药物性肝病患者中医体质分布和临床特点分析

目的：分析药物性肝病患者的性别、年龄、中医体质、中医证型等分布规律。方法：选取2020年8月至2022年8月解放军总医院第五医学中心中医肝病科收治的药物性肝病患者368例，收集患者相关临床资料，分析药物性肝病患者的性别、年龄、中医体质、中医证型等分布规律和临床特征。结果:药物性肝病患者中医体质分布以气郁质（19.02%）最为多见，其次依次为阴虚质（18.21%）、湿热质（15.22%）、阳虚质（13.32%）、血瘀质（11.14%）、平和质（7.61%）、痰湿质（6.25%）、气虚质（5.16%）、特禀质（4.08%）。药物性肝病患者中医体质在性别、年龄等方面均具有差异性，男性以湿热质、阴虚质为多见；女性以气郁质、阴虚质为多见，而阴虚质在男性、女性均多见；青年中以气郁质和湿热质较多见，中年中以痰湿质较多见、老年以血瘀质较多见。药物性肝病患者在中医证型分布中主要为湿热内蕴证125例（34%），其次分别为肝郁脾虚证98例（27%）、肝肾阴虚证56例（15%）、气滞血瘀证46例（12%）、寒湿中阻证43例（12%）；药物性肝病患者在体质与证型存在相关性，体质类型决定了该病证型的易感性。结论：根据药物性肝病患者的中医体质以及证型的分布特点以及相关临床特征，提示可以通过调节情志、合理饮食以及药物防治等方面做到“未病先防”“既病防变”，做到“辨体”“辨证”“辨病”的有机结合。

TCM Constitution Distribution and Clinical Characteristics of Patients with Drug-induced Liver Diseases

To analyze the distribution of sex，age，TCM constitutions，and TCM syndromes of the patients with drug-induced liver diseases.Methods:A total of 368 patients with drug-induced liver diseases treated in the TCM Department of Hepatology of the Fifth Medical Center of Chinese PLA General Hospital from August 2020 to August 2022 were enrolled in this study.The clinical data of the patients were collected，and the distribution and clinical characteristics of sex，age，TCM constitutions，and TCM syndromes were analyzed.Results:Qi stagnation(19.02%) was the most common TCM constitution in the patients with drug-induced liver diseases，followed by yin deficiency(18.21%)，dampness-heat(15.22%)，yang deficiency(13.32%)，blood stasis(11.14%)，neutral(7.61%)，phlegm-dampness(6.25%)，qi deficiency(5.16%)，and special(4.08%).The TCM constitution distribution of the patients with drug-induced liver diseases varied regarding sex and age.Specifically，male patients mainly presented the TCM constitutions of dampness-heat and yin deficiency，and female patients mainly presented the constitutions of qi stagnation and yin deficiency.Yin deficiency was the common constitution in both male and female patients.Qi stagnation and dampness-heat were common constitutions in the young patients，and phlegm dampness and blood stasis were common in middle-aged and old patients，respectively.In the distribution of TCM syndromes，internal accumulation of dampness-heat showed the highest frequency(125，34%)，followed by liver depression and spleen deficiency(98，27%)，liver-kidney yin deficiency(56，15%)，qi stagnation and blood stasis(46，12%)，and cold-dampness stagnation(43，12%).There was a correlation between TCM constitutions and syndromes in the patients with drug-induced liver diseases，and the constitution determined the susceptibility of the disease syndrome.Conclusion:According to the TCM constitutions and syndromes as well as the clinical characteristics of the patients with drug-induced liver diseases，the methods of regulating emotions and diets and prevention with drugs can be taken to prevent the occurrence and delay the progression of the diseases based on the differentiation of TCM constitutions，syndromes，and diseases.