慢性乙型肝炎中医辨证计量诊断及用药特点的探讨

Explore on the quantitative diagnosis of syndrome differentiation in TCM and drug-used characteristics of chronic hepatitis B

目的探讨慢性乙型肝炎中医辨证计量诊断及用药特点。方法 对我院2012~2014年收治的300例慢性乙型肝炎患者的临床资料进行回顾性分析,包括患者的临床症状、体征、中医证型、西医诊断结果、用药情况等。采用Logistic回归分析对各个中医证型中有意义的辨证计量进行筛选,根据患者的用药情况分析患者的用药特点。结果 300例慢性乙型肝炎患者共分为9个中医证型,其中以肝郁脾虚型患者所占比例明显高于其他中医证型的患者比例（P〈0.05）。300例患者最常见的中医症状、体征为纳呆、脉弦。对300例患者的9个中医证型进行辨证计量诊断发现,各证型均有3个以上贡献率较大的变量。柴胡、丹参为300例患者中医方剂中应用频数最多的药物。结论 对慢性乙型肝炎患者的中医辨证计量诊断和用药特点进行分析,可有效提高慢性乙型肝炎患者中医诊断和疗效评价的客观性。

Objective To explore the quantitative diagnosis of syndrome differentiation in TCM and drug-used charac- teristics of chronic hepatitis B. Methods Clinical data of 300 chronic hepatitis B patients from 2012 to 2014 of our hospital were analyzed retrospectively.Clinical data of patients liking clinical symptoms,sign,TCM syndrome,diagnosis results Of western medicine and drug-used condition were included.The meaningful dialectical quantitative among each TCM syndrome were screened by using Logistic regression analysis.The drug-used characteristics of patients were ana- lyzed according to the drug-used of patients. Results 300 chronic hepatitis B patients were grouped into 9 TCM syn- dromes,and the proportion of hepatic stagnation and spleen deficiency type patients were obvious more than other TCM syndrome patients （P〈0.05）.The TCM syndrome and sign among 300 patients were anorexia and wiry Pulse.It was found from the 9 quantitative diagnosis of syndrome ：differentiation in TCM of 300 patients that each type of symptom had more than 3 great variables.It counted that radix bupleuri and salvia mihiorrhiza were the most used drugs in TCM pre- scription of 300 patients. Conclusion Analysis on the quantitative diagnosis of syndrome differentiation in TCM and drug-used characteristics of chronic hepatitis B can enhance the objectivity of chronic hepatitis B TCM diagnosis and effects effectively.