1868例慢性乙型肝炎患者中医证候分布特征及与血清病毒学指标的相关性分析

The TCM Syndrome Distribution Characteristic of 1868 Chronic Hepatitis B Patients and the Correlation Analysis with Virology Indices of Serum by Logistic Regression

目的运用临床流行病学方法分析慢性乙型肝炎(Chronic hepatitis B,CHB)患者中医证候分布特征,并探讨其主要中医证型与血清病毒学指标的相关性。方法基于多中心、大样本的横断面调查方法回顾性分析1 868例CHB患者的中医证候分布特征,并运用二元logistic逐步回归分析以探讨其常见证型与病毒学指标的相关性。结果 CHB的常见中医证型为肝郁脾虚证(42.3%)、湿热蕴结证(23.1%)、肝郁气滞证(11.9%)、肝肾阴虚证(5.7%)、瘀血阻络证(5.3%)、脾肾阳虚证(3.4%);HBeAg与湿热蕴结证呈正相关(OR=9.010,P<0.01),与肝郁气滞证(OR=0.335,P<0.01)、肝肾阴虚证(OR=0.215,P<0.01)、瘀血阻络证(OR=0.506,P<0.05)、脾肾阳虚证(OR=0.111,P<0.01)均呈负相关;HBeAb与湿热蕴结证呈正相关(OR=3.489,P<0.01),与肝肾阴虚证(OR=0.356,P<0.01)、脾肾阳虚证(OR=0.108,P<0.01)呈负相关。结论 CHB中医证型以肝郁脾虚证最多见;CHB主要中医证型与病毒学指标之间存在相关性。

Objective To analyze TCM syndrome distribution characteristic of ChronicHepatitis B （CHB） by clinical epidemiology method, and explore the correlation between main TCM syndro me types of CHB and virology indices of serum. Methods The distribution characteristic of TCM syndromes of 1868 cases were retrospectively analyzed based on polycentric and large cross-sectional survey method, and using binary stepwise logistic regression by SPSS 19.0 Software to analyze the correlation. Results There were six familiar syndrome types of CHB： Liver depression-spleen deficiency syndrome （LDSDS, 42.3% ）, Damp-hot accumulate knot syndrome （DHAKS,23.1%）, Stagnation of the Liver-Qi syndrome （SLS,11.9%）, Yin deficiency of liver-kidney syndrome（YDLS,5.7%）, Blood stasis syndrome（BSS, 5.3%） and Yang deficiency of spleen-kidney syndrome （YDSS,3.4%）; HBeAg was positively related with DHAKS （OR=9.010 P〈0.01）, it showed negative correlation with SLS（OR=0.335 P〈0.01）, YDLS （OR=0.215 P〈0.01）, BSS （OR=0.506 P〈0.05） and YDSS （OR=0.111 P〈0.01）; HBeAb showed positive correlation with DHAKS （OR=3.489 P〈0.01）, and negatively correlated with YDLS （OR=0.356 P〈0.01）, YDSS （OR=0.108 P〈0.01）. Conclusion The most common TCM syndrome type was liver depression-spleen deficiency. TCM syndrome types of CHB has the correlation with virology indices of serum.