本文關(guān)鍵詞：226例病毒性肝炎肝硬化代償期中醫(yī)證型與肝臟硬度值的臨床資料調(diào)查　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 病毒性肝炎肝硬化代償期 中醫(yī)證型 肝臟硬度值 臨床資料調(diào)查

【摘要】：目的:通過對226例病毒性肝炎肝硬化代償期患者中醫(yī)證型與肝臟硬度值臨床資料調(diào)查結(jié)果的分析,為病毒性肝炎肝硬化代償期中醫(yī)分型的客觀化提供科學(xué)依據(jù),并為預(yù)測疾病發(fā)展及早期進(jìn)行中醫(yī)藥干預(yù)治療改善預(yù)后提供依據(jù)。方法:采用橫斷面研究,收集2015年01月至2016年10月在新疆維吾爾自治區(qū)中醫(yī)院(新疆醫(yī)科大學(xué)附屬中醫(yī)醫(yī)院)門診及住院部就診的病毒性肝炎肝硬化代償期患者,嚴(yán)格按照試驗設(shè)計進(jìn)行中醫(yī)望聞問切辨證,結(jié)合專家的診斷結(jié)果以確定證型,觀察患者肝臟硬度值(FibroTouch結(jié)果),并將所獲得資料進(jìn)行統(tǒng)計學(xué)處理及分析,分析其特點及規(guī)律,最終得出該病不同中醫(yī)證型與人口學(xué)項目、肝臟硬度、肝炎類型、Child-pugh評分、BMI、PLT、ALT、AST、AST/PLT(APRI)、AST/PLT、TBIL、ALP、r-GGT、ALB、PT、APTT之間的差異或相關(guān)性。結(jié)果:(1)226例病毒性肝炎肝硬化代償期患者中男性患病率顯高于女性,不同性別之間的中醫(yī)證型分布有差異性(P=0.0050.05),不同職業(yè)及文化之間中醫(yī)證型分布無差異性(P=0.061、P=0.8740.05);不同中醫(yī)證型對肝臟硬度有顯著影響(P=0.0020.05),不同性別、職業(yè)及文化程度對肝臟硬度值無顯著影響(P=0.196、P=0.218、P=0.0940.05),不同中醫(yī)證型與不同性別、職業(yè)及文化程度的交互對肝臟硬度值無顯著影響(P=0.379、P=0.429、P=0.4400.05);(2)不同肝硬化疾病類型之間肝臟硬度有差異性,以丙肝類型為重(P=0.0230.05);新疆地處西北干燥質(zhì)地,具有其獨特證型分布,以肝郁脾虛型及肝腎陰虛型為主,各證型肝臟硬度之間有顯著差異(P=0.0020.05),其肝臟硬度值大小順序依次為肝郁血瘀型濕熱內(nèi)蘊型肝腎陰虛型脾虛濕盛型脾腎陽虛型肝郁脾虛型;患者Child-pugh評分對中醫(yī)證型分布無顯著影響(P=0.0610.05),不同中醫(yī)證型、患者Child-pugh評分的高低對肝臟硬度值的影響有統(tǒng)計學(xué)意義(P=0.002、P=0.0320.05);不同中醫(yī)證型的BMI之間有極顯著差異性(P=0.0010.05),在肝腎陰虛型、脾腎陽虛型BMI與肝臟硬度值之間有線性相關(guān)性(P=0.021、P=0.0200.05);(3)不同中醫(yī)證型的PLT、ALT、AST、AST/PLT(APRI)、ALB之間有顯著差異性(P均0.05);不同中醫(yī)證型的TBIL、ALP、r-GGT、PT、APTT之間無差異性(P均0.05);肝臟硬度值與PLT、ALT、AST/PLT(APRI)、TBIL、ALB、PT、APTT之間均存在線性相關(guān)性,肝臟硬度值與AST/PLT(APRI)、中醫(yī)證型之間線性關(guān)系極其顯著(P0.01)。結(jié)論:本次課題驗證了病毒性肝炎肝硬化代償期患者的中醫(yī)分型與肝臟硬度值有較高的相關(guān)性,相關(guān)實驗室指標(biāo)也均能在不同角度反映其與中醫(yī)證型、肝臟硬度值的關(guān)聯(lián)性。
[Abstract]:Objective: to analyze the clinical data of 226 patients with liver cirrhosis in compensatory stage of viral hepatitis. To provide scientific basis for the objectivity of TCM classification in compensatory stage of viral hepatitis cirrhosis and to predict the development of disease and to improve the prognosis by early intervention of TCM. Methods: Cross-sectional study was adopted. From January 2015 to October 2016, we collected the compensated patients of viral hepatitis cirrhosis in outpatient and inpatient department of Xinjiang Uygur Autonomous region Hospital of traditional Chinese Medicine (affiliated traditional Chinese Medicine Hospital of Xinjiang Medical University). According to the experimental design strictly according to the traditional Chinese medicine look and smell question syndrome differentiation, combined with the expert diagnosis results to determine the syndrome type, observe the patient liver hardness value FibroTouch results). The obtained data were statistically processed and analyzed, and their characteristics and laws were analyzed. Finally, different TCM syndromes and demographic items, liver hardness, hepatitis type and Child-pugh score were obtained. BMI-PLT / alt / AST / AST / PLT / APRIK / AST / PLT / TBI / ALPER-GGTT / ALBUT / PT / AP / PLT / T / L / T / T / T / T / T / T / T / T / T / T / T / T. Results the prevalence rate of male was significantly higher than that of female in the compensatory stage of viral hepatitis cirrhosis. The distribution of TCM syndromes was different among different sexes (P0. 0050.05A), and there was no difference between different occupations and cultures in the distribution of TCM syndromes (P0. 061). Pe 0.8740.05; Different TCM syndromes had significant influence on liver hardness, but different sex, occupation and education had no significant influence on liver hardness. The interaction of different TCM syndromes with different gender, occupation and education level had no significant effect on liver hardness. P0. 4400.05; (2) there were differences in liver hardness among different types of liver cirrhosis. Xinjiang is located in the northwest dry texture, with its unique distribution of syndrome type, mainly liver stagnation and spleen deficiency type and liver and kidney yin deficiency type, there is a significant difference in liver hardness between each syndrome type (P < 0.0020.05). The order of liver hardness value is liver depression and blood stasis type dampness and heat accumulation type liver and kidney yin deficiency type spleen deficiency type spleen kidney yang deficiency type liver stagnation and spleen deficiency type; The Child-pugh score had no significant effect on the distribution of TCM syndromes. The effect of Child-pugh score on liver hardness was statistically significant (P < 0. 002, P < 0. 0320.05). The BMI of different TCM syndromes had very significant difference (P < 0. 0010. 05), which was in the type of deficiency of liver and kidney yin. There was a linear correlation between BMI and liver hardness in spleen and kidney yang deficiency type. (3) there were significant differences among different TCM syndromes of PLT / AST, AST / AST and APRIZH ALB (P < 0.05). There was no significant difference in APTT between different TCM syndromes of TBILL ALPER-GGTN PTT and TBILL (P < 0.05). There was a linear correlation between the liver hardness and the APTT of alt / PLT / APRI. Liver hardness and AST / PLT APRI. The linear relationship between TCM syndromes is extremely significant P0.01.Conclusion: this subject verifies that there is a high correlation between TCM classification and liver hardness in patients with liver cirrhosis compensatory stage of viral hepatitis. The related laboratory indexes can also reflect the correlation with TCM syndrome type and liver hardness in different angles.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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