超声、CT定量诊断脂肪肝与中医证型相关性的比较  

The comparative study between different imaging methods for diagnosing fatty liver quantitatively and TCM syndromes

作　　者：宫媛媛[1] 康澍[1] 张立苹[1] 蒋根娣[1] 

机构地区：[1]北京中医药大学东直门医院放射科,北京100700

出　　处：《中国中西医结合影像学杂志》2013年第4期343-345,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：国家中医药管理局中医药科学技术研究专项课题(06-07LB03)

摘　　要：目的:通过超声、CT对非酒精性脂肪肝的定量诊断,分析两者诊断的脂肪肝严重程度与中医证型的相关性。方法:选取非酒精性脂肪肝229例,分为肝郁脾虚、痰湿内阻、痰瘀互结、肝肾不足、湿热内蕴5个中医证型,同时进行轻、中、重度分级。应用超声与CT检查对脂肪肝进行定量诊断,分析脂肪肝程度与中医各证型的关系。结果:①各中医证型在2种检查方法定量诊断脂肪肝分级的分布结果,均显示肝郁脾虚证以轻度脂肪肝为主,肝肾不足证以重度脂肪肝为主,经χ2检验,各中医证型间的脂肪肝程度差异均有统计学意义(P<0.01);②2种影像学方法诊断的轻中重度脂肪肝进行中医证型间的两两比较,其中肝郁脾虚证与痰瘀互结证、肝郁脾虚证与痰湿内阻证、肝郁脾虚证与肝肾不足证、肝郁脾虚证与湿热内蕴证、痰湿内阻证与肝肾不足证、肝肾不足证与湿热内蕴证的脂肪肝程度分级比较差异均有统计学意义(P<0.001)。结果显示2种影像学方法的统计结果基本一致。结论:中医辨证分型与脂肪肝严重程度密切相关,对判断各证型脂肪浸润程度具有参考价值;提示超声、CT检查均可作为规范脂肪肝中医证型的可行方法。Objective：To analyze the correlationship between diagnosis by different imaging methods and TCM syndrome types of the non-alcoholic fatty liver patient on the basis of ultrasound and CT quantitative analysis.Methods：The 229patients of non-alcoholic fatty liver were divided into five groups against five TCM syndromes types,which were syndrome of stagnation of liver qi and spleen deficiency,syndrome of intermingled phlegm and blood stasis,syndrome of phlegm-dampness blocking internally,syndrome of deficiency of liver and kidney and syndrome of interior dampness-heat.All patients had been underwent ultrasound and liver CT scanning,and were classified into mild,moderate and severe grades.Quantitative diagnosis was done against fatty livers by using two imaging methods.The relationship between different grades of fatty liver and TCM syndrome types was analyzed,the difference of the two medical imaging methods was also concluded.Results：①Through the TCM type distribution in the two methods of quantitative diagnosis of fatty liver grading results,the main syndrome of mild fatty liver was syndrome of stagnation of liver qi and spleen deficiency,the main syndrome of severe fatty liver was syndrome of deficiency of liver and kidney.There were significant differences in fatty livers between different TCM types throughχ2 test（P〈0.01）.② Comparing the diagnosis from the two imaging methods of different fatty livers,there were significant differences between the different TCM diagnosis types（P〈0.001）.The results showed that the statistical results of the two imaging methods are consistent.Conclusion：There is a close correlation between the analysis of TCM syndromes and levels of the fatty liver,which is a reference value for judging the degree of infiltration of different syndrome types.Ultrasound and CT are both possible ways to specify the fatty liver TCM type.

关 键 词：脂肪肝 体层摄影术 X线计算机 超声检查 诊断 辨证分型 

分 类 号：R259[医药卫生—中西医结合]