通过现代超声检查探讨中医学之肝胆相合
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R256.4

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广东省科技计划项目(2016ZC0104,2017ZC0148);广州中医药大学青年科研人才培优项目(2016QN01,2017QN01)


Discussion on Theory of the Interrelation Between Liver and Gallbladder in Chinese Medicine th rough Modern Ultrasonography
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    摘要:

    目的:通过超声观察肝脏疾病对胆囊的影响,以探讨中医理论“肝胆相合”的真实性,为中医基础理论提供临床依据。方法:通过病例-对照研究,分析有无肝脏疾病患者的胆囊超声声像图变化,以总结肝脏疾病对胆囊超声声像图的影响。结果:试验组共147例,年龄22~92岁,包括原发性肝癌6例,肝硬化8例,脂肪肝51例,肝囊肿37例,肝脏回声增粗18例,肝血管瘤13例,肝内胆管结石14例。正常对照组共300例,年龄23~92岁,平均年龄54岁。胆囊声像图异常发生率试验组为38.1%,正常对照组为17.0%,2组比较,差异有统计学意义(P<0.01);试验组中胆囊结石、胆囊息肉、胆囊壁毛糙、胆囊增厚水肿的发生率均高于对照组(P<0.05)。在试验组中,原发性肝癌的胆囊声像图异常率最高(100%),胆囊声像图异常发生率大小为:原发性肝癌>肝硬化>肝脏回声增粗>脂肪肝>肝内胆管结石>肝囊肿>肝血管瘤。原发性肝癌、肝硬化、肝脏回声增粗、脂肪肝患者的胆囊声像图异常率明显高于正常的患者(P<0.01);而肝囊肿、肝血管瘤、肝内胆管结石这3种肝病的胆囊声像图异常与正常者相当(P>0.05)。结论:肝胆疾病的关系密切,其中原发性肝癌、肝硬化、肝脏回声增粗及脂肪肝与胆囊病变的发生有一定的相关性,但“肝胆相合”并不适用于所有肝病。

    Abstract:

    Objective:To observe the effect of liver disease on gallbladder through ultrasonography,so as to discuss the authenticity of the theory of the interrelation between liver and gallbladder in Chinese medicine and provide clinical reference for the basic theory of Chinese medicine.Methods:Through case-control studies,analyzed the ultrasonographic changes of gallbladder in patients with liver disease or without liver disease so as to summarize the effect of liver disease on the ultrasonographic images of gallbladder.Results:There were 147 cases of patients aged 22 to 92 in the experiment group,including 6 cases of primary liver cancer,8 cases of liver cirrhosis,51 cases of fatty liver,37 cases of liver cyst,18 cases of enlargement of the echo in liver,13 cases of liver hemangioma,and 14 cases of in trahepatic bile duct stone.There were 300 cases of patients aged 23 to 92 in the normal control group,with an average age of 54.The incidence of abnormal ultrasonic image of gallbladder was 38.1%in the experiment group and 17.0%in the normal control group,the difference being significant(P < 0.01).The incidence of gallbladder stones,gallbladder polyps,rough gallbladder wall and thickened edema of gallbladder was higher than that in the controlgroup( P <0.05).In the experiment group,the incidence of abnormal ultrasonic image of gallbladder was the highest in patients with primary liver cancer(100%).The incidence of abnormal ultrasonic image of gallbladder ranked as follows:primary liver cancer>liver cirrhosis>enlargement of the echo in liver>fatty liver>intrahepatic bile duct stone>liver cyst>liver hemangioma.The incidence of abnormal ultrasonic image of gallbladder in patients with primary liver cancer,liver cirrhosis,enlargement of the echo in liver and fatty liver was obviously higher than that in normal patients( P <0.01).The incidence of abnormal ultrasonic image of gallbladder in patients with liver cyst,liver hemangioma and intrahepatic bile duct stone was similar to that in normal patients(P>0.05).Conclusion:Liver disease and gallbladder disease are closely related to each other,and the occurrence of primary liver cancer,liver cirrhosis,enlargement of the echo in liver and fatty liver has a certain correlation with the occurrence of gallbladder disease.However,the theory of the interrelation between liver and gallbladder in Chinese medicine does not apply to all liver disease.

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王晓东,赖雪恩,田媛媛.通过现代超声检查探讨中医学之肝胆相合[J].新中医,2018,50(7):83-85

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  • 在线发布日期: 2018-07-09
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