肝炎后肝硬化患者中医证型与超声及病理学分级的相关性研究

发布时间：2018-01-15 17:26

本文关键词：肝炎后肝硬化患者中医证型与超声及病理学分级的相关性研究　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:以肝炎肝硬化的相关中医基本理论、西医影像学及病理学为研究基础,通过探讨肝炎肝硬化中医证型与超声检查及肝组织病理学分级的内在联系,为肝炎肝硬化的中医辨证分型寻找客观指标、量化标准,为本病的早期发现及中西医结合治疗提供科学依据。方法:采用回顾性研究方法。收集2013年1月至2015年1月在广西中医药大学第一附属医院住院,符合纳入标准的病例75例,符合肝炎肝硬化诊断标准,中医辨证据肝硬化中西医结合诊疗共识分为肝气郁结、水湿内阻、湿热蕴结、脾虚湿盛、肝肾阴虚、脾肾阳虚、瘀血阻络6个证型。在体检科选择8位健康者作为对照。拟定临床病例报告表,记录症状、体征、舌象、脉象、肝组织病理分级分期及腹部超声检查的检测指标等。1名主治中医师及1名主任中医师据其入院病例的症状、体征、舌象、脉象进行中医辨证,二者采用背靠背的形式。运用SPSS19.0统计软件采用统计描述、卡方检验等方法进行数据分析。结果:肝炎肝硬化患者不同证型组及正常对照组,关于门静脉内径(Dpv)、脾脏厚度及肝实质类型的比较均有差异,P0.05;各证型组的Dpv值由低到高依次为各证型组的Dpv由低到高依次为肝气郁结证水湿内阻证湿热蕴结证肝肾阴虚证脾肾阳虚证瘀血阻络证。各组间的脾脏厚度均数由低到高依次为瘀血阻络证肝气郁结证水湿内阻证湿热蕴结证肝肾阴虚证脾肾阳虚证。肝气郁结证、水湿内阻证、及湿热蕴结证均较多见细小均匀型与增粗增强型,脾肾阳虚证以增粗增强型最常见,瘀血阻络证较多见增粗增强型及粗结节型。各中医证型的肝炎肝硬化患者的肝组织炎性分级间两两比较,差异无统计学意义,P0.05。肝气郁结证组多见肝组织炎性分级G2;水湿内阻证组以G3、G2多见;湿热蕴结证组主要见于G3,G2次之;肝肾阴虚证组以G3多见;脾肾阳虚证组以G4多见;瘀血阻络证组多见于G4,G3次之。结论:肝炎肝硬化患者的中医证型同超声检查及肝组织分级存在一定相关性,Dpv、脾脏厚度作为中医辨证分型的客观指标,对本病的中医辨证分型及早期诊断均有重要参考价值。
[Abstract]:Objective: Based on the basic theory of Chinese medicine related liver cirrhosis, medical imaging and pathology as the research foundation, through the relation of the grade of TCM syndrome type of cirrhosis with ultrasound and liver tissue pathology, for the TCM Typing of hepatitis cirrhosis for objective indicators, quantitative criteria for early detection of this disease and combination of traditional Chinese and Western medicine to provide a scientific basis for treatment. Methods: a retrospective study. From January 2013 to January 2015 in the First Affiliated Hospital of Guangxi TCM University, met the inclusion criteria of 75 cases with liver cirrhosis diagnosis standard of TCM diagnosis and treatment, combined with the consensus into stagnation of liver cirrhosis evidence of traditional Chinese medicine and Western medicine, dampness and damp and hot water., spleen dampness, liver kidney yin deficiency, spleen kidney yang deficiency, blood stasis syndrome type 6 in the Department of physical examination. 8 healthy persons as control group. Clinical cases to report and record The symptoms, signs, tongue, pulse, grading and staging of liver tissue and abdominal ultrasound examination indexes of.1 attending doctor of traditional Chinese medicine and 1 Director of Chinese medicine according to the hospitalized patients, symptoms, signs, tongue, pulse condition of traditional Chinese medicine, the two are back to back form. Using SPSS19.0 statistical software using statistics description, chi square test and other methods for data analysis. Results: the patients with different syndromes of liver cirrhosis group and normal control group, the diameter of portal vein (Dpv), there were significant differences between, the thickness of spleen and liver parenchyma type P0.05; the syndrome group Dpv values ranged from low to high as the syndrome group the Dpv ranged from low to high as liver qi stagnation wet stasis syndrome of dampness heat syndrome of liver and kidney yin deficiency of spleen and kidney yang deficiency syndrome of blood stasis syndrome. The spleen thickness between groups were ranged from low to high as the blood stasis syndrome of liver qi stagnation syndrome dampness stagnation syndrome damp heat syndrome Liver kidney yin deficiency syndrome of Yang deficiency of spleen and kidney. Liver qi stagnation, wet stasis, and rdhs are more fine and uniform and thickening enhancement type, Yang deficiency of spleen and kidney to thickening enhanced the most common blood stasis syndrome more common thickening and enhanced coarse nodular type. Comparison of the TCM syndrome type the patients of liver cirrhosis with liver inflammation grades between the 22, there was no statistically significant difference, P0.05. group of liver qi stagnation syndrome rare liver inflammation grades G2; water dampness syndrome group in G3, G2; rdhs group mainly in G3, G2; liver and kidney yin deficiency group in G3 see; spleen kidney yang deficiency group to G4; blood stasis syndrome is more common in the G4 group, G3. Conclusion: the TCM Syndromes of the patients with liver cirrhosis with ultrasound and liver histological grade Dpv, there is a certain correlation, spleen thickness as the objective index of TCM syndrome differentiation of this disease in medicine. Differentiation of early The period diagnosis has important reference value.

【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【相似文献】