肝炎后肝硬化患者生活质量与中医基本证候的相关性  

Relationship between quality of life and basic syndromes of traditional Chinese medicine in patients with posthepatitic cirrhosis

作　　者：张琴[1] 王磊[1] 刘平[2] 

机构地区：[1]复旦大学上海公共卫生临床中心肝病科,上海201508 [2]上海中医药大学,上海201203

出　　处：《中西医结合学报》2010年第1期30-34,共5页Journal of Chinese Integrative Medicine

基　　金：国家重点基础研究发展计划(973计划)资助项目(No.2006CB504801)

摘　　要：目的:分析肝炎后肝硬化患者的生活质量与中医证候的相关性,探讨影响肝炎后肝硬化患者生命质量的主要因素。方法:采用新修订的简明健康生存质量(ShortForm-36Health Survey,SF-36)量表测试108例肝炎后肝硬化患者的生命质量分值,并采集肝炎后肝硬化患者相关临床信息,包括性别、年龄、体质量指数(body mass index,BMI)、病程、疾病的共性证候及主要实验室指标等。运用t检验、方差分析和逐步回归筛选影响肝炎后肝硬化患者生活质量的主要因素。结果:修订后的SF-36量表Cronbachsα系数为0.773,提示各项目间内部有良好的一致性。肝炎后肝硬化组修订后SF-36总评分及躯体功能、躯体角色、机体疼痛、心理健康、社会功能的平均评分显著低于正常对照组(P<0.01);相关分析结果提示,肝炎后肝硬化共性证候评分与躯体功能、心理健康、情感角色、活力、总体健康状况具有相关性(均r>0.6,P<0.01);多元逐步回归分析结果显示,在P=0.05水平,中医肝炎后肝硬化共同证候、天冬氨酸氨基转移酶、总胆红素、白蛋白、凝血酶原时间的回归系数分别是0.262、-0.2978、-0.4839、-0.4839、-0.5123、-0.5719,是影响肝炎后肝硬化患者生活质量的主要因素。结论:肝炎后肝硬化患者的生活质量全面下降,纳入疾病中医共性证候的修订后SF-36量表更为客观,对于肝炎后肝硬化患者生活质量的评价具有一定的临床实用价值。Objective： To investigate the main factors influencing the quality of life and the relationship between quality of life and basic syndromes of traditional Chinese medicine （TCM） in patients with posthepatitic cirrhosis.Methods： The outcomes of revised Short Form-36 Health Survey （SF-36） Questionnaire in 108 patients with posthepatitic cirrhosis and the normal control population were assessed, and the related clinical information including gender, age, body mass index （BMI）, course of disease, basic syndromes of disease and main laboratory parameters were collected. The data were analyzed by t-test, analysis of variance （ ANOVA） and stepwise regression analysis.Results： The Cronbach＇ s a coefficient of the revised SF-36 questionnaire was O. 773, indicating good consistency within the items. The outcomes of revised SF-36 and the scores of physical function, role physical, bodily pain, mental health, and social function in the patients with posthepatitic cirrhosis were significantly lower than those in the normal control population （P〈0.01）. Correlation analysis showed that there was a correlation between basic TCM syndromes and scores of physical function, mental health, role emotion, vitality, and general health. Stepwise regression analysis indicated that basic TCM syndromes, aspartate aminotransferase, total billirubin, albumin, and prothrombin time played major role in the quality of life in the patients with posthepatitic cirrhosis, and the values of regression coefficient were 0. 262, -0. 297 8, -0. 483 9, -0.483 9, -0.512 3, -0. 571 9 respectively.Conclusion： The quality of life in the patients with posthepatitic cirrhosis is significantly decreased. The revised SF-36 with basic TCM syndrome items is more objective and has certain clinical practical value on measurement of quality of life in patients with posthepatitic cirrhosis.

关 键 词：肝炎 肝硬化 生活质量 证候 中医学 

分 类 号：R259[医药卫生—中西医结合]