慢性乙型肝炎肝组织病理与中医证型的研究

Study on relationship among pathologic diagnosis and TCM type of syndromes in patients with chronic hepatitis B

目的探讨慢性乙肝患者肝组织病理与中医辨证分型的关系。方法 146例慢性乙肝患者进行肝活检及病理学分级分期的诊断,同时进行中医辨证分型诊断。结果 (1)146例慢性乙肝患者病理诊断属轻度慢性乙肝者74例、中度48例、重度24例;(2)中医辨证分型:属肝郁脾虚型58例(39.73%)、肝胆湿热型5例 (3.42%)、肝肾阴虚型17例(11.64%)、脾肾阳虚型6例(4.10%)及瘀血阻络型60例(41.10);(3)轻度肝损害组,中医辨证以肝郁脾虚型为主,占71.62%(53/74);中度组则以瘀血阻络型为主,占68.75%(33/48);重度组 24例,均属瘀血阻络型范围,只是少数患者伴有其它兼证。结论慢性乙肝中医辨证分型,可不同程度反映肝损害及肝纤维化程度,对临床诊断与治疗有指导意义。

Objective To evaluate the diagnostic value of pathologic diagnosis and traditional chinese medicine(TCM)type of syndromes in patients with chronic hepatitis B. Methods There were 146 patients with chronic hepatitis B by liver biopsy pathologic diagnosis and TCM differentiation of syndromes. Results There were the low-grade 74,moderate 48 and the severe 24 patients. TCM differentiation of symptoms and signs: stagnation of the liver Qi and deficiency of the spleen was 58,damp-heat of liver and gall 5,deficiency of liver-yin and kidney-yin 17, insufficiency of both the spleen and the kidney 6, blood stasis vessel obstruction syndrome 60 patients. Among low-grade chronic hepatitis B stagnation of the liver Qi and deficiency of the spleen was 71. 62% ,among moderate chronic hepatitis B blood stasis vessel obstruction syndrome was 68.75% , 24 cases were all bloos stasis vessel obstruction syndromes among severe grade chronic hepatitis B. Conclusion In patients with chronic hepatitis B TCM differentiation of symptoms and signs could reflect the state of the liver lesion and liver fibrosis.