肝硬化伴高甲胎蛋白血症的中医证候分析  

Analysis of TCM syndrome of hepatocirrhosis with abnormal alpha-fetoprotein

作　　者：邓欣[1] 杨大国[1] 李晓良[1] 吴其恺[1] 李知玉[1] 聂广[1] 

机构地区：[1]深圳市东湖医院中西医结合肝病科

出　　处：《中西医结合肝病杂志》2007年第4期195-197,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：广东省中医药局资助项目(No.1050149)

摘　　要：目的:探讨肝炎肝硬化伴高甲胎蛋白(AFP)血症的中医证候学特点,为实施肝癌阻断性治疗提供中医辨证论治思路。方法:采用前瞻性流行病学调查方法,提取115例肝炎肝硬化伴高AFP血症患者的中医症状、体征、舌、脉等四诊信息,对患者进行中医辨证,统计分析这类患者的证候学特点。结果:常见的症状依次为:尿黄(93.92%)、倦怠乏力(93.05%)、食少纳呆(72.18%)、脘腹胀满(71.31%)、身目发黄(46.96%)、恶心呕吐(42.61%);体征依次为:面色晦暗(70.44%)、肝掌(47.83%)、蜘蛛痣(37.40%)。舌苔白腻(36.53%),舌苔黄腻(34.79%),舌质红(33.92%),脉弦滑(26.96%)。中医证型依次为:湿热内蕴证(46.09%)、血瘀证(44.35%)、脾虚湿盛证(36.53%)、肝气郁结证(22.61%)、肝肾阴虚证(13.05%)、脾肾阳虚证(2.61%)。结论:肝硬化伴高甲胎蛋白血症阶段的中医证候特点以标实为主,正虚为次。标实主要是湿热、气滞、血瘀,正虚主要是气阴两虚。Objective： To explore the TCM syndrome of heaptocirrhosis with abnormal alpha-fetoprotein （AFP）, and provide the method of determination of treatment based on pathogenesis obtained through differentiation of symptome and signs for preventing precancerous lesion of liver. Methods： By means of prospective epidemiologic survey, the four diagnosis information of TCM symptom, physical sign, glossa, and pulse from 115 hepatocirrhosis with abnormal alpha-fetoprotein were extracted, and differentiations of symptoms and signs from patients were taken. Then the characteristics of TCM syndrome were analyzed. Results： Frequency of occuring symptom： yellow urine （93.92%）, lassitude （93.05%）, poor appetite （72. 18% ）, abdominal distention （71.31%）, yellow skin and eye （46. 96% ）, nausea and vomititing （42. 61% ）. Physical signs as follow： dark complexion （70. 44% ）, liver palms （ 47. 83% ）, spider nevus （ 37.40% ）, white and greasy fur （ 36. 53% ）, yellow and greasy fur （34. 79% ）, red tongue （33. 92% ）, sliding pulse with chord （26. 96% ）. TCM syndrome as follow： endoretention of damp-heat （46. 09% ）, syndrome of blood stasis （44. 35% ）, damp abundance due to splenic asthenia （36.53%）, depression of liver-Qi （ 22. 61% ）, hepatic and renal Yin deficiency （ 13.05% ）, asthenic splenonephro-Yang （2.61%）. Conclusion： The characteristic of TCM sydrome at the stage of heaptocirrhosis with abnormal alpha-fetoprotein is that excessiveness in the superficies is more important than deficiency in the base. Excessiveness in the superficies includes humid heat, stagnation of Qi and blood stasis. Deficiency in the base includes deficiency of both vital energy and Yin.

关 键 词：肝炎肝硬化 甲胎蛋白 肝癌前病变 中医证型 

分 类 号：R259[医药卫生—中西医结合]