乙肝肝硬变患者中医证型与Child-pugh分级和AFP相关性研究

目的:探讨乙肝肝硬变患者中医证型与Child-pugh分级和AFP间的相关性,以便正确评估各型肝硬变患者病情严重程度及预后转归,为中医辨证提供量化依据。方法:通过回顾性研究收集146例乙肝肝硬变患者相关资料,根据TBIL、ALB、PT、腹水、肝性脑病计算Child-pugh分级,分析患者证型与Child-pugh分级及AFP的相关性。结果:肝气郁结型以Child-pugh分级A级为主,占71.43%,水湿内停型、湿热蕴结型以Child-pugh分级B级为主,分别占47.06%、42.50%,脾肾阳虚型、肝肾阴虚型以Child-pugh分级C级为主,分别占52.00%、62.50%。脾肾阳虚型患者AFP最高,湿热蕴结型次之,肝气郁结型最低,但各证型间差异无统计学意义。结论:Chid-pugh分级与乙肝肝硬变各型间存在一定相关性,可作为中医辨证的参考依据,协助临床判断各型患者病情严重程度;乙肝肝硬变证型与AFP的相关性有待更大样本的研究。

Relevant Research Between TCM Syndromes of Hepatitis B Hepatocirrhosis and Child-pugh Grading and AFP

Objective:To explore the relevance between TCM syndromes of hepatitis B hepatocirrhosis and Child-pugh grading and AFP in order to correctly assess the severity and prognosis of hepatocirrhosis and provide quantitative basis for the TCM syndrome differentiation.Methods:The data of totally 146 patients with hepatitis B hepatocirrhosis were collected and reviewed.The Childpugh grading was calculated and the relevance between the syndromes and Child-pugh grading and AFP was analyzed according to TBIL,ALB,PT,ascites and hepatic encephalopathy.Results:The syndrome of liver qi depression mostly belonged to grade A of Child-pugh,accounting for 71.43％;syndromes of internal retention of water dampness,accumulation of damp heat mostly belonged to grade B,respectively accounting for 47.06％ and 42.50％;syndromes of spleen and kidney yang deficiency,liver and kidney yin deficiency mostly belonged to grade C,respectively accounting for 52.00％ and 62.50％.The AFP in patients with spleen and kidney yang deficiency was the highest,then the syndrome of accumulation of damp heat,and the syndrome of liver qi depression was the lowest.The differences between different syndromes had no statistical significance.Conelusion:There is certain relevance between Child-push grading and different syndromes of hepatitis B hepatocirrhosis,which can be the reference for TCM syndrome differentiation and help determine the severity of patients' condition.The relevance between the syndromes of hepatitis B hepatocirrhosis and AFP needs larger sample research.