182例肝炎肝硬化患者舌象与门静脉高压胃镜表现的相关性分析  

Correlation between tongue manifestations and endoscopic representations of portal hypertension in 182 cases of liver cirrhosis

作　　者：赵丽红[1] 王天芳[1] 吴秀艳[1] 薛晓琳[1] 李永纲[2] 孙凤霞[3] 李秀惠[4] 张秋云[5] 陈盛铎[6] 毛德文[7] 江宇泳[3] 杨慧银[2] 李宁[1] 李昕[1] 王思颖[1] 葛舰[1] 

机构地区：[1]北京中医药大学基础医学院中医诊断系北京100029 [2]解放军302医院 [3]首都医科大学附属北京地坛医院 [4]首都医科大学附属北京佑安医院 [5]首都医科大学中医药学院 [6]湖北省中医院 [7]广西中医药大学第一附属医院

出　　处：《北京中医药大学学报》2014年第3期199-203,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(No.2011CB505105);北京中医药大学创新团队项目(No.2011CXTD08);高等学校学科创新引智计划资助(B07007)

摘　　要：目的分析肝炎肝硬化患者的舌象与门静脉高压胃镜表现的相关性,为探讨其舌象表现及病机特点提供依据。方法统一制定《肝炎肝硬化临床信息采集表》,进行全国多中心的横断面流行病学调查,收集肝炎肝硬化患者的舌象信息;采用电子胃镜记录门静脉高压表现的信息;运用SPSS的频次、频率分析及相关性分析探索两者间的相关性。结果 182例肝炎肝硬化患者中属于代偿期者59例,失代偿期者123例,其中前者的门脉高压胃镜表现程度轻于后者;存在有食管胃静脉曲张或门脉高压性胃病时,代偿期患者舌下络脉增粗和舌下络脉迂曲的出现频率较高(P<0.05),失代偿期患者黄苔的出现频率较高(P<0.05),而瘀斑/瘀点舌的出现频率较低(P<0.05);与门静脉高压胃镜表现具有相关性(均为正相关)的舌象,在代偿期为舌下络脉增粗、迂曲、颜色紫黑及红绛舌(P<0.05),失代偿期为胖舌(P<0.05)。结论代偿期和失代偿期肝炎肝硬化患者的舌象与门静脉高压胃镜表现有一定的相关性,初步认为两期分别以瘀血和水停为突出病机。Objective To analyze the correlation between tongue manifestations and endoscopic representations of portal hypertension in the patients with liver cirrhosis, and provide evidence for investigating the characteristics of tongue manifestations and pathogenesis of liver cirrhosis. Methods A national cross-section epidemiological survey was conducted by using a collection form of liver cirrhosis clinical information made by the research group uniformly for collecting the tongue data from the patients with liver cirrhosis. The information about endoscopic representations of portal hypertension was recordedby using electron endoscope, and the correlation between tongue manifestations and endoscopic representations of portal hypertension was analyzed by using SPSS frequency and rate and correlation analysis. Results In 182 patients, there were 59 at the compensated stage and 123 at the decompensated stage, and the endoscopic representations of portal hypertension were mild at the compensated stage. When the patients with esophageal and gastric varices or portal hypertensive gastropathy at the compensated stage, sublingual veins thickened and occurrence frequency of tortuous sublingual veins were higher （ P 〈 O. 05）. The occurrence frequency of yellow tongue fur was higher （P 〈 0.05 ） and that of ecchymosis/ petechia was lower （ P 〈 0.05 ） at the decompensated stage. The tongue manifestations correlated to endoscopic representations of portal hypertension （positive correlation ） were thickened and tortuous sublingual veins, and dark purple or deep red tongue at the compensated stage （P 〈 O. 05）, and enlarged tongue at the decompensated stage （P 〈 0.05 ）. Conclusion The tongue manifestations are correlated to endoscopic representations of portal hypertension at both compensated stage and decompensated stage, which indicates initially that the main pathogenesis is blood stasis at the compensated stage and water retention at the decompensated stage.

关 键 词：肝炎肝硬化 舌象 门静脉高压 胃镜 

分 类 号：R575.2[医药卫生—消化系统]