乙肝后肝硬化不同中医证型与TGF-β1、肝纤维化指标以及肝功能分级的相关性的研究  

Correlation research on TCM syndrome types and TGF-β1,liver fibrosis markers,as well as liver function classification in hepatitis B cirrhosis

作　　者：来丽群[1] 樊德利[2] 

机构地区：[1]杭州市中医院消化内科,浙江杭州310007 [2]杭州市第二人民医院检验科,浙江杭州310007

出　　处：《中国卫生检验杂志》2014年第6期808-810,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨慢性乙肝后肝硬化中医辨证分型与转化生长因子、肝纤维化血清血指标以及肝功能分级的相关性,为乙肝后肝硬化的辨证分型的客观化、标准化研究提供依据。方法观察乙肝后肝硬化患者各种证型之间及与健康者之间TGF-β1、透明质酸酶(HA)、层黏蛋白(LN)、Ⅳ型胶原蛋白(Ⅳ-C)、Ⅲ型胶原蛋白(PC-Ⅲ)。结果 TGF-β1、肝纤维化指标及肝功能分级与中医辨证分型密切相关。肝硬化各种证型之间与健康对照组之间比较,TGF-β1的值差别具有统计学意义(P<0.05)。肝肾阴虚证、瘀血内阻证组HA、PC-Ⅲ高于水湿内阻证、肝气郁结组(P<0.05),瘀血内阻证组HA、LN、Ⅳ-C、PC-Ⅲ组高于水湿内阻证、肝气郁结组,差异具有显著性(P<0.01)。结论 TGF-β1、肝纤维化指标可以作为乙肝后肝硬化的中医辨证中证型的量化指标,辨证论治指导临床用药。Objective To investigate the relationship between TCM syndrome differentiation typing of chronic hepatitis B cirrho- sis and transforming growth factor, serum markers of liver fibrosis, as well as liver function classification, so as to provide basis for standardization and objectification of TCM syndrome differentiation typing of the hepatitis B cirrhosis. Methods The levels of TGF - β1, hyaluronidase（ HA）, laminin（ LN）, IV collagen protein （ IV - C） and Ⅲcollagen protein （ PC - Ⅲ ） were ob- served and compared among hepatitis B induced cirrhosis patients with different TCM syndrome types as well as various syn- dromes and health controls＇. Results TGF - β1, serum markers of liver fibrosis, liver function classification and TCM syn- drome typing were closely related. TGF - β1 values had significant statistical difference between hepatitis B induced cirrhosis patients and the healthy controls （ P 〈 0.05 ）. The levels of HA and PC - Ⅲ in patients with yin deficiency of liver and kidney, patients with stagnation of blood stasis were higher than those with damp obstruction and those with stagnation of liver qi, the difference was statistically significant （P 〈 0.05 ）. While the levels of HA, IN, IV - C and PC - Ⅲ in patients with stagnation of blood stasis were all higher than those with damp obstruction and those with liver qi stagnation, the difference was statistically significant （P 〈 O. 01 ）. Conclusion TGF - β1 and serum markers of liver fibrosis can be used as qualitative indexes of TCM syndrome differentiation typing and guide the clinical medication of hepatitis B induced cirrhosis.

关 键 词：肝硬化 乙型肝炎 中医证型 转化生长因子(TGF—β1) 肝纤维化 肝功能 

分 类 号：R575.2[医药卫生—消化系统]