Wilson病中医证型与客观指标相关性研究

Research on the Correlation between Chinese Medical Syndrome Types and Objective Indices of Wilson's Disease

目的探讨Wilson病(Wilson's disease,WD)中医证型与临床资料及理化指标的相关性。方法对116例WD患者进行中医辨证分型,以常见中医证型为因变量,临床及理化指标为自变量,运用SPSS 19.0软件进行二元Logistic逐步回归分析探讨中医证型与临床、理化指标的相关性。结果 WD中医证型以肝胆湿热(35.3%)、肝郁脾虚(13.8%)、肝肾阴虚(13.8%)、痰湿阻络(12.1%)4个证型常见。肝胆湿热证与K-F环分级、总胆红素(total bilirubin,TBIL)、谷丙转氨酶(alanine transaminase,ALT)、层粘蛋白(laminin,LN)正相关(P<0.01);肝肾阴虚证与TBIL正相关(P<0.01);痰湿阻络证与临床类型、铜蓝蛋白(ceruloplasmin,CP)、谷草转氨酶(aspartate aminotransferase,AST)、总蛋白(total protein,TP)正相关(P<0.01,P<0.05);气血两虚证与病程、血氨、尿素氮(blood urea nitrogen,BUN)、LN正相关(P<0.01,P<0.05)。结论 WD患者中医证型与临床资料、理化指标之间有一定的相关性,可以为中医辨证分型客观化提供试验依据。肝胆湿热、肝郁脾虚、肝肾阴虚、痰湿阻络为常见证型。

Objective To explore the correlation between Chinese medical syndrome types of Wilson＇s disease （WD） and clinical materials as well as physical and chemical indices. Methods Totally 116 WD patients were typed by Chinese medical syndrome. The correlation between Chinese medical syndrome types and clinical materials as well as physical and chemical indices were analyzed using bina- ry stepwise Logistic regression by SPSS 19, 0 Software, taking the common Chinese medical syndrome types as the dependent variable and clinical materials as well as physical and chemical indices as the in- dependent variables. Results Gan-Gallbladder dampness-heat syndrome （GGDHS, 35.3% ）, Gan-stag- nation and Pi-deficiency syndrome （GSPDS, 13.8%）, Gan-Shen yin deficiency syndrome （GSYDS, 13.8% ）, and phlegm-dam pness retention syndrome （ PDRS, 12.1% ） were most often seen. GGDHS was positively correlated with grade of K-F ring, total bilirubin （TBIL）, alanine transaminase （ALT）, laminin （LN） （P 〈0.01 ）. GSYDS was positively correlated with TBIL （P 〈0.01 ）. PDRS was positively correlated with clinical types, ceruloplasmin （CP）, aspartate aminotransferase （AST）, and total protein （TP） （P 〈 0.01, P 〈0.05）. Qi blood deficiency syndrome was positively correlated with disease course, blood am- monia, blood urea nitrogen （BUN）, and LN （P 〈0.01, P 〈0.05）. Conclusions Chinese medical syn- drome types were correlated with clinical materials, physical and chemical indices in WD patients, which could provide experimental reference for Chinese medical syndrome typing. GGDHS, GSPDS, GSYDS, and PDRS were most often seen.