355例肝炎后肝硬化患中医证候与生物学指标的关系

目的:通过分析肝炎后肝硬化的病理生物学指标与各主证候的相关性,探讨影响疾病证候病机的病理因素。方法:规范采集355例肝炎后肝硬化患者的临床信息,记录完整的诊治资料,建立数据库,选择有统计学意义的信息指标进入多变量分析,运用多元逐步回归方法,探索影响证候的主要因素。结果:建立了6个不同证型(肝肾阴虚、湿热内蕴、瘀热内蕴、脾肾阳虚、肝郁脾虚和气虚血瘀)与影响因素之间的回归方程。结论:肝实质细胞合成功能减退是肝硬化基本病机“气虚血瘀”的病态基础之一;慢性炎症和肝实质损伤可能是湿热和瘀热的病态基础;肝肾阴虚与瘀热内蕴之间的相互联系可能具有其生物病理学基础。

Correlation between syndromes of posthepatitic cirrhosis and biological parameters: a report of 355 cases

Objective: To investigate the pathological factors of syndrome pathomechanism through studying the correlation between syndromes of posthepatitic cirrhosis and biological parameters. Methods: Clinical information of three hundred and fifty-five patients with posthepatitic cirrhosis was collected and the database was established. Parameters with statistical significance were analyzed with multi-factor regression analysis to investigate the main influencing factors of the syndromes of posthepatitic cirrhosis. Results: Formulae of six syndromes, including syndrome of yin deficiency of liver and kidney, syndrome of damp heat, syndrome of stagnated heat smoldering, syndrome of yang deficiency of spleen and kidney, syndrome of stagnation of liver qi and spleen deficiency and syndrome of blood stasis due to qi deficiency, were established with stepwise regression analysis. Conclusions: One of the pathophysiological bases of syndrome of blood stasis due to qi deficiency in cirrhosis is synthetic dysfunction of hepatocytes. The pathophysiological basis of syndrome of damp heat is inflammatory injury, which is also syndrome of stagnated heat smoldering in cirrhosis patients. The relationship between syndrome of yin deficiency of liver and kidney and stasis and damp heat may be the pathophysiological basis of the posthepatitic cirrhosis