摘要
目的:探索岭南地区乙型肝炎肝硬化的发病特征、中医证候规律,为制定及优化乙型肝炎肝硬化的临床诊疗方案提供科学依据。方法:运用回顾性研究的方法,对2002年10月-2010年4月在广东省中医院肝病科、消化科住院的593例乙型肝炎肝硬化患者的资料从人口学信息、中医证候及证型等方面进行分析。结果:593例乙型肝炎肝硬化患者中男性475例,女性118例,男女之比为4.03∶1;年龄最大92岁,最小18岁,平均(52.94士13.19)岁,30～69岁是乙型肝炎肝硬化发病的高发年龄;病程从1天(既往未做相关检查,初次发现乙型肝炎肝硬化)到50年不等,平均(11.68士10.40)年;肝功能代偿期患者96例,占16.19%,肝功能失代偿期患者497例,占83.81%。乙型肝炎肝硬化的常见症候有20余种,最常见的症状有乏力、腹胀、双下肢浮肿、身目黄染、口干口苦、胁痛、纳差、眠差、小便黄、便溏等,其中疲倦乏力、腹胀出现频率最高。单纯证型共11个,复合证型15个,辨证属于单纯证型的患者共190例(32.04%),属复合证型的患者共403例(67.96%)。前10位的中医证型分别是(肝郁脾虚,湿瘀互结)型>(肝郁脾虚,湿热瘀结)型>湿热蕴结型>(肝郁脾虚,湿热蕴结)型>热伤胃络型>肝郁脾虚型>(脾气亏虚,湿浊中阻)型>湿热瘀结型>(脾气亏虚,湿热蕴结)型>(肝肾阴虚,湿瘀互结)型,其中6个(6/10)属复合证型。结论:乙型肝炎肝硬化患者具有男性发病率高、年龄偏大、病程较长、住院次数较多、并发症多、死亡率高等特点。从临床证候来看,湿、热、瘀、虚是其主要的病变特点,其主要的中医证型多以复合证型为多见,(肝郁脾虚,湿瘀互结)型、(肝郁脾虚,湿热瘀结)型、湿热蕴结型、(肝郁脾虚,湿热蕴结)型等是最常见的中医证型,这与乙型肝炎肝硬化的病变阶段、病机以及发病特点密切相关。
Objective：To study the pathogenetic characteristics of hepatitis B cirrhosis,TCM law of symptom in the Lingnan region,for the development and optimization of clinical treatment of hepatitis B cirrhosis to provide a scientific basis.Methods： A retrospective study of 593 inpatients with cirrhosis of hepatitis B in October 2002-2010 in April at the liver branch and department of gastroenterology of Guangdong provincial TCM hospital were performed.The patients information included the demographic information,symptom and treatment of TCM,etc.law.Results： Five hundred and ninety three patients with hepatitis B cirrhosis included 475 cases of male,118 cases of female,male to female ratio was 4.03∶ 1;the oldest 92 years old,minimum of 18 years,mean age（52.94 ± 13.19）years old,30~69 years were the common age of hepatitis B cirrhosis.The course of disease was from 1 day（who were found liver cirrhosis without making inspection previously） to 50 years,with an average of（11.68 ± 10.40）years;compensated liver function of 96 patients,accounting for 16.19%,decompensated liver function in patients with 497 cases,accounting for 83.81%.Common symptoms of liver cirrhosis more than twenty,the most common symptoms were fatigue,abdominal distension,lower extremity edema,jaundice,dry mouth,bitter mouth,hypochondriac pain,anorexia,poor sleep,yellow urine,loose stools etc.,in which fatigue,abdominal distension had the highest frequency.A total of 11 pure syndrome,complex syndrome of 15,patients with syndrome simply total of 190 cases（32.04%）,with complex syndrome total of 403 cases（67.96%）,could be seen in the clinical syndrome in order to compound syndrome based.Top 10 syndromes were liver depression and spleen,wet stasis each node card liver depression and spleen,damp stasis results syndrome heat accumulation syndrome liver depression and spleen,damp accumulation syndrome hot hurt a stomach syndrome liver spleen deficiencyspleen Qi deficiency,dampness retention syndrome in damp stasis results syndrome spleen Qi deficiency,heat accumulation syndrome liver and kidney,wet stasis each end syndrome,of which 6（6 / 10） was a complex syndrome.Conclusion：The clinical data of 593 cases a detailed analysis of medical records,can be seen,male hepatitis B patients with a high incidence of liver cirrhosis,older age,longer duration,greater frequency of hospitalization,complications,high mortality characteristics.From the perspective of clinical symptoms,wet,heat,stasis is the main pathological features of the main syndromes and more to complex syndrome is more common,the liver spleen,wet stasis each node syndrome,the liver spleen,hot and humid stasis results certificate,heat accumulation syndrome,the liver spleen,heat accumulation syndrome is the most common syndromes,which is the pathological stage of liver cirrhosis,pathogenesis and disease characteristics are closely related.
出处
《中西医结合肝病杂志》
CAS
2011年第6期326-329,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
关键词
肝炎
乙型
肝硬化
中医证候特征
回顾性分析
hepatitis B
liver cirrhosis
TCM symptoms features
retrospective analysis
