苔黄对慢性乙型肝炎肝胆湿热证的证型定性价值分析  

Qualitative value of yellow tongue coating for liver and gallbladder damp-heat syndrome in patients with chronic hepatitis B

作　　者：唐义爽 赵瑜[1] 徐琳[1] 海亚美 沈晓萍[1] 田华捷 刘倩[1] 彭景华[1] 冯琴[1] 胡义扬[1,2,3] 

机构地区：[1]上海中医药大学附属曙光医院肝病研究所,上海201203 [2]肝肾疾病病证教育部重点实验室,上海201203 [3]上海高校中医内科学E-研究院,上海201203

出　　处：《中华中医药杂志》2016年第7期2864-2866,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81373857;No.81403298);国家重大科技专项(No.2012ZX10005001-004);上海市自然科学基金项目(No.14ZR1442000);上海市教育委员会"晨光计划"(No.14CG41)~~

摘　　要：目的:探讨苔黄对慢性乙型肝炎(CHB)临床常见证型肝胆湿热证的定性价值。方法:将756例CHB患者分别经3位专家判别证候分为肝胆湿热证组(429例)和非肝胆湿热证组(327例),运用χ2检验及Logistic回归筛选出对CHB肝胆湿热证有鉴别诊断意义的症状,绘制ROC曲线,通过曲线下面积(AUC)分析比较各症状对证型的定性价值。结果:苔黄、苔腻、苔厚、口臭4个症状的偏回归系数B分别为2.962、0.798、0.789、1.694,OR值分别为19.33、2.221、2.202、5.44,与CHB肝胆湿热证呈密切正相关。四者的AUC分别为0.839、0.688、0.644、0.635,差异有统计学意义(P<0.01);灵敏度分别为88.3%、64.8%、40.6%、45.0%,特异度分别为79.6%、72.8%、88.2%、82.1%。结论:苔黄对CHB肝胆湿热证具有较高的定性价值。Objective： To evaluate the qualitative value of yellow tongue coating for liver and gallbladder damp-heat syndrome（LGDHS） in patients with chronic hepatitis B（CHB）. Methods： According to the main syndrome types judged by three experts, the 756 CHB patients were divided into LGDHS group（429 cases） and NLGDHS group（327 cases）. Then Chi-square test and Binary Logistic regression were applied to screen for symptoms of the differential diagnosis significance in CHB LGDHS, ROC curve was plotted and the area under ROC curve（AUC） was calculated to assess the diagnosis value of each TCM symptom. Results： The partial regression coefficient（B） of yellow tongue coating, greasy tongue coating, thick tongue coating and bad breath was 2.962, 0.798, 0.789, 1.694 and the OR was 19.33, 2.221, 2.202, 5.44, respectively, it was suggested that there existed a close positive relationship between the four symptoms and LGDH of CHB. The corresponding AUC was 0.839, 0.688, 0.644 and 0.635, with statistical significance（P〈0.01）. Sensitivity of the four symptoms was 88.3%, 64.8%, 40.6%, 45.0% and specificity was 79.6%, 72.8%, 88.2%, 82.1%, respectively. Conclusion： Yellow tongue coating has a high qualitative value in the diagnosis of CHB patients with LGDH.

关 键 词：苔黄 慢性乙型肝炎 肝胆湿热证 定性价值 

分 类 号：R259[医药卫生—中西医结合]