慢性乙肝肝硬化患者中医体质分析及与相关病理特征关联性探究  

Analysis of the constitution of Traditional Chinese Medicine in patients with chronic hepatitis B cirrhosis and its correlation with the relevant pathological characteristics

作　　者：张璐鹏 张开波 李英宵 李志恒[1] 李鲜[2] ZHANG Lupeng;ZHANG Kaibo;LI Yingxiao;LI Zhiheng;LI Xian(The Second Clinical Medical College,Henan University of Traditional Chinese Medicine,Zhengzhou,450003.China;Department of Hepatobiliary Spleen and Stomach,Henan Province Hospital of TCM)

机构地区：[1]河南中医药大学第二临床医学院,郑州450003 [2]河南省中医院肝胆脾胃科

出　　处：《中国中西医结合消化杂志》2021年第8期550-554,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：河南省卫生健康委员会基金资助项目(No:20-21ZYZD09)。

摘　　要：目的:探讨慢性乙肝肝硬化患者中医体质及其与相关病理特征关联性。方法:选取2018年1月~2019年10月我院163例慢性乙肝肝硬化患者,入院后对所有患者中医体质进行分型,统计分析不同中医体质类型患者肝功能Child-pugh分级、FibroScan值(FS)、B淋巴细胞计数(CD5+、CD5-、CD19)、乙肝病毒载量(HBV-DNA)、肝脏纤维化分期。结果:共163例慢性乙肝肝硬化患者,中医体质分型占比最高前3位依次是湿热质(24.54%)、气虚质(21.47%)、平和质(16.56%);平和质、气虚质患者肝功能Child-pugh分级A级占比最高,气虚质、阳虚质、痰湿质、血瘀质、特禀质患者B级占比最高,阴虚质、湿热质C级占比最高;血瘀质患者FS值最高,特禀质患者FS值最低;CD5+较高的中医体质包括湿热质、阴虚质、气郁质、特禀质,CD5-较高的中医体质包括阳虚质、气虚质、血瘀质,CD19较高的中医体质包括湿热质、特禀质、血瘀质;湿热质患者HBV-DNA病毒载量≥5×10^(6) U/mL者占比最多,为70.00%,特禀质、阴虚质均无病毒载量≥5×10^(6) U/mL者;平和质患者肝脏纤维化分期S0期占比最高,为51.85%,阳虚质患者S0期、S1期占比最高,均为36.36%,气虚质患者S1期、S2期占比最高,均为37.14%,特禀质、痰湿质、湿热质、气郁质患者S2期占比最高,分别为100.00%、62.50%、40.00%、31.58%,阴虚质患者S3期占比最高,为66.67%,血瘀质患者S4期占比最高,为41.67%。结论:慢性乙肝肝硬化患者中医体质的分布存在一定规律性,主要为湿热质、气虚质、平和质,且患者中医体质与肝功能Child-pugh分级、FS值、B淋巴细胞计数、乙肝病毒载量及肝脏纤维化分期存在一定关系。Objective:To explore the TCM constitution of patients with chronic hepatitis B cirrhosis and its correlation with related pathological features.Methods:From January 2018 to October 2019,163 patients with chronic hepatitis B cirrhosis in our hospital were selected,the TCM constitution of all patients was typed after admission,The liver function Child-pugh grade,FibroScan value(FS),B lymphocyte count(CD5+,CD5-,CD19),hepatitis B virus load(HBV-DNA),and liver fibrosis stage were statistically analyzed in patients with different TCM constitution types.Results:A total of 163 patients with chronic hepatitis B cirrhosis in this group,the first three types of constitution in TCM were dampness and heat(24.54%),Qi deficiency(21.47%)and peace(16.56%);Child-pugh grade A accounted for the highest proportion of liver function in patients with peace and Qi deficiency,patients with Qi deficiency,Yang deficiency,phlegm and dampness,blood stasis,and idiosyncrasy had the highest proportion of patients with grade B,and Yin-deficiency and damp-heat-quality C have the highest proportion;Blood stasis patients had the highest FS value,and idiopathic patients had the lowest FS value;The TCM Constitution with high CD5+level includes damp heat,Yin deficiency,Qi depression,and idiosyncrasy,CD5-Higher TCM constitutions include Yang deficiency,Qi deficiency,and blood stasis,the TCM Constitution with high CD19 level includes dampness and heat,idiosyncrasy and blood stasis;The HBV-DNA viral load in patients with hot and humid conditions≥5×10^(6) U/mL accounted for the largest proportion,with 70.00%,those with idiosyncrasy and Yin deficiency had no viral load≥5×10^(6) U/mL;The hepatic fibrosis stage S0 accounted for the highest proportion in patients with pinghe,which was 51.85%,patients with Yang deficiency had the highest proportion of stage S0 and S1,both of which were 36.36%,patients with Qi deficiency had the highest proportion in stage S1 and S2,both of which were 37.14%,patients with idiosyncrasy,phlegm,damp heat,and Qi depression ac

关 键 词：慢性乙肝肝硬化 中医体质 肝功能CHILD-PUGH分级 FibroScan值 B淋巴细胞计数 乙肝病毒载量 肝脏纤维化 

分 类 号：R575.1[医药卫生—消化系统]