脂肪肝的CT定量定性分析与中医证型相关性研究

目的:通过CT对非酒精性脂肪肝(NAFL)进行定性定量诊断分析,探讨NAFL的CT诊断与中医证型之间的相关性。方法:选取NAFL 229例,分为肝郁脾虚、痰湿内阻、痰瘀互结、肝肾不足、湿热内蕴5个中医证型,均行肝脏螺旋CT扫描,测量肝、脾CT值,将不同中医证型NAFL的轻中重CT分级及肝、脾CT比值进行统计分析。结果:中医证型之间CT定量诊断的轻、中、重分级差异有统计学意义(P<0.01);5个证型之间肝、脾CT比值差异有统计学意义(P<0.01),肝、脾CT比值按照秩次排列为肝郁脾虚证>湿热内蕴证>痰湿内阻证>痰瘀互结证>肝肾不足证。结论:NAFL的CT定量诊断与中医证型密切相关,各中医证型脂肪浸润程度的变化,与NAFL中医病因病机、证型演变相吻合,提示肝、脾CT比值可作为区分NAFL中医证型的客观性指标之一。

Association between CT qualitative and quantitative analysis and TCM syndrome types of fatty liver

Objective：To investigate correlationship between diagnosis by CT and TCM syndrome types of the non-alcoholic fatty liver patient on the basis of CT qualitative and quantitative analysis.Methods：The 229 patients of non-alcoholic fatty liver were divided into five groups against five TCM syndromes types,which are syndrome of stagnation of liver qi and spleen deficiency,syndrome of intermingled phlegm and blood stasis,syndrome of phlegm-dampness blocking internally,syndrome of deficiency of liver and kidney and syndrome of interior dampness-heat.All patients had been underwent liver CT scanning and given CT value of liver and spleen.The CT classifications of severity and the ratio of liver and spleen CT value were analysed statistically.Results：CT quantitative classifications were significantly different（P〈0.01）among the different types of traditional chinese medicine syndromes,and the ratio of liver and spleen CT value as well（P〈 0.01）,which follows the order from the maximum down to the minimum from syndrome of stagnation of liver qi and spleen deficiency,syndrome of intermingled phlegm and blood stasis,syndrome of phlegm-dampness blocking internally,syndrome of deficiency of liver and kidney to syndrome of interior dampness-heat.Conclusion：There is a close correlation between CT quantitative diagnosis and the different traditional chinese medicine syndromes types of the fatty liver.The variety of the degree of fatty infiltration expressed by the CT value conforms with evolution of the etiology and pathogenesis in the TCM syndromes types.So the ratio of liver and spleen CT value could be introduced as a kind of objective index to distinguish the fatty liver syndrome type of traditional Chinese medicine.