自身免疫性肝病患者中医体质分布及临床特点分析＊

目的 分析2016年9月-2019年9月在解放军总医院第五医学中心确诊的181例自身免疫性肝病（Autoimmune Liver Diseases,ALD）住院患者的中医体质分布规律。方法 按性别、疾病、年龄及肝硬化将患者分组,计算181例ALD患者《中医体质量表》得分情况,分析ALD患者中医体质类型分布有无差异,比较各个疾病主要体质类型有无差异。结果 ALD患者以偏颇体质为主,其体质分布比例为：阳虚质（26.52%）、血瘀质（16.77%）、气郁质（13.81%）、阴虚质（13.26%）、气虚质（9.94%）、平和质（9.94%）、湿热质（7.73%）、痰湿质（2.76%）、特禀质（1.10%）;ALD患者不同年龄之间,肝硬化患者与非肝硬化患者体质分布类型比较具有统计学意义（P < 0.05）;ALD患者组间AIH、PBC及PBC-AIH比较体质无统计学差异。气郁体质患者单核细胞绝对值大于血瘀体质患者（P < 0.05）;血瘀体质患者胆碱酯酶、乳酸脱氢酶与某些体质类型有明显差异;阳虚体质患者腺苷脱氢酶高于阴虚体质患者（P < 0.05）。结论 ALD患者的整体中医体质类型以阳虚质为主;不同体质与临床指标存在关联,并且阳虚质患者预后相对较差,ALD当以温阳为主要治疗原则。

Analysis of the Distribution and Clinical Characteristics of Traditional Chinese Medicine Constitution in Patients with Autoimmune Liver Diseases

Objective To analyze the distribution pattern of traditional Chinese medicine (TCM )constitution in 181 inpatients with autoimmune liver diseases (ALD) diagnosed at the Fifth Medical Center of PLA General Hospital from September 2016 to September 2019.Methods Patients were grouped according to gender, disease, age and cirrhosis, and the TCM Constitution Scale scores of 181 patients with ALD were calculated to analyze whether there were differences in the distribution of TCM constitution types in ALD patients and compare the differences in the main constitution types of each disease.Results Patients with ALD had mainly biased constitution, and the proportion of their constitution distribution was: yang deficiency (26.52%), blood stasis (16.77%), qi stagnation (13.81%), yin deficiency (13.26%), qi deficiency (9.94%), smooth state (9.94%), damp heat (7.73%), phlegm damp (2.76%), and extraordinary endowment (1.10%). There was a statistically significant difference (P < 0.05) between different ages of ALD patients and the type of distribution of body mass in cirrhotic patients compared with non-cirrhotic patients; there was no statistically significant difference between groups of ALD patients for AIH, PBC and PBC-AIH comparative body mass. The absolute value of monocytes was greater in patients with qi yu constitution than in patients with blood stasis constitution (P < 0.05); cholinesterase and lactate dehydrogenase were significantly different in patients with blood stasis constitution and certain constitution types; adenosine dehydrogenase was higher in patients with yang deficiency constitution than in patients with yin deficiency constitution (P < 0.05).Conclusion The overall TCM constitution type of ALD patients was dominated by yang deficiency constitution; there was an association between different constitutions and clinical indicators, and the prognosis of yang deficiency patients was relatively poor, and ALD should be treated mainly by warming yang.