慢性乙型重型肝炎不同时段舌脉象的动态分析  

Dynamic changes of tongue and pulse presentations in patients with chronic severe hepatitis B at different weeks of disease course

作　　者：肖阁敏[1] 关卫兵[1] 戴敏[1] 王拥泽[1] 杨跃武[1] 谢和平[1] 杨宏志[1] 

机构地区：[1]中山大学附属第三医院中医科,广州510630

出　　处：《传染病信息》2010年第5期279-281,共3页Infectious Disease Information

基　　金：国家"十一五"科技重大专项(2008ZX10005-007)

摘　　要：目的通过观察慢性乙型重型肝炎舌脉象的动态变化,初步探讨慢性乙型重型肝炎的病理病机和证候演变过程及其规律。方法分析104例慢性乙型重型肝炎患者不同病程(病程第1、3、5、8周)舌脉象的分布情况。结果慢性乙型重型肝炎各病程舌、脉象出现频数大于50%的是:舌质红、舌下脉络增粗或迂曲、舌苔厚、舌苔腻、舌苔黄、舌苔白6种舌象;脉数、脉滑、脉弦、脉实、脉细、脉沉6种脉象。它们频率不同地出现在病程第1、3、5、8周。其中,病程第1周舌象出现频数大于50%的为:舌质红、舌苔黄、舌苔厚、舌苔腻;第3周同第1周;第5周较第1、3周增加了舌下脉络增粗或迂曲;第8周较第5周增加了舌苔白,减少了舌质红、舌苔黄、舌苔腻。慢性乙型重型肝炎病程第1、3、5和8周出现频数大于50%的脉象分别为:第1周,脉数、脉弦、脉实;第3周在第1周基础上增加脉滑;第5周,脉弦、脉数;第8周,脉弦、脉细、脉沉。结论慢性乙型重型肝炎的病机演变规律是湿热→湿热夹毒→瘀毒→正虚血瘀。Objective To investigate the pathogenesis and syndrome evolution with the disease progression by observing the dynamic changes of tongue and pulse presentations in the patients with chronic severe hepatitis B. Method The occurrence frequency of tongue and pulse presentations in the patients with chronic severe hepatitis B at week 1, 3, 5 and 8 of disease course was recorded and analyzed. Results The 6 tongue presentations, of which the occurrence frequency was more than 50%, were red tongue proper, sublingual vein enlargement or circuity, and thick, greasy, yellow and white tongue fur, and the 6 pulse presentations, of which the occurrence frequency was more than 50%, were frequent, slippery, wiry, replete, small and sunken pulse. But their oc- currence frequency was different at week 1, 3, 5 and 8 of disease course. At week 1, the tongue presentations, of which the occurrence frequency was more than 50%, were red tongue proper and yellow, thick and greasy tongue fur; at week 3, they were the same as those at week 1; at week 5, sublingual vein enlargement or circuity occurred in addition to those at week 1; at week 8, they were thick and white tongue fur and sublingual vein enlargement or circuity excluding red tongue proper and yellow and greasy tongue fur. At week 1, the pulse presentations, of which the occurrence frequency was more than 50%, were frequent, wiry and replete pulse; at week 3, slippery pulse occurred in addition to those at week 1; at week 5, they were wiry and frequent pulse; at week 8, they were wiry, small and sunken pulse. Conclusion The pathological changes of chronic severe hepatitis B go through the pro- gression from dampness-heat accumulation, to exogenous dampness-heat and epidemic toxin, to blood stasis and toxin, and to asthenia of healthy energy and blood stasis.

关 键 词：肝炎 乙型 慢性 脉象 中医病机 

分 类 号：R512.62[医药卫生—内科学] R228[医药卫生—临床医学]