801例肝炎肝硬化患者病性类证候要素与常见脉象的相关性分析

Correlation between pattern elements of disease nature and common pulse manifestation in 801 patients with viral hepatitis cirrhosis

目的基于病证结合分析肝炎肝硬化患者病性类证候要素与常见脉象的相关性,为丰富常见脉象的临床意义以及探讨其形成机理提供依据。方法运用课题组统一制订的《肝炎肝硬化临床信息采集表》,进行全国多中心的横断面流行病学调查,收集肝炎肝硬化患者的中医症状、舌象、脉象(包括深浅、至数、宽细、长短、硬度、流利度等)信息,制订《肝炎肝硬化常见证候要素辨识标准》,依此判定患者的病性类证候要素类型;统计学方法采用频数、频率等描述性分析、卡方检验与简单相关分析的方法。结果 801例患者中,选取出现频率大于20%的作为常见脉象,其中弦脉602例(75.2%),细脉279例(34.8%),沉脉232例(29.0%),滑脉185例(23.1%)。弦脉与血瘀、气滞呈正相关关系,相关系数r分别为0.141、0.166(P<0.05);滑脉与阴虚、湿热呈正相关关系,相关系数r分别为0.093、0.131(P<0.05);沉脉与气虚、阳虚呈正相关关系,相关系数r分别为0.099、0.111(P<0.05);细脉与阴虚、气虚、阳虚、水停呈正相关关系,相关系数r分别为0.089、0.109、0.105、0.075(P<0.05)。结论肝炎肝硬化患者病性类证候要素与常见脉象间存在一定的相关性。

Objective To enrich the clinical meanings of common pulse manifestations, and to explore mechanisms of those pulses by analyzing the correlation between pattern elements of disease nature and common pulse manifestations in patients with viral hepatitis or cirrhosis based on the combination of pat- tern and diseases. Methods A national muhicenter cross-sectional epidemiological survey was conduc- ted to collect TCM symptoms, tongue manifestations and pulse conditions （including depth, frequency, width, length, hardness, and frequency of pulse）of patients with viral hepatitis or cirrhosis. The survey questionnaire used the Information Collection form of Vital Hepatitis Cirrhosis drafted by the research group. Standard of Hepatitis Cirrhosis Pattern Elements Differentiation was made to identify patterns and pattern elements. Descriptive statistics such as frequency and rate, Chi-square test, and correlation analy- sis were used. Results Pulses of 801 patients were collected. Pulses with occurrence rate above 20% was defined as common pulse manifestations, in which wiry pulse accounted for 75.2% （ n = 602 ） ; thready pulse,29.0 % （n =279） ;deep pulse 29% （n =232） ; and slippery pulse, 23.1% （n = 185）. There was positive correlation between wiry pulse and blood stasis and qi stagnation （correlation coefficient was 0. 141 and 0. 166 respectively ,P 〈0.05 ）. There was positive correlation between slippery pulse and yin deficiency and damp heat （correlation coefficient were 0.093 and 0.131 respectively,P 〈 0. 05 ）. There was positive correlation between deep pulse and qi deficiency and yang deficiency （correlation coefficient was 0. 099 and 0.111 respectively, P 〈 0.05）. There was positive correlation between thready pulse pulse and yin deficiency, qi deficiency, yang deficiency and water retention（ correlation coefficient was 0. 089,0. 09, 0. 105 and 0.075 respectively, P 〈 0.05）. Conclusion There is a certain correlation between pattern ele- ments and common pulse manifestations in viral hepatitis cirrhosis patients.