PHG患者中医证候分型与疾病严重程度的关系研究  

Relationship between TCM syndrome types and the severity of PHG

作　　者：倪友琼 胡乃毅 张紫涵 NI Youqiong;HU Naiyi;ZHANG Zihan(Department of Gastroenterology,Wuhan Integrated Traditional Chinese and Western Medicine Hospital(Wuhan First Hospital),Wuhan Hubei 430030,China)

机构地区：[1]武汉市中西医结合医院(武汉市第一医院)消化内科,湖北武汉430030

出　　处：《四川中医》2024年第1期83-86,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探讨门静脉高压性胃病(portal hypertensive gasbropathy,PHG)患者不同中医辨证证候分型与疾病严重程度的关系。方法:回顾性分析2019年1月至2022年11月在我院确诊并进行治疗的247例PHG患者临床资料,收集所有患者基线资料、血清指标等一般资料,均进行中医证候诊断,比较不同中医证候分型患者疾病严重程度、Child-Pugh分级及临床指标间差异并分析其中相关性。结果:247例患者中包含湿热蕴结证52例、肝气郁结证45例、肝肾阴虚证35例、水湿内阻证33例、瘀血阻络证45例及脾肾阳虚证37例。不同中医证候患者PHG疾病分级构成比差异具有统计学意义,其中瘀血阻络证2级、3级占比最高,分别为20.61%、25.64%;不同中医证候患者Child-Pugh分级构成比差异具有统计学意义(P<0.05),其中以湿热蕴结证B级、C级占比最高,分别为20.61%、25.00%。不同中医证候患者纤维蛋白原、血小板计数、超敏C反应蛋白水平差异具有统计学意义(P<0.05);以肝气郁结证为参照,瘀血阻络证发生4级PHG的危险程度差异具有统计学意义(P<0.05)。结论:PHG患者常见中医证候主要为湿热蕴结证、肝气郁结证、肝肾阴虚证、水湿内阻证、瘀血阻络证及脾肾阳虚证6种,且中医证候分型与疾病严重程度、Child-Pugh分级密切相关,其中瘀血阻络证、湿热蕴结证病情相对严重,能作为中医辨证治疗的客观依据。Objective:To investigate the relationship between different TCM syndrome types and the severity of portal hypertensive gastropathy(PHG).Methods:Clinical data of 247patients with PHG diagnosed and treated in the hospital from January 2019to November 2022were reviewed.The patients’baseline data,serum indicators and other general data were collected.All patients received TCM syndrome diagnosis.Disease severity,Child-Pugh grade and clinical indicators in patients with different TCM syndrome types were comparatively analyzed,and correlation analysis was performed.Results:Among the 247patients,there were 52patients with dampness-heat amassment syndrome,45patients with liver qi stagnation syndrome,35patients with liver-kidney yin deficiency syndrome,33patients with water dampness stagnation syndrome,45patients with static blood blocking collaterals syndrome and 37patients with spleen-kidney yang deficiency syndrome.There were statistically significant differences in the constituent ratios of different grade of PHG among patients with different TCM syndromes.The proportions of grade 2and grade 3static blood blocking collaterals syndrome were the highest(20.61%and 25.64%).There were statistically significant differences in the constituent ratios of Child-Pugh grades among patients with different TCM syndromes(P<0.05).The proportions of grade B and grade C dampness-heat amassment syndrome were the highest(20.61%and 25.00%).There were statistically significant differences in fibrinogen,platelet count and high-sensitivity C-reactive protein levels among patients with different TCM syndromes(P<0.05).Referring to liver qi stagnation syndrome,there was a statistically significant difference in the risk of grade 4PHG in patients with static blood blocking collaterals syndrome(P<0.05).Conclusion:The common TCM syndrome types of PHG include dampness-heat amassment syndrome,liver qi stagnation syndrome,liver-kidney yin deficiency syndrome,water dampness stagnation syndrome,static blood blocking collaterals syndrome and spleen-kid

关 键 词：门静脉高压 中医证候分型 严重程度 相关性 

分 类 号：R573[医药卫生—消化系统] R657.34[医药卫生—内科学]