1003例慢性乙型肝炎(ALT≥2×ULN)患者中医常见症状及证候分布特点研究  

Study on Common Symptoms and Distribution Characteristics Of Traditional Chinese Medicine Syndromes of 1003 Chronic Hepatitis B(ALT≥2ULN) Patients

作　　者：叶永安[1] 田德禄[1] 蒋健[2] 李志红[1] 李筠[3] 陈建杰[2] 赵一鸣[4] 王融冰[5] 杨世忠[6] 邵凤珍[7] 季光[8] 杨晋翔[9] 周大桥[10] 成冬生 刘铁军[6] 张玮[12] 孙克伟[13] 王玉芬[1] 

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]上海中医药大学曙光医院,上海200021 [3]中国人民解放军第302医院,北京100039 [4]北京大学第三医院,北京100191 [5]首都医科大学北京地坛医院,北京100015 [6]长春中医药大学附属医院,长春130021 [7]天津中医药大学第一附属医院,天津300193 [8]上海中医药大学,上海201203 [9]北京中医药大学第三附属医院,北京100029 [10]深圳市中医院,深圳518033 [11]陕西省中医医院,西安710003 [12]上海中医药大学附属龙华医院,上海200032 [13]湖南中医药大学第一附属医院,长沙410007

出　　处：《世界中医药》2015年第9期1293-1298,1304,共7页World Chinese Medicine

基　　金：科技部"十五"攻关课题(编号:2004BA721A03)

摘　　要：目的:开展全国范围内多中心慢性乙型肝炎(ALT≥2×ULN)患者证候调查,归纳该病的证候分布特点以及主要证型。方法:调查全国共计1 003例慢性乙型肝炎(ALT≥2×ULN)患者,采集舌象、脉象及中医症状指标,通过量化评价确定症状分布频次及构成比,分析该病的主要证候分类及占比。结果:慢性乙型肝炎(ALT≥2×ULN)常见中医症状(前10位)依次为:困倦乏力(84.55%)、胁痛(75.67%)、尿黄(75.37%)、口干(66.20%)、烦躁易怒(60.42%)、胃部满闷(58.33%)、口苦(54.24%)、食欲不振(53.24%)、面色晦暗(51.94%)、腹部胀满(48.16%)等;在单一证候及有兼证存在的情况下,肝胆湿热和肝郁脾虚证具有较高的发生率,复合证候"肝胆湿热,肝郁脾虚"证为慢性乙型肝炎(ALT≥2×ULN)临床最常见相兼证候,肝郁脾虚及肝胆湿热证患者常见症状构成比及肝功能指标有显著差异。结论:"肝胆湿热""肝郁脾虚"及复合证候"肝胆湿热,肝郁脾虚"证为慢性乙型肝炎(ALT≥2×ULN)核心病机。Objective：To explore the main syndrome types and distribution regularities of traditional Chinese medicine（TCM） syndromes by collecting muti-center nationwide clinical data of chronic hepatitis B（ALT≥2ULN） patients.Methods：A total of 1003 chronic hepatitis B（ALT≥2×ULN） patients were recruited.By collecting the clinical manifestations of tongue,pulse and TCM symptom index and determining the distribution frequency and constituent ratio of symptoms by quantitative evaluation,the main syndrome types and their percentages were investigated.Results：The main symptoms of chronic hepatitis B（ALT≥2ULN）were：sleepy and fatigue（84.55%）,hypochondriac pain（75.67%）,yellow urine（75.37%）,dry mouth（66.20%）,indignation（60.42%）,distension syndrome（58.33%）,bitter taste（54.24%）,anorexia（53.24%）,darkish face（51.94%）,abdomen distended（48.16%）.In occasions where there are more than one syndrome,dampness-heat in the liver and gallbladder syndrome and liver stagnation and spleen deficiency syndrome had a higher incidence,and the complex syndrome of dampness-heat in the liver and gallbladder and liver stagnation and spleen deficiency was the most common complex syndrome in chronic hepatitis B（ALT≥2×ULN）.Symptoms constitute and liver function index have a significant difference between the patients with dampnessheat in the liver and gallbladder syndrome from the patients with liver stagnation and spleen deficiency syndrome.Conclusion：The core syndrome of chronic hepatitis B（ALT≥2ULN） is dampness-heat in the liver and gallbladder syndrome,liver stagnation and spleen deficiency syndrome,and the complex syndrome of damp heat in the liver and gallbladder and liver stagnation and spleen deficiency.

关 键 词：慢性乙型肝炎 证候 常见症状 分布特点 

分 类 号：R259[医药卫生—中西医结合]