病毒性肝炎西医诊断和中医证型关系的探讨

摘要

Objective To investigate the correlation between western medicine diagnosis and traditional Chinese medicine (TCM) syndrome in viral hepatitis. Method Retrospective study was conducted on the relationship between different clinical types of viral hepatitis, different clinical degrees of chronic hepatitis and different clinical types of severe hepatitis and TCM syndrome in 552 cases of viral hepatitis. Results Dampness-heat in the liver and gallbladder came first among TCM syndromes of acute and chronic hepatitis, and then stagnation of liver Qi and spleen deficiency and obstruction of collaterals by blood stasis. Different clinical degrees of chronic hepatitis were mainly manifested with dampness-heat in the liver and gallbladder, especially mild degree of chronic hepatitis. Early stage of severe hepatitis was mainly manifested with dampness-heat in the liver and gallbladder, and intermediate and late stage of severe hepatitis with Qi deficiency and blood stasis additionally. Conclusions The common viral hepatitis TCM syndromes were dampness-heat in the liver and gallbladder, stagnation of liver Qi and spleen deficiency and obstruction of collaterals by blood stasis. These TCM syndromes are commonly seen in different clinical types, different clinical degrees of chronic hepatitis, and different clinical stages of severe hepatitis, and their percentages decreased with disease progress and aggravation. Dampness stagnancy due to spleen deficiency and Qi deficiency and blood stasis are more commonly seen in moderate and severe degree of chronic hepatitis and intermediate and late stage of severe hepatitis. There are certain correlations between western medicine diagnosis and TCM syndrome in viral hepatitis.%目的 探讨病毒性肝炎西医诊断与中医证型的关系.方法 分析552例病毒性肝炎患者疾病不同临床类型、慢性肝炎不同临床分度、重型肝炎不同临床分期与中医证型的关系.结果 急性、慢性肝炎组中医证型均以肝胆湿热证为主,其次是肝郁脾虚证和肝络瘀阻证；慢性肝炎轻、中、重度组均以肝胆湿热证为主,但轻度组肝胆湿热证更多见；重型肝炎早期以肝胆湿热证为主,中、晚期气虚瘀黄证与肝胆湿热证基本相当.结论 病毒性肝炎常见中医证型依次是肝胆湿热证、肝郁脾虚证和肝络瘀阻证,见于各临床类型、慢性肝炎不同分度及重型肝炎不同分期,所占比例随着疾病进展及严重程度增加而减少；脾虚湿困证和气虚瘀黄证更常见于慢性肝炎中、重度和重型肝炎中、晚期.病毒性肝炎患者西医诊断与中医证型有一定的关联.