乙型肝炎肝硬化患者中医证型与超声声像图、门脉血流动力学和肝功能分级的关系  

Relationship between Traditional Chinese Medicine Syndromes and Ultrasonography, Portal Hemodynamics, Liver Function Grading for Patients with Hepatitis B Cirrhosis

作　　者：何少贞 黄帅 吴红杨 沈丽芸 HE Shaozhen;Wu Hongyang;HUANG Shuai(Department Function,Qionghai Hospital of Traditional Chinese Medicine,Qionghai Hainan 571400,China;Department of Gastroenterology,Qionghai Hospital of Traditional Chinese Medicine,Qionghai Hainan 571400,China)

机构地区：[1]琼海市中医院功能科,海南琼海571400 [2]琼海市中医院消化内科,海南琼海571400

出　　处：《四川中医》2022年第1期62-65,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探讨乙型肝炎肝硬化患者中医证型与超声声像图、门脉血流动力学和肝功能分级的关系。方法:回顾性分析2018年5月-2020年5月我院156例乙型肝炎肝硬化患者临床资料,对比不同中医证候患者的超声声像图、门脉血流动力学和肝功能分级的差异。结果:血瘀证肝硬化患者肝左叶上下径最小,除脾肾阳虚证外,显著低于其他各证型(P<0.05);湿热内蕴证肝硬化患者门静脉直径显著低于肝肾阴虚、脾肾阳虚和血瘀证各组门脉直径(P<0.05),血瘀证肝硬化患者门静脉平均血流速度显著低于湿热内蕴证、脾虚湿盛证和湿热内蕴证肝硬化患者(P<0.05),肝气郁结证肝硬化患者血流量显著高于脾肾阳虚证和血瘀证肝肾患者(P<0.05);肝气郁结证和湿热内蕴证以A级为主,且明显高于脾肾阳虚证肝硬化患者(P<0.05),而脾肾阳虚证和血瘀证肝硬化者C级所占比例显著高于湿热内蕴证肝硬化患者(P<0.05);肝气郁结证肝硬化患者总蛋白(STP)水平显著高于血瘀证肝硬化患者(P<0.05),肝气郁结证和湿热内蕴肝硬化患者白蛋白(ALB)水平显著高于肝肾阴虚证和脾肾阳虚证肝硬化患者(P<0.05)。结论:不同证型肝硬化患者与超声声像图、门脉血流动力学参数及肝功能分级具有一定相关性,在临床上结合超声声像图、门脉血流动力学参数及肝功能分级,可为病情评估以及中医辨证分型提供更加客观的依据。Objective:To explore the relationship between TCM syndromes and ultrasonography,portal hemodynamics,liver function grading for patients with hepatitis B cirrhosis.Methods:The clinical data of 156 patients with hepatitis B cirrhosis in the hospital from May 2018 to May 2020 were retrospectively analyzed.The differences in ultrasonography,portal hemodynamics and liver function grading among patients with different TCM syndromes were compared.Results:The upper and lower diameters of liver left lobe were the shortest in cirrhosis patients of blood stasis syndrome,which were significantly shorter than those of the other syndromes except spleen-kidney yang-deficiency(P<0.05).The portal vein diameter in cirrhosis patients of interior dampness-heat syndrome was significantly shorter than that of liver-kidney Yin-deficiency,spleen-kidney Yang-deficiency,and blood stasis syndrome(P<0.05).The mean flow velocity of portal vein in cirrhosis patients of blood stasis syndrome was significantly lower than that of interior dampness-heat syndrome,spleen-deficiency dampness-overabundance syndrome(P<0.05).The blood flow volume in cirrhosis patients of liver-Qi stagnation syndrome was significantly higher than that of spleen-kidney Yang-deficiency and blood stasis syndrome(P<0.05).The liver-Qi stagnation syndrome and interior dampness-heat syndrome were mainly on grade A,significantly higher than that in cirrhosis patients of spleen-kidney Yang-deficiency(P<0.05).The proportion of grade C in cirrhosis patients of spleen-kidney Yang-deficiency and blood stasis syndrome was significantly higher than that of interior dampness-heat syndrome(P<0.05).The level of serum total protein(STP)in cirrhosis patients of liver-Qi stagnation syndrome was significantly higher than that of blood stasis syndrome(P<0.05).The level of albumin(ALB)in cirrhosis patients of liver-Qi stagnation syndrome and interior dampness-heat syndrome was significantly higher than that of liver-kidney Yin-deficiency and spleen-kidney Yang-deficiency(P<0.05).Conclusion:The

关 键 词：乙型肝炎 肝硬化 中医证型 血流动力学 肝功能 

分 类 号：R259[医药卫生—中西医结合]