594例轻度慢性乙型肝炎中医证候分布规律调查研究

目的:探讨轻度慢性乙型肝炎(CHB)患者的中医证候分布规律,为规范化治疗CHB提供参考依据.方法:运用中医证候量表对594例轻度CHB患者进行中医证候调查,采用聚类分析的方法对纳入的患者进行聚类,并结合变量频数分析对证型归属进行判定.结果:收集的轻度CHB病例均以肝郁脾虚为主要证型,在此基础上合并有6个兼证,分别为肝郁脾虚兼湿热阴虚血瘀证型(62.80％)、肝郁脾虚兼肝肾阴虚证型(24.24％)、肝郁脾虚兼肝郁化火证型(5.05％)、肝郁脾虚兼肝胃不和证型(3.70％)、肝郁脾虚兼中气亏虚证型(2.53％)和肝郁脾虚兼瘀血阻络证型(1.68％).肝郁脾虚兼湿热阴虚血瘀证型又进一步分为5个亚型,分别为脾虚为主型(45.30％)、普通型(22.52％)、气滞为主型(17.70％)、湿热为主型(10.46％)、肾虚为主型(4.02％).结论:肝都脾虚证型为轻度CHB的基本证型.

Investigation of TCM syndrome distribution law in 594 patients with mild chronic hepatitis B

Objective:To discuss the distribution law of the traditional Chinese medicine(TCM) syndrome in mild chronic hepatitis B,and provide the evidence to standardize treatment of chronic hepatitis B.Methods: Five hundred ninety-four patients with chronic hepatitis B were collected,the TCM syndrome was judged by the scale of the TCM syndrome,and the identification patterns were determine by the distribution of variables using cluster analysis.Results:The main identification pattern of mild chronic hepatitis B was liver stagnation and spleen deficiency.There were six accompanying syndromes within the main pattern,damp heat-Yin deficiency and blood stasis syndrome(62.80%),Yin deficiency of liver and kidney syndrome(24.24%),depressed liver Qi transforming into fire syndrome(5.05%),liver and stomach incoordination syndrome(3.70%),Qi deficiency syndrome(2.53%),blood stasis syndrome(1.68%),and the liver stagnation and spleen deficiency accompanying damp heat-Yin deficiency and blood stasis syndrome also included five subtypes,spleen deficiency syndrome(45.30%),usual syndrome(22.52%),Qi stagnation syndrome(17.70%),damp heat syndrome(10.46%),kidney deficiency syndrome(4.02%).Conclusion: The main identification pattern of mild chronic hepatitis B is liver stagnation and spleen deficiency.