慢性乙型肝炎阴虚证素的临床研究

Clinical study on yin deficiency syndrome factor of chronic hepatitis B

目的:对慢性乙型肝炎患者阴虚证进行调查,分析其与患者性别、年龄、家族史、病情程度、病程、病毒DNA指标、脏腑病位、舌色、舌苔的关系,为临床辨识该病阴虚证提供依据。方法:选择2011年11月至12月首都医科大学附属北京中医医院肝病门诊就诊的慢性乙型肝炎患者464例,并与104例健康人比较,观察患者的四诊信息,进行证候分析,并记录患者肝功能、病毒指标和肝脏B超检查结果,进行统计分析。结果:随着患者年龄增高、病程延长、病情程度加重、病毒DNA指标加重,阴虚证素显著增多(P<0.05,P<0.01)。慢性乙型肝炎女性患者阴虚证积分较男性患者显著增高(P<0.05)。有乙型肝炎家族史的患者阴虚证较无家族史患者显著增多(P<0.05)。慢性乙型肝炎患者出现的脏腑病位证素主要是肾、肝、心、脾,与阴虚证显著相关的是肾、心、肝(P<0.05,P<0.01)。阴虚证以红绛舌、青紫舌为主要舌色,青紫舌阴虚证积分最为显著(P<0.05)。各种舌苔阴虚证积分无显著性差异。结论:慢性乙型肝炎阴虚证常见于有家族史、病程长、病情重、病毒指标高、年龄大、女性患者。阴虚证常见肾阴虚、心阴虚、肝阴虚,其舌象以红绛舌、青紫舌多见。积极治疗慢乙肝阴虚证对于治疗慢乙肝,阻止病情向肝硬化、肝癌发展具有积极的意义。

Objective:To investigate the yin deficiency syndrome in patients with chronic hepatitis B,and to analyze its relationship with gender,age,family history,severity of disease,course of disease,viral DNA index,viscera disease location,tongue color and coating,so as to provide a reference for clinical identification of yin deficiency syndrome in patients with chronic hepatitis B.Methods:Clinical data of 464 cases with chronic hepatitis B in Beijing Hospital of TCM Affiliated to Capital Medical University from November to December in 2011.Compared with 104 healthy people,the four diagnostic informations of patients were observed,syndromes were analyzed,and the liver function,HBV viral index and the results of B-mode ultrasonography were recorded.All the data were input into SPSS 22.0 statistical software for variance analysis,correlation analysis and other statistical analysis.Results:With the increase of age,the course of disease,the severity of disease and viral DNA index,yin deficiency syndrome increased significantly(P<0.05,P<0.01).The score of yin deficiency syndrome in female patients with chronic hepatitis B was significantly higher than that in male patients(P<0.05).The score of yin deficiency syndrome in patients with family history of hepatitis B was significantly higher than that in patients without family history(P<0.05).The viscera disease location syndrome elements of chronic hepatitis B patients were kidney,liver,heart and spleen.The kidney,heart and liver were significantly related to yin deficiency syndrome(P<0.05,P<0.01).Crimson tongue,purplish tongue were the main tongue color of yin deficiency syndrome.The score of yin deficiency syndrome of blue and purple tongue is the most significant(P<0.05).There was no significant difference in the scores of yin deficiency syndrome of tongue coating.Conclusion:Yin-deficiency syndrome is often found in patients with family history,long course of disease,severe disease,high viral index,being older and female patients.Yin deficiency syndrome is mainly kidney yin deficiency,heart yin deficiency,liver yin deficiency.Its tongue image is mainly crimson and purple tongue.Active treatment of yin deficiency syndrome of chronic hepatitis B haspositive significance for the treatment of chronic hepatitis B and the prevention of the progression to liver cirrhosis and liver cancer.