300例丙氨酸氨基转移酶小于参考值上限2倍慢性乙型病毒性肝炎患者中医证型与肝组织病理关系研究
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R512.6+2

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国家“十三五”科技重大专项(2018ZX10725506-002);厦门市中医院院内课题(XMSZYY201607)


Study on Relationship between Chinese Medicine Syndrome and Liver Pathology in 300 Patients with Chronic Viral Hepatitis B(ALT < 2×ULN)
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    摘要:

    目的:引用肝脏病理学指标阐明中医证候实质,探索丙氨酸氨基转移酶(ALT) 小于参考值上限2 倍(ALT<2×ULN) 的慢性乙型病毒性肝炎患者中医微观辨证要素。方法:对300例ALT<2×ULN的慢性乙型病毒性肝炎患者进行中医辨证分型及肝组织病理分级、分期,探讨中医证型与肝脏病理之间的关系。结果:全部患者肝组织结果显示:肝脏炎症分级≥G2者占46.00%,纤维化分期≥S2者占38.67%;肝组织病理≤G2或≤S2的患者以无证可辨型、肝郁脾虚型为主。不同中医证型患者的肝脏炎症分级(G) 和(或)(S) 纤维化分级差异均有统计学意义(P<0.01)。瘀血阻络型较非瘀血阻络型在肝组织炎症程度及纤维化程度病变重,差异有统计学意义(P<0.01),瘀血阻络证肝组织炎症程度以G3、G4为主,肝组织纤维化程度以S4为主。结论:患者的中医证型与其肝组织病理具有一定的相关性。

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    Abstract:Objective:To explore the microscopic factors that differentiate Chinese medicine syndrome in patients with chronic viral hepatitis B whose alanine aminotransferase(ALT) were less than twice the upper limit of reference value(ALT<2×ULN) by elucidating the essence of Chinese medicine syndromes through referring to liver pathological indexes. Methods:A total of 300 patients with chronic hepatitis B(ALT < 2×ULN) were differentiated into Chinese medicine syndrome and were classified and staged their liver tissue pathology;the relationship between Chinese medicine syndrome and liver pathology was discussed. Results: According to the liver tissue of all patients, the grade of liver inflammation≥G2 accounted for 46.00% ,and the liver fibrosis stage≥S2 accounted for 38.67%;patients whose hepatic tissue pathology≤G2 or ≤S2 were mainly with no differentiated syndrome or syndrome of liver depression and spleen deficiency. The grading of liver inflammation(G) and/or grading of fibrosis stage(S) in patients with different Chinese medicine syndromes were statistically significant in differences(P<0.01). The degree of liver inflammation and fibrosis was more serious in the patients of static blood obstructing collaterals type than in the patients of non-static blood obstructing collaterals type,the difference being significant (P<0.01). The degree of liver tissue inflammation in the patients of static blood obstructing collaterals type was mainly G3 and G4, while the degree of liver tissue fibrosis was mainly S4. Conclusion: There is a certain correlation between Chinese medicine syndrome type and liver pathology.

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王敏,唐金模,梁惠卿,龚先琼,宫嫚.300例丙氨酸氨基转移酶小于参考值上限2倍慢性乙型病毒性肝炎患者中医证型与肝组织病理关系研究[J].新中医,2020,52(12):53-56

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  • 在线发布日期: 2020-06-15
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