肝硬化患者不同中医证型眼底体征  

Fundus Signs of Different TCM Syndrome Types in Patients with Liver Cirrhosis

作　　者：李新宇 王静敏 廖林丽 杨成昊 彭俊[2] 彭清华[1,2] LI Xinyu;WANG Jingmin;LIAO Lini;YANG Chenghao;PENG Jun;PENG Qinghua(Hunan University of Chinese Medicine,Changsha Hunan China 410208;The First Hospital AffiLated to Hunan University of Chinese Medicine,Changsha Hunan China 410007)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《中医学报》2022年第3期632-636,共5页Acta Chinese Medicine

基　　金：湖南省研究生创新课题项目(CX20200789,CX20200790)。

摘　　要：目的:分析肝硬化患者不同中医证型眼底体征各自的特点及相关规律,为肝硬化的临床诊治提供辅助依据,同时扩展目诊的研究范畴。方法:将150例肝硬化患者分为实证组、虚实夹杂证组、虚证组,另取70名正常人作为对照组,并通过眼底照片获得相关眼底体征及眼底血管管径像素值,比较不同中医证型中的眼底体征分布特点。结果:肝硬化组眼底动脉管径、动静脉比值显著低于对照组,眼底静脉管径显著高于对照组,差异均有统计学意义(P<0.05)。眼底动脉变细、眼底静脉扩张、动静脉比值变小的频率和重度改变在肝硬化实证组中所占比例最高,血管迂曲的频率、视盘旁静脉螺旋状弯曲重度改变在虚实夹杂证中所占比例最高,血管粗细不均、视网膜渗出的频率和重度改变以及视盘旁静脉螺旋状弯曲的频率、血管迂曲的重度改变在虚证中所占比例最高。结论:肝硬化患者会出现眼底改变;实证组患者的眼底改变以眼底血管管径改变为主,虚实夹杂证组的眼底血管形态改变最为显著,虚证组的眼底改变种类最多。Objective: To analyze the characteristics and related laws of fundus signs of different TCM syndrome types in patients with liver cirrhosis, so as to provide auxiliary basis for the clinical diagnosis and treatment of liver cirrhosis, and expand the research scope of visual diagnosisMethods: 150 patients with liver cirrhosis were divided into excess syndrome group, deficiency mixed with excess syndrome group and deficiency syndrome group.Another 70 normal people were taken as the control group.The pixel values of relevant fundus signs and fundus vascular diameter were obtained through fundus photography pictures, and the distribution characteristics of fundus signs in different TCM syndrome types were compared.Results: The diameter of fundus artery and the ratio of artery to vein in liver cirrhosis group were significantly lower than those in control group, and the diameter of fundus vein was significantly higher than that in control group(P<0.05).The frequency and severe changes of fundus artery narrowing, fundus vein dilation, arteriovenous ratio reduction, and severe changes accounted for the highest proportion in the excess syndrome group.The frequency of tortuous blood vessels and the severe changes in the spiral curve of the parapapillary veins accounted for the highest proportion in the deficiency mixed with excess syndrome group.Uneven blood vessel thickness, frequency and severe changes of retinal exudation, frequency of parapapillary veins spirally bending, severe changes of vascular tortuosity, and slight reduction of the arteriovenous ratio accounted for the highest proportion in the deficiency syndrome group.Conclusion: Fundus changes occur in patients with liver cirrhosis;the fundus changes of patients in the excess syndrome group are mainly the diameter changes of fundus vessels, the morphological changes of fundus vessels in the deficiency mixed with excess syndrome group are the most significant, and the fundus changes in the deficiency syndrome groupare the most.

关 键 词：肝硬化 中医证型 眼底体征 眼底血管 实证 虚实夹杂证 虚证 目诊 

分 类 号：R259.752[医药卫生—中西医结合]