94例肝硬化难治性腹水患者中医证候特征分析

Analysis of TCM syndrome of ninety-four liver cirrhosis patients with refractory ascites

目的:探讨肝硬化难治性腹水患者的中医证候特征,为肝硬化难治性腹水的中医治疗提供辨证施治依据。方法:采用前瞻性流行病学调查方法,提取94例肝硬化难治性腹水患者的中医症状、体征、舌、脉等四诊信息,对患者进行中医辨证,进行统计分析这类患者的证候学特点。结果:肝硬化难治性腹水患者常见的中医证候依次为:脾虚湿阻证(80.8%),血瘀证(71.3%),湿热蕴结证(55.3%),肝气郁结证(44.7%),肝肾阴虚证(9.6%),脾肾阳虚证(4.3%)。其中同一患者常有几个证候重叠。结论:肝硬化难治性腹水患者的中医证候较少见单一证候,兼夹证多见。脾虚湿阻兼夹瘀热的复合证型,是肝硬化难治性腹水的最特征性证候。

Objective：To explore the TCM syndrome of Liver cirrhosis patients with refractory ascites and to Provide the basis for TCM syndrome differentiation and treatment of liver cirrhosis with refractory ascites.Methods：By means of prospective epidemiologic survey,the four diagnosis information of TCM symptom,physical sign,glossa and pulse from 94 liver cirrhosis patients with refractory ascites were extracted and differentiations of symptoms and signs from patients were taken.Then the characteristics of TCM syndrome were analyzed.Results：TCM syndrome type of Liver cirrhosis patients with refractory ascites as follow：damp abundance due to splenic asthenia（80.8%）.syndrome of blood stasis（71.3%）.endoretention of damp heat（55.3%）.depression of liver- Qi（44.7%）.hepatic and renal yin deficiency（9.6%）and asdthenic splenonephro- yang（4.3%）.Among them one patient often have several overlap syndrome.Conclusion：The TCM syndrome type of Liver cirrhosis patients with refractory ascites is rare single type.but more overlap.The characteristic of the TCM syndrome types is spleen deficient with wet resistance and stasis hot composite type.