CAJ | 학술논문

目的：为慢性乙型肝炎患者的中医辨证分型与临床检验结果建立起对应关系，从而为中医治疗提供客观的诊疗依据。方法196例慢性乙型肝炎患者，按中医辨证分型的结果分为五组（肝肾阴虚型35例，湿热中阻型24例，脾肾阳虚型26例，瘀血阻络型42例，肝郁脾虚型69例），均检测乙型肝炎病毒的脱氧核糖核酸（HBV-DNA），乙型肝炎五项包括乙型肝炎表面抗原（HBsAg）、乙型肝炎表面抗体（HBsAb）、乙型肝炎 E 抗原（HBeAg）、乙型肝炎 E 抗体（HBeAb）和乙型肝炎核心抗体（HBcAb），总胆红素（TBIL），血清丙氨酸氨基转移酶（ALT），麝香草酚浊度实验（TTT）。结果在 HBV-DNA 检测方面，五组患者多数呈阳性，整体进行比较，组间差异无统计学意义（P ＝0．937）。但在乙型肝炎五项、TBIL、ALT 和 TTT 检测方面，均体现出检测结果与中医辨证分型的对应关系。如在 TTT 检测方面，肝肾阴虚型和肝郁脾虚型患者中，多数患者 TTT 检测结果介于7～10之间，两组依次与其他三组比较，差异均有统计学意义（P 值均为0．000）；湿热中阻型和瘀血阻络型患者中，TTT 检测结果普遍＜6，两组依次与其他三组比较，差异均有统计学意义（P 值均为0．000）；脾肾阳虚型患者中，TTT 检测结果普遍＞10，与其他四组比较，差异均有统计学意义（P 值均为0．000）。结论慢性乙型肝炎患者的中医辨证分型与临床检验结果具有一定的相关性。
목적：위만성을형간염환자적중의변증분형여림상검험결과건립기대응관계，종이위중의치료제공객관적진료의거。방법196례만성을형간염환자，안중의변증분형적결과분위오조（간신음허형35례，습열중조형24례，비신양허형26례，어혈조락형42례，간욱비허형69례），균검측을형간염병독적탈양핵당핵산（HBV-DNA），을형간염오항포괄을형간염표면항원（HBsAg）、을형간염표면항체（HBsAb）、을형간염 E 항원（HBeAg）、을형간염 E 항체（HBeAb）화을형간염핵심항체（HBcAb），총담홍소（TBIL），혈청병안산안기전이매（ALT），사향초분탁도실험（TTT）。결과재 HBV-DNA 검측방면，오조환자다수정양성，정체진행비교，조간차이무통계학의의（P ＝0．937）。단재을형간염오항、TBIL、ALT 화 TTT 검측방면，균체현출검측결과여중의변증분형적대응관계。여재 TTT 검측방면，간신음허형화간욱비허형환자중，다수환자 TTT 검측결과개우7～10지간，량조의차여기타삼조비교，차이균유통계학의의（P 치균위0．000）；습열중조형화어혈조락형환자중，TTT 검측결과보편＜6，량조의차여기타삼조비교，차이균유통계학의의（P 치균위0．000）；비신양허형환자중，TTT 검측결과보편＞10，여기타사조비교，차이균유통계학의의（P 치균위0．000）。결론만성을형간염환자적중의변증분형여림상검험결과구유일정적상관성。
Objective To establish the corresponding relationship between syndrome differentiation of TCM and clinical test results in chronic hepatitis B patients,and thus to provide objective evidence for TCM treatment. Methods 196 patients with chronic hepatitis B,according to the Chinese medicine dialectical typing results were divided into five groups(liver kidney yin deficiency syndrome type 35 cases,Shire Zhongzu syndrome type 24 cases, Yang deficiency of spleen and kidney syndrome type 26 cases,damp heat resistance type and blood stasis syndrome type 42 cases,liver stagnation and spleen deficiency syndrome type 69 cases).HBV -DNA,hepatitis B,TBIL,ALT, TTT were detected.Results In the HBV -DNA test,the majority of the five groups were positive,the overall compar-ison,the difference was not statistically significant (P =0.937).But in the second liver five,TBIL,ALT and TTT detection,the detection results were reflected in the corresponding relationship between TCMsyndrome differentiation. Such as in TTT detection,liver kidney yin deficiency syndrome type and liver stagnation and spleen deficiency syn-drome type group of patients,most patients with TTT detection results between 7 and 10,two groups sequentially com-pared with the other three groups,the differences were statistically significant (all P =0.000);damp heat resistance type and blood stasis type in the patients group,TTT detection results were generally less than 6,two groups in turn compared with the other three groups,the differences were statistically significant (all P =0.000);Yang deficiency of spleen and kidney in the patients group,TTT detection results were generally more than 10,and compared with the other four groups,the differences were statistically significant (all P =0.000).Conclusion TCMsyndrome differen-tiation of chronic hepatitis B patients has a certain correlation with the clinical test results.