156例脂肪肝的中医证候学研究

目的研究脂肪肝(FLD)的症状分布规律和证候特征,进一步探讨其发病机制。方法采取横断面的方法,制定临床证候调查表,全面收集FLD患者一般临床资料和中医四诊所得症状资料,进行统计分析。结果排名前4位的症状和体征为肢体倦怠、体胖、胁肋不适、腰膝酸软;前3位的脉象是脉弦、细、滑。在临床证候群中,脾虚肝郁占46.79%、痰湿中阻占30.77%、肝肾不足占27.56%、痰瘀互结占22.44%等;证候与临床严重程度和病程的关系:轻度FLD中脾虚肝郁明显最多见,中度FLD中痰湿内阻最多见,重度FLD中肝肾不足最多见;5年以内脾虚肝郁最多见、痰湿内阻次之,5年以后肝肾不足和痰瘀互结最多见。结论脾虚肝郁是FLD最常见的证候,痰湿是形成FLD的重要病理因素,肾虚在FLD的病机转化中具有重要地位。

Symptomatologic study of TCM on 156 cases of fatty liver disease

Objective To study the distribution law and symptom characteristics of fatty liver disease(FLD)and to further discuss the pathogenesis.Method The questionnaire of clinical symptoms was set up by transect method to collect the general materials from FLD patients and symptom materials from TCM four diagnostic methods,which were then analyzed statistically.Result The first four symptoms were fatigue,corpulent,discomfortable in costal region and ache-weak of the waist and knee.The first three pulse manifestations were wiry pulse,thready pulse and slippery pulse.In clinical symptom group the syndrome of spleen deficiency and liver-qi stagnation accounted for 46.79%,the syndrome of phlegm-damp accumulating in the middle for 30.77%,the syndrome of deficiency of liver and kidney for 27.56% and the syndrome of agglomeration of phlegm and stasis for 22.44%.The relationship between syndrome and disease seriousness or disease course showed:the syndrome of spleen deficiency and liver-qi stagnation was the most common in mild FLD,the syndrome of phlegm-damp accumulating in the middle was the most common in moderate FLD and the syndrome of deficiency of liver and kidney was the most common in serious FLD.Within 5 years there were more the syndrome of spleen deficiency and liver-qi stagnation and the syndrome of phlegm-damp accumulating in the middle came second.After 5 years there were more the syndrome of deficiency of liver and kidney and the syndrome of agglomeration of phlegm and stasis.Conclusion The syndrome of spleen deficiency and liver-qi stagnation is the most common in FLD,phlegm-damp is the important pathological factor of FLD and kidney deficiency is the key in FLD pathogenic development.