门静脉高压性胃病与中医证型及PLT、CHE、D-二聚体的相关性研究  

Correlation between PortalHypertensionGastropathy,TCMPatterns and PLT,CHE,D-dimer

作　　者：杜丽明[1] 李广鉴[1] 孙秋[1] 王文鸽[1] 何俗非[2] DU Liming;LI Guangjian;SUN Qiu;WANG Wenge;HE Sufei(Kailuan General Hospital,Tangshan 063000,China;Tianjin University of Traditional Chinese Medicine)

机构地区：[1]开滦总医院,河北唐山063000 [2]天津中医药大学

出　　处：《西部中医药》2022年第4期120-123,共4页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金应急管理项目(81842041);河北省中医药管理局科研计划项目(2019265)。

摘　　要：目的:探讨肝硬化门静脉高压性胃病(portal hypertension gastropathy,PHG)病情程度与中医证型、血小板计数(platelet count,PLT)、胆碱酯酶(cholinesterase,CHE)、血浆D-二聚体(plasma d-dimer,D-D)的相关性。方法:选择确诊为PHG的184例肝硬化患者,每位患者进行Child-Pugh分级及胃镜检查,评估患者病情的轻重程度,将患者的中医辨证分型与病情程度结合,患者的病情程度与PLT、CHE、D-二聚体指标相结合,对不同证型之间与病情程度之间进行分析,对病情程度与PLT、CHE、D-二聚体指标进行分析。结果:184例患者中湿热蕴结证所占比例最大,其次是肝气郁结证、瘀血阻络证、脾肾阳虚证、水湿内阻证、肝肾阴虚证。PHG病情程度与Child-Pugh分级差异有统计学意义(P<0.05)。PHG病情程度与不同中医证型之间差异有统计学意义(P<0.05),对PHG不同病情程度中PLT、CHE、D-二聚体进行比较,差异有统计学意义(P<0.05)。结论:PHG病情程度与不同中医辩证分型、Child-Pugh分级、PLT、CHE、D-二聚体存在相关性,对于临床组方用药、中医辨证论治提供一定的客观依据。Objective:To discuss the connections between the degree of PHG,TCM patterns,PLT,CHE,DD.Methods:For 184 patients with liver cirrhosis diagnosed with PHG,Child-Pugh classification and gastroscopy was performed in each patient,to assess the disease condition of the patients,after combining syndrome differentiation and pattern of the patients with the disease conditions,the disease condition and PLT,CHE,D-D,to survey their connections between different patterns and the disease conditions,and the correlations of the disease conditions with PLT,CHE and D-D.Results:The proportion of damp-heat accumulation pattern in the observed patients was the biggest,the next liver-qi stagnation pattern,stagnated blood obstructing collateral pattern,spleenkidney Yang deficiency pattern,water-dampness internal obstruction pattern,liver-kidney yin deficiency pattern.The difference had statistical meaning between disease conditions of PHG and Child-Pugh classification(P<0.05).The difference was statistically significant in the disease conditions of PHG and different TCM patterns(P<0.05),the difference was statistically significant in PLT,CHE and D-D in PHG patients in different disease conditions(P<0.05).Conclusion:PHG patients′states are connected with syndrome differentiation and patterns,Child-Pugh classification,PLT,CHE and D-D,which could be served as the objective evidence for clinical prescription and medication,syndrome differentiation and treatment.

关 键 词：门静脉高压性胃病 中医证型 胆碱酯酶 血浆D-二聚体 

分 类 号：R573[医药卫生—消化系统]