慢性乙型肝炎中医证型分布特征研究
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摘要
目的:分析近五年慢性乙型肝炎(Chronic Hepatitis B,CHB)中医证型分布规律。方法:检索国内外涉及CHB中医证型分布的研究文献,将符合纳入标准的22篇文献进行特征评价与证型分布统计。结果:出现频次前8位的证型分别为肝郁脾虚证、湿热中阻证、肝胆湿热证、肝气郁结证、肝肾阴虚证、瘀血阻络证、脾气虚证、脾肾阳虚证,与《慢性乙型肝炎中医诊疗专家共识(2012)》辨证分型基本一致。结论:CHB的中医辨证分型可以初步规范为肝郁脾虚证、湿热蕴结证、肝郁气滞证、肝肾阴虚证、瘀血阻络证、脾肾阳虚证六种,人体体质的多元性与CHB自身的复杂性决定了其分型标准难以囊括所有患者的证型。
Objective: To analyze the syndrome distribution law,evaluate and improve the relevant research results according to the statistical data of the literatures on distribution of TCM syndromes of chronic hepatitis B in the past five years. Methods: Retrieve domestic and foreign research literature related to the TCM syndrome distribution of CHB,choose 22 documents accorded with the criteria,carry out the characteristics evaluation and statistical analysis of the syndrome distribution. Results: The top eight with high occurrence frequency include liver stagnation and spleen deficiency,retention of damp-heat,syndrome of dampnheat of liver and gallbladder,liver qi stagnation syndrome,syndrome of yin deficiency of liver and kidney,syndrome of static blood blocking collaterals,syndrome of deficiency of spleen qi,syndrome of yang deficiency of spleen and kidney,which were basically the same as the syndrome differentiation of The consensus of experts on traditional Chinese medicine diagnosis and treatment for chronic hepatitis B( 2012). Conclusion: TCM syndromes according to differentiation of CHB can be preliminarily specified into liver stagnation and spleen deficiency syndrome,retention of damp heat syndrome,liver qi stagnation syndrome,yin deficiency of liver and kidney,blood stasis blocking the collaterals and yang deficiency of the spleen and kidney. The diversity of the constitution of human body and the complexity of the CHB determine that the syndrome criteria are difficult to include all patterns of the patients.
Objective: To analyze the syndrome distribution law,evaluate and improve the relevant research results according to the statistical data of the literatures on distribution of TCM syndromes of chronic hepatitis B in the past five years. Methods: Retrieve domestic and foreign research literature related to the TCM syndrome distribution of CHB,choose 22 documents accorded with the criteria,carry out the characteristics evaluation and statistical analysis of the syndrome distribution. Results: The top eight with high occurrence frequency include liver stagnation and spleen deficiency,retention of damp-heat,syndrome of dampnheat of liver and gallbladder,liver qi stagnation syndrome,syndrome of yin deficiency of liver and kidney,syndrome of static blood blocking collaterals,syndrome of deficiency of spleen qi,syndrome of yang deficiency of spleen and kidney,which were basically the same as the syndrome differentiation of The consensus of experts on traditional Chinese medicine diagnosis and treatment for chronic hepatitis B( 2012). Conclusion: TCM syndromes according to differentiation of CHB can be preliminarily specified into liver stagnation and spleen deficiency syndrome,retention of damp heat syndrome,liver qi stagnation syndrome,yin deficiency of liver and kidney,blood stasis blocking the collaterals and yang deficiency of the spleen and kidney. The diversity of the constitution of human body and the complexity of the CHB determine that the syndrome criteria are difficult to include all patterns of the patients.
引文
[1]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].中华肝脏病杂志,2011,19(1):13-24.
[2]吕嫒嫒,薛博瑜.慢性乙型肝炎的中医治疗[J].吉林中医药,2013,33(2):138-140.
[3]中华中医药学会内科肝胆病学组.慢性乙型肝炎中医诊疗专家共识(2012年1月)[J].临床肝胆病杂志,2012,28(3):164-168.
[4]陈玮.福州市区慢性乙型肝炎抗病毒治疗患者中医证型调查分析[D].福州:福建中医学院,2009.
[5]江振豪.马来西亚霹雳州华裔慢性乙型肝炎中医证型研究[D].福州:福建中医学院,2009.
[6]袁虹,夏章,曹廷智,等.慢性乙型重型肝炎分期论治的辨证模式研究[C].上海:中华中医药学会全国第十四次肝胆病学术会议论文汇编,2010:238-244.
[7]李知玉,杨大国,邓欣,等.500例不同年龄段慢性乙型肝炎病毒携带者中医证候调查[J].中医药信息,2010,27(3):1-4.
[8]王振常,毛德文,黄彬,等.慢性乙型肝炎中医证型与生化及氧化损伤指标的相关性研究[J].辽宁中医杂志,2010,37(3):390-392.
[9]吴春城.闽南地区慢性乙型肝炎中医证型分布及人口学和生物学基础[D].福州:福建中医药大学,2010.
[10]张盛杰,孙莲娜,薛建华,等.慢性乙型肝炎中医证型分布规律规范化初探[J].中西医结合肝病杂志,2010,20(6):324-328.
[11]J Li,HY,Jany,LF Wang.Relationship between HBV DNA genotype and Chinese medicine syndrome pattern in patients with chronic hepatitis B[J].Zhongguo Zhong Xi Yi Jie He Za Zhi,2010,30(10):38-41.
[12]崔坡.慢性乙型肝炎中医证候横断面研究[D].北京:北京中医药大学,2011.
[13]高庆华,桂明进,干磊,等.慢性乙型肝炎中医证型分布特点及与肝功能指标的相关性研究[J].内蒙古中医药,2011,30(12):2-3.
[14]凌琪华,陈建杰,徐文杰,等.慢性乙型肝炎患者中医证型特点及分布规律的初探[J].中医杂志,2011,52(S1):82-83.
[15]王政.1260例慢性乙型肝炎常见中医证型与实验室指标的相关性研究[D].成都:成都中医药大学,2011.
[16]冯小红,张红峰.慢性乙型肝炎患者中医证型特点及分布差异[J].中医临床研究,2012,4(13):63-64.
[17]肖玲辉,张斌,扈晓宇.慢性乙型肝炎的中医证型分布特点观察分析[J].中国医药指南,2012,10(25):399-401.
[18]吴韶飞.利用数据挖掘技术分析404例慢性乙型肝炎患者中医证候组群分布规律[D].济南:山东中医药大学,2012.
[19]吴银亚,谭善忠,沈建军,等.慢性乙型肝炎病毒感染携带者中医证型分布特点[J].中国中医药信息杂志,2012,19(5):17-19.
[20]邢宇锋,张晓晖,陈英杰,等.慢性乙肝病毒携带者中医证候分布规律调查及病机探讨[J].中西医结合肝病杂志,2012,22(4):196-199.
[21]罗彬,李红钊,宁俊云.乙型肝炎中医分型与医学实验室检查的关系分析[J].吉林医学,2012,33(5):905-906.
[22]杨广栋.慢性乙型肝炎证候分布特征研究[D].北京:中国中医科学院,2012.
[23]王若飞.慢性乙型肝炎中医证型分布与实验室检测特点[J].时珍国医国药,2013,24(9):2227-2228.
[24]江涛.慢性乙型肝炎中医证型与六项肝脏生化指标间相关性研究[D].北京:首都医科大学,2013.
[25]胡大庆,施卫兵,王金萍,等.轻症慢性乙型肝炎的中医证型与病理相关性研究[J].山西中医,2013,29(4):51-52.
[2]吕嫒嫒,薛博瑜.慢性乙型肝炎的中医治疗[J].吉林中医药,2013,33(2):138-140.
[3]中华中医药学会内科肝胆病学组.慢性乙型肝炎中医诊疗专家共识(2012年1月)[J].临床肝胆病杂志,2012,28(3):164-168.
[4]陈玮.福州市区慢性乙型肝炎抗病毒治疗患者中医证型调查分析[D].福州:福建中医学院,2009.
[5]江振豪.马来西亚霹雳州华裔慢性乙型肝炎中医证型研究[D].福州:福建中医学院,2009.
[6]袁虹,夏章,曹廷智,等.慢性乙型重型肝炎分期论治的辨证模式研究[C].上海:中华中医药学会全国第十四次肝胆病学术会议论文汇编,2010:238-244.
[7]李知玉,杨大国,邓欣,等.500例不同年龄段慢性乙型肝炎病毒携带者中医证候调查[J].中医药信息,2010,27(3):1-4.
[8]王振常,毛德文,黄彬,等.慢性乙型肝炎中医证型与生化及氧化损伤指标的相关性研究[J].辽宁中医杂志,2010,37(3):390-392.
[9]吴春城.闽南地区慢性乙型肝炎中医证型分布及人口学和生物学基础[D].福州:福建中医药大学,2010.
[10]张盛杰,孙莲娜,薛建华,等.慢性乙型肝炎中医证型分布规律规范化初探[J].中西医结合肝病杂志,2010,20(6):324-328.
[11]J Li,HY,Jany,LF Wang.Relationship between HBV DNA genotype and Chinese medicine syndrome pattern in patients with chronic hepatitis B[J].Zhongguo Zhong Xi Yi Jie He Za Zhi,2010,30(10):38-41.
[12]崔坡.慢性乙型肝炎中医证候横断面研究[D].北京:北京中医药大学,2011.
[13]高庆华,桂明进,干磊,等.慢性乙型肝炎中医证型分布特点及与肝功能指标的相关性研究[J].内蒙古中医药,2011,30(12):2-3.
[14]凌琪华,陈建杰,徐文杰,等.慢性乙型肝炎患者中医证型特点及分布规律的初探[J].中医杂志,2011,52(S1):82-83.
[15]王政.1260例慢性乙型肝炎常见中医证型与实验室指标的相关性研究[D].成都:成都中医药大学,2011.
[16]冯小红,张红峰.慢性乙型肝炎患者中医证型特点及分布差异[J].中医临床研究,2012,4(13):63-64.
[17]肖玲辉,张斌,扈晓宇.慢性乙型肝炎的中医证型分布特点观察分析[J].中国医药指南,2012,10(25):399-401.
[18]吴韶飞.利用数据挖掘技术分析404例慢性乙型肝炎患者中医证候组群分布规律[D].济南:山东中医药大学,2012.
[19]吴银亚,谭善忠,沈建军,等.慢性乙型肝炎病毒感染携带者中医证型分布特点[J].中国中医药信息杂志,2012,19(5):17-19.
[20]邢宇锋,张晓晖,陈英杰,等.慢性乙肝病毒携带者中医证候分布规律调查及病机探讨[J].中西医结合肝病杂志,2012,22(4):196-199.
[21]罗彬,李红钊,宁俊云.乙型肝炎中医分型与医学实验室检查的关系分析[J].吉林医学,2012,33(5):905-906.
[22]杨广栋.慢性乙型肝炎证候分布特征研究[D].北京:中国中医科学院,2012.
[23]王若飞.慢性乙型肝炎中医证型分布与实验室检测特点[J].时珍国医国药,2013,24(9):2227-2228.
[24]江涛.慢性乙型肝炎中医证型与六项肝脏生化指标间相关性研究[D].北京:首都医科大学,2013.
[25]胡大庆,施卫兵,王金萍,等.轻症慢性乙型肝炎的中医证型与病理相关性研究[J].山西中医,2013,29(4):51-52.