性肝炎病例,记录其中医证型及肝功能指标,统计各肝功能指标升高不同区段的证型出现概率,将有统计学意义组进行规律总结。结果:经统计学分析,谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷酰转肽酶(GGT)的不同组间各证型出现概率有统计学差异(P<0.05);ALT、AST、GGT正常以肝郁脾虚证为主,重度升高组以肝胆湿热证为主,ALT、AST轻中度升高多见于肝郁脾虚证、肝肾阴虚证、肝胆湿热证,GGT中度升高各证型分布较均匀。结论:部分肝功能指标升高程度不同,中医证型的分布规律随之改变,二者具有相关性。

Objective： Through exploring the relationship between liver function index and TCM syndrome of viral hepatitis patient,analyzing the occurrence-probability of different TCM syndromes in different degree-elevated liver function.Then summarize the law,find assistant evidences to judge the TCM syndrome type.Methods： Collecting 270 clear-diagnosed cases of Viral Hepatitis,recording their liver function index and TCM syndrom,analyzing the distribution regularities of different TCM syndrome types in different elevated section of liver function index.Results： ALT,AST,GGT groups have significant differences between different TCM syndromes（P0.05）;when ALT,AST,GGT are normal,spleen deficiency and liver qi stagnation pattern is the most common,severe rise can be seen more in damp and hot pattern,mild-to-moderate elevated ALT,AST are mainly seen in spleen deficiency and liver qi stagnation pattern,damp and hot pattern and kidney yin deficiency pattern;moderate elevated GGT turns out to be seen the same in kidney yin deficiency pattern.Conclusion： As some of the liver function index changes,TCM syndrome type distribution regularities are different,the two are proved related.