肝炎后肝硬化中医证候与肝功能损伤关系的探讨  

Study on the Characteristics of Traditional Chinese Medical Syndrome of Hepatocirrhosis Relation with Liver Function Disorder

作　　者：张琴[1] 陈慧芬[1] 陈良[1] 方志红[1] 吴定中[1] 刘平[2] 魏建军[2] 曹素华[3] 

机构地区：[1]上海市传染病医院中西医结合科,上海200083 [2]上海中医药大学肝病研究所,上海200021 [3]复旦大学上海医学院统计教研室,上海200030

出　　处：《上海中医药杂志》2004年第3期8-11,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市科技发展基金项目课题 (编号 :0 340 56)

摘　　要：为分析肝炎后肝硬化中医证候与肝功能损伤的关系 ,探讨中医证候的病理学基础 ,在系统聚类基础上 ,用主成分分析等多元统计学方法对肝炎后肝硬化患者中医四诊信息处理分析所获得的中医证候判别结果 ,再用多元统计分析方法总结 12 1例肝炎后肝硬化患者的临床常规实验室检测资料在中医证候间的变化规律。结果 :丙氨酸转移酶(ALT)、纤维结合蛋白 (Fn)、载脂蛋白AI(APOAⅠ )、促凝血活酶试验 (HPT)、血浆凝血因子Ⅴ (FⅤ )、肿瘤坏死因子 α(TNF α) 6项指标变化对临床中医类型判别有一定意义。相关实验室指标在三类证候间的变化显示湿热内蕴、瘀血阻络邪实为主证候的天冬氨酸转移酶(AST)、丙氨酸转移酶 (ALT)活性显著高于正虚为主、兼有邪实的其他两类。肝肾阴虚、瘀热内蕴证候的血Fn、FV、FⅤⅡ、白蛋白 (Alb)、血小板计数 (PLT)、血小板比率 (PCT)均显著低于其他两类证候 ,凝血酶原时间 (PT)比后两类显著延长。提示肝组织炎症性损伤可能是湿热内蕴病机的病理基础 。Analyzing the characteristics of traditional Chinese medical syndrome of hepatocirrhosis relates with liver function disorder in order to explore the pathological basis of TCM syndrome. The result of TCM syndrome is based on multi statistical methods such as systemic cluster analysis and principal component analysis, and the chemical indexes of 121 cases were measured and analyzed to determine the correlation between syndromes and chemical indexes. Results: Six indexes like ALT, Fn, APOAI, HPT, FV and TNF α were correlated with Chinese medical syndromes. The activities of AST and ALT were higher in two excess syndromes like dampness heat accumulation and collateral blood stasis than in deficiency syndromes and other excess syndromes; the Fn, FV, FVⅡ, Alb, PLT and PCT were obviously lower in liver kidney yin deficiency syndrome and stasis heat accumulation syndrome than other syndromes; but the PT delayed in the latter syndromes. It is suggested that inflammatory injury in the liver tissues may be the pathological basis of dampness heat accumulation, liver dysfunction be the pathological basis of liver kidney yin deficiency.

关 键 词：肝炎后肝硬化 中医证候 多元分析 

分 类 号：R259.7[医药卫生—中西医结合]