86例肝硬化随访患者中医证候演变研究

Study on the Evolution of TCM Syndromes in 86 Followed-up Patients with Liver Cirrhosis

目的:观察肝硬化患者中医证候的动态变化。方法:对86例肝硬化患者进行1～3年的随访,采集患者不同时间的中医四诊信息,通过聚类分析等方法对患者前后两次主要的症状、体征以及中医证候因子积分进行比较分析。结果:肝硬化患者的症状体征主要表现为肝肾阴虚的临床征象,中医证候积分上,肝肾阴虚中医证候因子积分明显高于其他证候组,阴虚血热、肝气郁结、脾肾阳虚这三类中医证候积分均较第一次随访时有明显增加(P<0.05),而肝肾阴虚、脾虚湿盛两组随访前后证候积分变化不明显(P>0.05)。结论:肝硬化阶段呈现虚实夹杂的证候特点,正虚以肝肾阴虚为主,并且随着病情进展,肝肾阴虚证候更加明显。

Objective：To investigate the dynamic changes of TCM syndromes in patients with liver cirrhosis .Methods： One to three years of follow-ups were conducted to 86 patients with liver cirrhosis to collect TCM information of the four diagnostic methods at different time.Cluster analysis was used to compare and analyze the two main symptoms , signs and TCM syndrome factor scores .Results： The symptoms of patients with liver cirrhosis showed clinical signs for yin deficiency of liver and kidney .As for TCM syndrome integral , yin deficiency of liver and kidney syndrome factor score was significantly higher than other syndrome group .The scores of yin deficiency and blood heat , stagnation of liver qi , deficiency of spleen and kidney yang were obviously increased compared with the outcomes of the first follow-up visit （P〈0.05）.The scores of liver and kidney deficiency , spleen deficiency and exuberant dampness did not change signifi-cantly during the two follow-ups（P〉0.05）.Conclusion： The characteristics of TCM syndromes in patients with liver cirrhosis mani-fests deficiency-excess complication , and the deficiency is mainly of liver and kidney yin deficiency , which aggravates with the develop-ment of the disease .