慢性乙型肝炎中医病因病机演变规律研究

目的探讨慢性乙型肝炎中医病因病机演变规律。方法选择慢性乙型肝炎、早期肝硬化、肝硬化腹水患者为研究对象,以面对面访谈法收集临床资料,确定中医证候,按实证、虚证、虚实夹杂证、受损的脏腑、证素分别统计,分析其病因病机演变规律。结果慢性乙型肝炎随着病情进展,单纯虚证、单纯实证减少,而虚实夹杂证增多;损伤的脏腑主要有肝、胆、脾、胃、肾、三焦等,其中肝、脾是其主要的受损脏腑,随着病情进展,肾、三焦、胆、胃受损频率均增加;单纯慢性乙型肝炎以气虚、气郁、湿、湿热为多,早期肝硬化以气虚、气郁、湿热、血瘀为多,肝硬化腹水以气虚、湿热、血瘀、阴虚、水为多。结论慢性乙型肝炎在病性、病位及证素上均有自身的演变规律。

Research on Developing Law of Pathogeny and Mechanism of Chronic Hepatitis Type B

Objective To discuss the developing law of pathogeny and mechanism of chronic hepatitis type B.Methods Patients of chronic hepatitis type B,early hepatocirrhosis and ascites caused by hepatocirrhosis was chosen as objects and clinical information was collected face to face.Patterns of Chinese medicine were confirmed and counted seperately according to efficiency,deficiency and efficiency-deficiency sydrome,harmed Zang-Fu organs and syndrome factors.Finally,the developing law of pathogeny and mechanism was analyzed.Results As the state of chronic hepatitis type Bevolving,simple efficiency and deficiency sydrome decrease with efficiency-deficiency sydrome increasing.Zang-Fu organs damaged by chronic hepatitis type B including mostly liver,gallblader,spleen,stomach,kidney,Trijiao and so on,among which spleen and liver are mainly damaged.As the state of chronic hepatitis type B evolving,the frequencies of damage to gallblader,spleen,stomach,kidney,Trijiao and so on increase.Most simple chronic hepatitis type B cases are due to Shi,Shi-Re,efficiency and stasis of Qi,while most of early hepatocirrhosis stem from Shi-Re,extravasated blood,efficiency and stasis of Qi,with that of ascites caused by hepatocirrhosis originating from Shi-Re,extravasated blood,Shui,efficiency of Qi and Yin. Conclusion There is developing law in the character,location and syndrome factors of chronic hepatitis type B.