肝纤维化指标与慢性乙型肝炎中医辨证的相关性  

Correlation between Liver Fibrosis Index and Syndrome Differentiation of Chinese Medicine in Chronic Hepatitis B

作　　者：顾树江 张春铭[1] GU Shujiang;ZHANG Chunming(Changping District Hospital of Traditional Chinese Medicine,Beijing 102200,China)

机构地区：[1]北京市昌平区中医医院,北京102200

出　　处：《大医生》2019年第14期48-49,共2页Doctor

摘　　要：目的分析慢性乙型肝炎(CHB)中医辨证分型与患者血清肝纤维化指标的相关性。方法选取2018年1月至12月北京市昌平区中医医院收治的100例CHB患者,依据中医辨证分为瘀血阻络型组(n=35)、湿热中阻型组(n=32)与肝郁脾虚型组(n=33),随机纳入40例CHB患者建立对照组。纳入患者均进行肝纤维化血清学指标检测,包括检测层粘蛋白(LN)、血清Ⅲ型前胶原(PC-Ⅲ)及Ⅳ型胶原(Ⅳ-C)。对比分析各组检测结果。结果瘀血阻络型组患者PC-Ⅲ、LN及Ⅳ-C较对照组、湿热中阻型组及肝郁脾虚型组明显更高(P<0.05);湿热中阻型组患者PC-Ⅲ、LN、Ⅳ-C较肝郁脾虚型组及对照组明显更高(P<0.05);肝郁脾虚型组患者PC-Ⅲ、LN、Ⅳ-C较对照组明显更高(P<0.05)。结论进行PC-Ⅲ、LN、Ⅳ-C指标检测有助于使中医临床辨证深入至细胞水平,使辨证分型结果更明确。Objective To analyze the correlation between syndrome differentiation of Chinese medicine and serum liver fibrosis indexes in chronic hepatitis b(CHB).Methods A total of 100 patients with CHB admitted to Changping District Hospital of Traditional Chinese Medicine from January to December 2018 were randomly divided into blood stasis obstructing collaterals group(BSOC,n=35),damp-heat blocking middle energizer group(DHBM,n=32)and liver stagnation and spleen deficiency group(LSSD,n=33)according to syndrome differentiation,and 40 patients with CHB were randomly assigned to control group.The serological indexes of liver fibrosis were detected in all the patients,including laminin(LN),serum procollagenⅢ(PC-Ⅲ)and collagen type IV(Ⅳ-C),and the results of each group were compared.Results The PC-Ⅲ,LN andⅣ-C levels of patients in BSOC group were significantly higher than the control group,DHBM group and LSSD group(P<0.05).The PC-Ⅲ,LN andⅣ-C levels of patients in DHBM group were significantly higher than the control group and LSSD group(P<0.05).The PC-Ⅲ,LN andⅣ-C levels of patients in LSSD group were significantly higher than the control group(P<0.05).Conclusion The detection of PC-Ⅲ,LN andⅣ-C helps make syndrome differentiation of Chinese medicine to the cellular level,thus making the classification result more clear.

关 键 词：肝纤维化 层粘蛋白 血清Ⅲ型前胶原 Ⅳ型胶原 慢性乙型肝炎 

分 类 号：R51[医药卫生—内科学]