96例原发性胆汁性肝硬化患者中医证候调查  

Survey on Chinese Medicine Syndrome of 96 Patients with Primary Biliary Cirrhosis

作　　者：杜宏波[1] 江宇泳[2] 薛亚春 王菲[3] 宋媛媛[4] 李尚恒[3] 万钢[2] 王宪波[2] 

机构地区：[1]北京中医药大学东直门医院,北京市东城区海运仓5号100700 [2]首都医科大学附属北京地坛医院 [3]首都医科大学研究生部 [4]北京中医药大学研究生部

出　　处：《中医杂志》2017年第7期575-578,共4页Journal of Traditional Chinese Medicine

基　　金：北京市中医管理局中医药科技项目(JJ2012-15);北京市中医管理局人才培养项目([2011]-146)

摘　　要：目的研究原发性胆汁性肝硬化的临床特征、中医证候分布规律与病机演变规律。方法收集2012年6月至2014年9月在北京地坛医院就诊的96例原发性胆汁性肝硬化患者,调查并记录患者一般情况、主要症状及体征、中医四诊信息,统计不同疾病阶段(慢性肝炎、肝纤维化、肝硬化)症状、证候分布特征。结果 96例患者病位证素以肝、脾、肾为主,部分涉及胆;病性证素有10种,出现频次前5位的依次是气虚(78)、气滞(64)、湿(48)、阴虚(34)、血瘀(33),湿、热表现相对不突出;脏腑失调证素有10种,出现频次前5位的依次是,脾虚(63)、肝郁(57)、肝阴虚(23)、肾阴虚(23)、肾虚(9)、脾阳虚(3)。不同疾病阶段病位证素均以肝、脾为主,后期影响至肾;病性方面,气虚、气滞贯穿全程,阴虚、血瘀渐进加重,湿与热在肝纤维化期最突出;脏腑失调方面,脾虚、肝郁全程较高,肝阴虚、肾阴虚逐渐加重,其中脾虚表现最为突出。结论原发性胆汁性肝硬化患者以气虚、气滞、阴虚、血瘀较为突出,病位以肝、脾、肾为主。Objective To explore clinical character,distribution rule of Chinese medicine syndrome and pathogenesis evolution law of primary biliary cirrhosis. Methods Collected 96 patients with primary biliary cirrhosis presented at Beijing Ditan Hospital,from June 2012 to September 2014. Surveyed and recorded common condition,main syndrome and signs,Chinese medicine diagnostic information of the patients. Counted symptoms and syndrome distribution character in different disease phases,including chronic hepatitis,liver fibrosis and cirrhosis of the liver.Results In 96 patients,the syndrome elements of disease location were mainly liver,spleen and kidney,partly involving gallbladder; there were 10 kinds of disease syndrome nature,with the top 5 frequent elements being Qi deficiency（78）,Qi stagnation（64）,dampness（48）,Yin deficiency（34）,blood stagnation（33） successively.Dampness and heat were relatively less prominent; there were 10 kinds of viscera disorder syndrome elements,and the top five were spleen deficiency（63）,liver stagnation（57）,liver Yin deficiency（23）,kidney Yin deficiency（23）,kidney deficiency（29）,spleen Yang deficiency（3） successively. Syndrome elements of disease location in different disease process were all mainly liver and spleen,with kidney involved in later period; in disease nature,Qi deficiency and Qi stagnation went through the whole process while Yin deficiency and blood stagnation worsened gradually. Dampness and heat stood out the most in liver cirrhosis; as for viscera disorders,spleen deficiency and liver stagnation were the highest in the whole process,with liver Yin deficiency and blood stagnation worsened gradually,among which spleen deficiency was the most prominent. Conclusion Qi deficiency,Qi stagnation,Yin deficiency and blood stasis stood out in patients with primary biliary cirrhosis,and liver,spleen and kidney stood out in disease location.

关 键 词：原发性胆汁性肝硬化 中医证候 证素 

分 类 号：R259[医药卫生—中西医结合]