泉州地区非酒精性脂肪性肝病合并原发性高血压人群肝郁脾虚证量化辨证研究  

Study on Quantitative Syndrome Differentiation of Stagnation of Liver Qi and Spleen Deficiencyin Patients with Non-alcoholic Fatty Liver Disease and Essential Hypertension in Quanzhou

作　　者：吴秋英[1] 蔡月虹[1] 郭伦聪[1] 陈弼沧 WU Qiuying;CAI Yuehong;GUO Luncong;CHEN Bicang(Department of Encephalopathy,Quanzhou Hospital of Traditional Chinese Medicine,Quanzhou 362000,China;Department of General Medicine,Xiamen Hospital of Traditional Chinese Medicine,Xiamen 361009,China)

机构地区：[1]福建省泉州市中医院脑病科,福建泉州362000 [2]福建省厦门市中医院全科医疗科,福建厦门361009

出　　处：《中西医结合研究》2021年第3期149-153,共5页Research of Integrated Traditional Chinese and Western Medicine

基　　金：泉州市科学技术局科研项目(No.2014Z074);第六批全国老中医药专家学术经验继承工作项目(No.国中医药人教发[2017]29号);厦门市科学技术局科研项目(No.3502Z20189006)。

摘　　要：目的探索泉州地区非酒精性脂肪性肝病合并原发性高血压肝郁脾虚证量化辨证方法。方法遴选420例于泉州市中医院体检中心诊断的非酒精性脂肪性肝病合并原发性高血压且辨证为肝郁脾虚证的患者为研究对象,采用“专家研讨法”确定泉州地区上述人群肝郁脾虚证的基本症状,采用条件概率换算法对基本症状进行赋分,采用最大似然判别法计算辨证阈值,最后对量化辨证法进行回顾性和前瞻性卡方检验。结果该量化辨证法的回顾性卡方检验显示其敏感度为86.12%,特异度为86.95%,准确度为87.19%,阳性似然比为7.01;前瞻性卡方检验显示其敏感度为86.05%,特异度为87.14%,准确度为86.71%,阳性似然比为6.96。结论非酒精性脂肪性肝病合并原发性高血压肝郁脾虚证量化辨证法具有客观、量化、准确、简便等优点,值得在临床上进一步推广使用。Objective To explore the quantitative syndrome differentiation method of non-alcoholic fatty liver disease(NAFLD)complicated with essential hypertension(EH)of syndrome of stagnation of liver qi and spleen deficiency in Quanzhou.Methods A total of 420 cases of NAFLD complicated with EH diagnosed in the physical examination center of Quanzhou hospital of traditional Chinese medicine were selected as the subjects,which syndrome differentiation were stagnation of liver qi and spleen deficiency.The basic symptoms of stagnation of liver qi and spleen deficiency in the above-mentioned population in Quanzhou were determined by expert discussion method.The basic symptoms were scored by conditional probability conversion method,and the threshold of syndrome differentiation was calculated by maximum likelihood discriminant method.Finally,the quantitative syndrome differentiation method was retrospectively and prospectively analyzed by doing the chi-square test.Results The retrospective chi square test showed that the sensitivity,specificity,accuracy and positive likelihood ratio were 86.12%,86.95%,87.19%and 7.01 respectively.The prospective chi square test showed that the sensitivity,specificity,accuracy and positive likelihood ratio were 86.05%,87.14%,86.71%and 6.96 respectively.Conclusion The quantitative syndrome differentiation method of NAFLD complicated with EH of syndrome of stagnation of liver qi and spleen deficiency has the advantages of objectivity,quantification,accuracy and simplicity.It is worth further promotion and application in clinical practice.

关 键 词：非酒精性脂肪性肝病 原发性高血压 肝郁脾虚证 量化辨证 

分 类 号：R256.49[医药卫生—中医内科学]