慢性乙型肝炎中医证型与实验室指标相互关系的研究

Correlative Study Between Chinese Medical Syndrome and Laboratory Index in Chronic Hepatitis B

为探讨慢性乙型肝炎中医证型与实验室指标的相互关系 ,将 2 56例慢性乙肝患者按中医辨证分成肝胆湿热 (A)、肝郁脾虚 (B)、肝肾阴虚 (C)、脾肾阳虚 (D)和瘀血阻络 (E)五个证型 ,观察各证型与实验室指标的相互关系。结果 :A型ALT、AST、TBiL及IgG显著高于其他证型 (P <0 0 5) ,而脾肿大率低于其他证型 (P <0 0 5) ;B型仅次于A型 ,即ALT、AST显著高于除A型以外的其他证型 (P <0 0 5) ,脾肿大率也相对较低 ;E型的特点是脾肿大率高 ,IgG值为最高 (P <0 0 5)。HBeAg阳性率有在实证中较低而在虚证中较高的倾向。在一定程度上提示肝脏不同的病理变化是慢性乙型肝炎的不同中医证型的内在基础。

To study the correlation between Chinese medical syndrome and laboratory index in chronic hepatitis B,256 cases were randomized into five syndromes:liver-gallbladder dampness heat syndrome(A),liver-depression and spleen-asthenia syndrome(B),liver-kidney Yin deficiency syndrome (C),spleen-kidney Yang deficiency syndrome (D)and blood stasis in collateral syndrome (E).Results:ALT,AST,TBiL and IgG were highest in syndrome A,second in syndrome B,with significant differences as compared to other syndromes(P<0.05),while the possibility of splenomegaly was lower in syndrome A than any of other syndromes(P<0.05);the possibility of splenomegaly in syndrome B was secondly lower;in syndrome E,the possibility of splenomegaly and IgG were highest (P<0.05);positive rate of HBeAg tended to be higher in excess syndrome than in deficiency syndrome.It is revealed that the different pathological changes in the liver are the essential basis for the syndrome differentiation of chronic hepatitis B.