肝硬化患者中医“证”的实质研究

目的：探讨肝硬化中医“证”的实质。方法：将８０例乙肝后肝硬化患者按辨证分为肝郁脾虚、气滞血瘀及热郁血瘀３型，分别检测血清透明质酸（ＨＡ）、腺苷脱氨酶（ＡＤＡ）、谷胱甘肽－Ｓ－转移酶（ＧＳＴ）、Ｎ－乙酰－β－Ｄ氨基葡萄糖酶（ＮＡＧ）、羟腈航５５２例Ⅲ型前胶原水平，并观察５２例辨证治疗的血清指标的变化。结果：ＨＡ、ＡＤＡ、ＧＳＴ及ＰＣⅢ水平较健康对照组显著升高，其水平知“证”密切相关，其规律为热郁血瘀

Study on Essence of Syndrome of Traditional Chinese Medicine in Liver Cirrhotic Patients

OBJECTIVE: To explore the essence of Syndrome of traditional Chinese medicine (TCM) in cirrhostic patients. METHODS: Eighty patients of post-hepatitis-B cirrhosis were classified, according to Syndrome Differentiation of TCM, into three types: the Liver-Qi Stagnancy and Spleen-Deficiency type (A), the Qi-Stagnancy and blood stasis type (B) and the Heat Stagnancy and blood stasis type (C), serum hyaluronic acid (HA), adenosine deaminase (ADA), glutathione-s-epoxide transferase (GST), N-acetyl-beta-D-glucosaminidase (NAG), hydroxyproline (HYP) and procollagen type III (PC III) of 52 patients were determined before and after treatment based on Syndrome Differentiation. RESULTS: Serum HA, ADA, GST and PC III of patients were significantly higher than those of the healthy control (P < 0.01), and the change of these parameters were closely associated with types of Syndrome, which were, in turn, C > B > A > control, the difference between groups was significant (P < 0.05, P < 0.01). After treatment, the liver function and above-mentioned serologic parameters were significantly improved (P < 0.05, P < 0.01). CONCLUSIONS: Syndrome of cirrhosis patients has its inherent essential content. Serum HA, ADA, GST and PC III could serve as objective indexes for establishing Syndrome Differentiation and guiding treatment. TCM treatment of cirrhosis based on Syndrome Differentiation has good effect with beneficial anti-fibrotic action.