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Journal of Chinese Integrative Medicine ›› 2003, Vol. 1 ›› Issue (2): 108-112.doi: 10.3736/jcim20030207

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Clinical investigation on characteristics of traditional Chinese medical syndrome of hepatocirrhosis

Qin Zhang1(), Ping Liu2, Hui-fen Chen1, Liang Chen1, Su-hua Cao3, Ying Liu2, Jian-jun Wei2, Zhi-hong Fang1, Ding-zhong Wu1   

  1. 1. Department of Integrated Traditional Chinese and Western Medicine, Shanghai Municipal Infectious Disease Hospital, Shanghai 200083, China
    2. Institute of Liver Diseases, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
    3. Department of Health Statistics, Fudan University, Shanghai 200032, China
  • Received:2003-05-12 Online:2003-06-20 Published:2018-10-19

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Objective

To explore the characteristics of traditional Chinese medical syndrome (TCM syndrome) of hepatocirrhosis.


Methods

Clinical information from the four diagnosis methods of traditional Chinese medicine (TCM) and related laboratorial indexes were systematically collected from 223 hepatocirrhosis cases, and the multi-statistical methods including systematic cluster analysis, principal component analysis, stepwise discrimination and variance analysis were made with the software SAS 6.11.


Results

Multi-analysis showed that there were 3 categories of syndrome characteristics. Type 1 (134 cases): damp heat, blood stasis, deficiency of liver and spleen Qi; Type 2 (62 cases): deficiency of both Qi and Yin with severe deficiency of Qi, heat with severe dampness, blood stasis; Type 3 (27 cases): deficiency of both Qi and Yin with severe deficiency of Yin, stasis and heat or dampness. Analysis of the changes of the related laboratorial indexes among the three types of syndrome showed that Type 1 mainly manifested asthenia syndrome with sthenia syndrome , and its indexes of AST、ALT、GGT levels were markedly higher than those of Type 2 and Type 3, both of which mainly showed sthenia syndrome with asthenia syndrome, and that Type 3 was in active inflammation, deficiency of both Qi and Yin (deficiency of Yin > deficiency of Qi), and its FN、Alb、FⅤ、FⅦ、PLT、PCT levels were obviously reduced.


Conclusion

The multi-statistical methods can reveal the characteristics and regularity of TCM syndrome of hepatocirrhosis, and the 3 categories of syndrome characteristics basically conform to clinical manifestations. The result of TCM syndrome distribution and laboratorial indexes infer that damp heat is the pathological basis of hepatocirrhosis, and the degree of liver function disorder and liver damage may be the pathological basis of deficiency of Yin of both liver and kidney.

Key words: hepatocirrhosis, traditional Chinese medical syndrome, multi-analysis

CLC Number: 

  • R657-31

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症状和体征 频数 频率（%） 症状和体征 频数 频率（%）
乏力 194 87.89 面晦暗 95 42.60
腰膝酸软 183 82.06 五心烦热 92 41.26
睡眠障碍 181 81.16 尿少 90 40.35
脉弦 157 70.40 腹壁脉络曲张 88 39.46
口苦 147 65.92 苔厚 87 39-01
肢体困重 145 65.02 身黄 86 38.56
尿黄 143 64.13 潮热 79 35.42
口干 137 61.43 胁隐痛 79 35.42
纳谷不馨 135 60.53 胁刺痛 78 34.98
齿衄 132 59.19 苔白 72 32.28
耳鸣 127 56.95 胁胀痛 64 28.70
苔黄 127 56.95 少苔 63 28.25
苔腻 112 50.22 舌紫暗 60 26.90
两目干涩 111 49.78 舌瘀斑 51 22.87
脉细 111 49.78 舌暗红 47 21.08
头晕 109 48.88 舌红 46 21.97
腹胀 106 47.53 脉沉 40 17.94
目黄 106 47.53 下肢浮肿 37 16.59
舌边有齿痕 99 44.39 面无华 31 13.90

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类型 例数 主 成 分
1 134 湿热,累计贡献率为18.15%：(6)胃脘胀、脾大、唇暗红、苔黄、脉滑数(3.07%);(7)睡眠障碍、口干、头重、头晕、便干(2.91%);(11)口苦、口臭、目痛、苔黄、苔燥(2.34%);(12)厌油、苔厚(2.27%);(13)口干、尿黄、苔黄腻(2.18%);(14)恶心呕吐、目黄、身黄、尿黄(2.11%); (21)抑郁、头重、目黄、身黄(1.68%);(22)口臭、肌衄、头重、性欲减退、脉弦(1.59%)。
血瘀,累计贡献率为17.64%：(2)腹胀痛、胁刺痛、鼻衄、肌衄、目痛、舌瘀斑、面色晦暗、腹壁脉络曲张(4.98%);(5)胁刺痛、肝掌、唇暗红、舌瘀斑(3.29%); (8)舌瘀斑、肝缩小(2.86%);(10)齿衄、鼻衄、面色晦暗、舌质紫暗、蜘蛛痣(2.47%);(15)胁胀、鼻衄、腹胀痛、脾大(2.08%);(16)胁刺痛、脉细(1.96%);(18)头重、腹刺痛、身黄、蜘蛛痣、舌质绛、脉滑(1.84%)。
气虚,累计贡献率为16.52%：(1)乏力、气短、头晕目眩、脘胀、胃部不适、腹胀、食谷不化(6.24%); (3)气短、睡眠障碍、抑郁、便溏(4.18%);(4)少气懒言、便溏、舌边有齿痕(3.48%);(9)肌衄、尿黄、面无华、苔薄(2.62%)。
2 62 (脾肾)气虚、湿邪内停累计贡献率为27.82%：(1)乏力、胁隐痛、腰膝酸软、小便不利、尿少、下肢浮肿、腹壁脉络曲张、舌边有齿痕(8.86%);(5)视物模糊、肢体困重、移动性浊音、面色无华、舌边有齿痕(4.38%);(6)纳谷不馨、不欲饮、便溏(3.98%);(7)腰膝酸软、夜尿多、骨节疼痛(3.71%);(8)小便清长、舌边有齿痕(3.51%);(9)胃脘胀、腹泻、苔腻(3.20%);(10)女子月经不调、带下量多(3.06%);(11)少气懒言、舌边有齿痕、脉弦(2.84%)。
阴虚(肝肾)、内热,累计贡献率为24.06%：(2)潮热、五心烦热、两目干涩、耳鸣、健忘、头晕(6.54%);(3)胁隐痛、舌红、少苔、脉细数(5.09%);(4)乏力、盗汗、口干、性欲减退(4.60%);(12)口干、齿衄、鼻衄、脉沉(2.71%);(13)尿黄、目黄、便秘(2.65%);(14)睡眠障碍、耳鸣、脉沉(2.47%);(15)抑郁、胁刺痛、男性乳房发育、肌衄、脉沉(2.39%)。
3 27 气阴两虚、阴虚内热,累计贡献率为33.18%：(1)乏力、睡眠障碍、潮热、五心烦热、低热、目眩(11.56%);(2)抑郁、易恐善惊、两目干涩、齿衄、便秘(9.12%);(3)少气懒言、自汗、两目干涩、口干、头晕、少苔(8.19%); (9)睡眠障碍、健忘、胁胀、脉细、少苔(4.31%)。
瘀热,累计贡献率为16.83%：(6)泛酸、嗳气、不欲饮、头痛、便秘(6.2%);(7)头痛、骨节疼痛、胃脘刺痛、肌衄、男性乳房发育(5.65%);(8)舌有瘀斑、脉沉弦细(4.98%)。
湿邪内阻,累计贡献率为13.78%：(4)恶心、胃脘不适、胸闷、腹胀、食谷不化、身黄、尿黄(7.12%);(5)胃部不适、腹泻、肢体困重(6.66%)。

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Step Entered Variable Number In Partial R**2 F Statistic Prob>F
1 Y11 (TNF-α) 1 0.0618 3.820 0.0247
2 Y14 (FⅤ) 2 0.0640 3.931 0.0223
3 Y13 (HPT) 3 0.0479 2.865 0.0611
4 Y4 (FN) 4 0.0446 2.636 0.0760
5 Y7 (apoA1) 5 0.0352 2.043 0.1345
6 Y3 (AST) 6 0.0352 2.220 0.1134

"

生化指标 类别（n）
Type 1（67） Type 2（40） Type 3（14）
AST（U/L） 350.6900±209.84 127.4400±112.93** 117.2100±77.62**
FN(g/L) 0.1549±0.133 0.1542±0.074△△ 0.1270±0.021**
apoA1(g/L) 1.0530±0.791 1.0490±0.284** 0.9240±0.378**
HPT(s) 64.9300±26.76 77.1250±27.36 61.0000±26.065
FⅤ(%) 64.0000±30.596 69.9500±44.206**△△ 39.0710±18.32*
TNF-α(pg/ml) 57.5400±39.11 68.5500±42.54△ 53.2100±23.92
TSB(μmol/L) 138.5000±110.8 79.1400±62.11**△ 125.6000±104.53
ALT(U/L) 384.2000±214.03 194.4000±127.2**△△ 125.6000±104.53
TP(g/L) 68.3300±7.5 72.3200±9.91 67.5300±9.71
Alb(g/L) 33.9600±6.937△△ 34.7000±7.29△△ 30.5900±2.97
TBA(μmol/L) 93.3300±72.6 55.6600±55.44** 89.4100±60.55
apoB(g/L) 0.6891±0.2883△△ 0.6495±0.593* 0.6236±0.1388
PT(IRN) 1.7300±0.57 1.7200±0.74 2.2600±0.67
GGT(U/L) 110.9700±105.36△ 105.7000±141.62 68.8600±48.59
FⅦ（%） 51.5970±30.077△ 58.3720±38.16△ 33.2900±24.67
FⅩ（%） 47.4300±26.985 59.9500±37.98△* 48.2100±19.50
AFP (μg/L) 208.7300±116.075 112.2100±72.625**△△ 190.1900±124.5
PLT(×109/L) 90.4200±50.56△△ 89.8300±54.52△△ 66.5000±26.61
MPV（fl） 10.1100±1.58 10.0100±1.42 10.1500±1.27
PCT (%) 0.0930±0.055 0.0970±0.058△ 0.0650±0.027*
PDW(%) 16.1000±1.603 15.7700±2.266 16.2900±1.683
HA(ng/L) 434.3400±202.89 407.6800±200.53 518.2900±177.80
CG(μg/L) 2288.4500±884.62 3733.0500±1141.30**△△ 2566.7900±844.23
PCⅢ(μg/L) 140.5800±22.76 133.4000±17.89 1450.64±17.64
ⅣC (ng/ml) 65.7200±17.89 64.5700±17.87 70.3600±19.33
LN (ng/ml) 146.8500±21.78 156.2300±31.56 147.7900±22.61
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