广西地区232例肝衰竭患者中医体质调查研究

A study on the TCM-defined constitutional patterns in 232 patients with liver failure in Guangxi

目的:探讨广西地区肝衰竭患者的中医体质规律,为本病的诊断与治疗提供依据。方法:采用问卷调查的方法,以王琦的《中医体质分类与判定表》为标准,对肝衰竭患者进行体质调查及中医体质判定。结果:肝衰竭患者的中医体质类型以湿热、血瘀、气虚、阳虚体质的比重最大,分别占调查总人数的22.4%、18.1%、18.1%、16.3%;其次是阴虚、痰湿、气郁体质,分别占调查总人数的10.3%、7.8%、4.3%;而平和体质、特禀体质所占比例较少,分别为1.7%,0.8%。因引起肝衰竭的病因不同,患者的体质有所偏倚。急性、亚急性肝衰竭以湿热、痰湿体质为多见,慢加急性肝衰竭以血瘀、湿热、阳虚体质并见,慢性肝衰竭则以气虚、湿热、阳虚体质多见。结论:肝衰竭患者中医体质类型分布主要以湿热、血瘀、气虚、阳虚体质较为多见,不同病因和不同类型的肝衰竭患者中医体质有所偏颇,根据肝衰竭患者体质分布特点可指导本病的个体化治疗。

Objective：To investigate the constitutional patterns,as defined by the principles of traditional Chinese medicine（TCM）,of patients with liver failure in Guangxi,so as to provide guidance for the diagnosis and treatment of this patient population. Methods：A questionnaire-based survey was conducted to collect information on the constitutional patterns of patients with hepatic failure,using a recognized scale for classification and determination of TCM-defined constitutions. Results：The dampness-heat pattern was detected most frequently（22.4%）in patients with liver failure,followed by the blood stasis pattern（18.1%）,the qi deficiency pattern（18.1%）,the yang deficiency pattern（16.3%）,the yin deficiency pattern（10.3%）,the phlegm-dampness pattern（7.8%）,and the qi depression pattern（4.3%）. The proportion of patients with liver failure who had the balance-harmony pattern or the special pattern was smaller,accounting for only 1.7% or 0.8%of the participants. Constitutional patterns varied between patients,depending on the cause of liver failure. The dampness-heat pattern and the phlegm-dampness pattern were more commonly seen in patients with acute or subacute liver failure. Patients with acute-on-chronic liver failure were more likely to have the blood stasis pattern,the dampness-heat pattern,and the yang deficiency pattern. In patients with chronic liver failure,the predominant patterns were qi deficiency,dampness-heat,or yang deficiency. Conclusion：Patients with liver failure may have different constitutional patterns,depending on the cause and the type of the disease. Overall,the main patterns are dampness-heat,blood stasis,qi deficiency and yang deficiency. It may be possible to provide individualized treatment for patients with liver failure based on their constitutional patterns.