CAJ | 학술논문

目的：开展全国范围内多中心慢性乙型肝炎（ALT≥2×ULN）患者证候调查，归纳该病的证候分布特点以及主要证型。方法：调查全国共计1003例慢性乙型肝炎（ALT≥2×ULN）患者，采集舌象、脉象及中医症状指标，通过量化评价确定症状分布频次及构成比，分析该病的主要证候分类及占比。结果：慢性乙型肝炎（ALT≥2×ULN）常见中医症状（前10位）依次为：困倦乏力（84．55％）、胁痛（75．67％）、尿黄（75．37％）、口干（66．20％）、烦躁易怒（60．42％）、胃部满闷（58．33％）、口苦（54．24％）、食欲不振（53．24％）、面色晦暗（51．94％）、腹部胀满（48．16％）等；在单一证候及有兼证存在的情况下，肝胆湿热和肝郁脾虚证具有较高的发生率，复合证候“肝胆湿热，肝郁脾虚”证为慢性乙型肝炎（ALT≥2× ULN）临床最常见相兼证候，肝郁脾虚及肝胆湿热证患者常见症状构成比及肝功能指标有显著差异。结论：“肝胆湿热”“肝郁脾虚”及复合证候“肝胆湿热，肝郁脾虚”证为慢性乙型肝炎（ALT≥2×ULN）核心病机。
목적：개전전국범위내다중심만성을형간염（ALT≥2×ULN）환자증후조사，귀납해병적증후분포특점이급주요증형。방법：조사전국공계1003례만성을형간염（ALT≥2×ULN）환자，채집설상、맥상급중의증상지표，통과양화평개학정증상분포빈차급구성비，분석해병적주요증후분류급점비。결과：만성을형간염（ALT≥2×ULN）상견중의증상（전10위）의차위：곤권핍력（84．55％）、협통（75．67％）、뇨황（75．37％）、구간（66．20％）、번조역노（60．42％）、위부만민（58．33％）、구고（54．24％）、식욕불진（53．24％）、면색회암（51．94％）、복부창만（48．16％）등；재단일증후급유겸증존재적정황하，간담습열화간욱비허증구유교고적발생솔，복합증후“간담습열，간욱비허”증위만성을형간염（ALT≥2× ULN）림상최상견상겸증후，간욱비허급간담습열증환자상견증상구성비급간공능지표유현저차이。결론：“간담습열”“간욱비허”급복합증후“간담습열，간욱비허”증위만성을형간염（ALT≥2×ULN）핵심병궤。
Objective:To explore the main syndrome types and distribution regularities of traditional Chinese medicine(TCM)syn-dromes by collecting muti-center nationwide clinical data of chronic hepatitis B (ALT≥2ULN)patients.Methods:A total of 1 003 chronic hepatitis B(ALT≥2 ×ULN)patients were recruited.By collecting the clinical manifestations of tongue,pulse and TCMsymptom index and determining the distribution frequency and constituent ratio of symptoms by quantitative evaluation,the main syndrome types and their percentages were investigated.Results:The main symptoms of chronic hepatitis B (ALT≥2ULN) were:sleepy and fatigue(84.55%),hypochondriac pain(75.67%),yellow urine(75.37%),dry mouth(66.20%),indigna-tion(60.42%),distension syndrome(58.33%),bitter taste(54.24%),anorexia(53.24%),darkish face(51.94%),abdo-men distended(48.16%).In occasions where there are more than one syndrome,dampness-heat in the liver and gallbladder syn-drome and liver stagnation and spleen deficiency syndrome had a higher incidence,and the complex syndrome of dampness-heat in the liver and gallbladder and liver stagnation and spleen deficiency was the most common complex syndrome in chronic hepatitis B (ALT≥2 ×ULN ).Symptoms constitute and liver function index have a significant difference between the patients with dampness-heat in the liver and gallbladder syndrome from the patients with liver stagnation and spleen deficiency syndrome.Conclusion:The core syndrome of chronic hepatitis B (ALT≥2ULN)is dampness-heat in the liver and gallbladder syndrome,liver stagnation and spleen deficiency syndrome,and the complex syndrome of damp heat in the liver and gallbladder and liver stagnation and spleen deficiency.