慢性乙型肝炎及肝硬化血瘀证目征改变的临床研究

目的:研究慢性乙型肝炎及肝硬化血瘀证目征改变特点,探讨慢性乙型肝炎及肝硬化血瘀证与血瘀证目征、病情等指标的关系。方法:选择病例共126例,分为非血瘀证组、血瘀证轻度、中度和重度四组,拍摄球结膜图像。结果:(1)四组的血瘀证积分和目征积分均有显著性差异(P<0.05)。(2)慢性乙肝及肝硬化的目征主要表现为球结膜微血管增粗、扭曲、网状畸形、报伤点、血管瘤、陈旧性出血、血管色调变暗等,单个项目在各组间无显著性差异(P>0.05)。(3)血瘀证目征对是、非血瘀证判别符合率为85.7%,对是、非血瘀证及血瘀证轻、中、重度的判别符合率为63.5%;血瘀证积分与病情轻重有相关性(r=0.790,P=0.000)。结论:(1)血瘀证目征是判断慢性乙肝及肝硬化是、非血瘀证及血瘀证轻、中、重度的有效、客观、简便诊断方法。(2)慢性乙肝及肝硬化的球结膜微血管改变具有多样性的特点。(3)瘀血作为病理产物同时也作为病因是慢性乙肝及肝硬化病情加重的关键因素。

Clinical Study on the Characteristics of the Change of Eye-signs in Blood Stasis Syndrome of Patients with Posthepatitic Cirrhosis or Chronic Hepatitis B

Objective：To study the characteristics of the change of eye-signs in blood stasis syndrome of patients with posthepatitic cirrhosis or chronic hepatitis B and aoproach the relation among blood stasis syndrome, eye-signs in blood stasis syndrome, pathogenetic condition etc.Methods：126 patients were divided into four groups, no-BSS group, mild, moderate and severe BSS group.Shooting images of bulbar conjunctival of the patients. Results：（ 1 ）There was significant difference in blood stasis score and eye-signs score of BSS among the groups （P〈0.05） .（2）The change of eye-signs in blood stasis syndrome of patients with chronic hepatitis B or posthepatitic cirrhosis was reticular malformation,twist,augmentation,dard colour valcular baoshangdian,hemangioma and remote hemorrhage. There were no significant difference in each items of eye-signs among groups （P 〉0.05）.（3）There were significant correlation between Blood stasis score and pathogenetic condition （r=0.790, p=0.000）. The coincidence of eye-signs of BSS to no-BSS was 85.7%,and that of eye-signs of BSS to no-BSS and mild, moderate and severe BSS was 63.5%.Conclusion ：（1）Eye-signs score of BSS was an effective, objective, convenient method on diagnosing BSS ofposthepatitic cirrhosis and chronic hepatitis B. Eye-signs score of BSS can be as the BSS diagnosis scale. （2）The changes of the bulbar conjunctival microvessel of patients with posthepatitic cirrhosis or chronic hepatitis B hepatitis is variform. （3）Stagnant blood which is not only pathological product but also etiopathogenisis, is the key factor which exacerbates cirrhosis and chronic hepatitis B.