慢性乙型肝炎肝纤维化中医证型与肝组织病理分级、分期关系的探讨

Correlation Between Chinese Medical Syndrome and Pathological Stage and Grade of Liver Tissue in Patients with Liver Fibrosis Following Chronic Hepatitis B

为探讨慢性乙型肝炎肝纤维化中医证型与肝组织病理分期、分级的关系 ,对 133例慢性乙型肝炎肝纤维化患者进行辨证分型 ,并分析各种证型与病理分期、分级的关系。结果 :按传统辨证方法 133例患者可分为 5型 :肝郁脾虚、湿热中阻、肝肾阴虚、脾肾阳虚、瘀血阻络 ;不同证型之间肝组织病理分期、分级有明显差异 ,肝郁脾虚型S1 、G2 较多 ,湿热中阻型S2 、G2 、G3 较多 ,肝肾阴虚型S3 、G2 、G3 较多 ,瘀血阻络型S3 、S4、G4较多。提示慢性乙型肝炎肝纤维化中医辨证分型 ,具有一定的病理学基础 ;肝郁、湿阻、阴虚、阳虚、瘀阻的发展变化 ,其病理学基础是肝脏炎症的逐渐加剧、纤维化程度的不断加重。

To investigate the correlation between the Chinese medical syndrome and pathological stage and grade,133 cases were randomized into 5 types by syndrome differentiation:type I(liver-depression and spleen asthenia),type Ⅱ(dampness-heat accumulation),type Ⅲ(liver-kidney yin-deficiency),type Ⅳ(spleen-kidney yang deficiency)and type Ⅴ(blood-stasis in collateral).There were striking differences between the syndrome and the pathological stage and grade.S 1 and G 2 increased in type Ⅰ,S 2,G 2 and G3 increasing in type Ⅱ,S 3,G 2 and G 3 increasing,S 3,S 4 and G 4 increasing in type Ⅴ.It is indicated that the Chinese medical syndrome of liver fibrosis has certain pathological basis;the fibrosis increasing with the hepatitis.