1. 北京中医药大学东直门医院
2. 首都医科大学附属北京同仁医院
纸质出版:2020
移动端阅览
[1]叶永安,刘蕊洁,杨先照,李莹,张鹏,梁亦骏.乙型肝炎肝硬化中医证型、证素分布特点文献研究[J].中医杂志,2020,61(04):346-350.
YE Yong′an, LIU Ruijie, YANG Xianzhao, et al. Literature Study on Chracteristics of Traditional Chinese Medicine Syndrome Types and Syndrome Elements Distribution of Hepatitis B Virus-Related Hepatocirrhosis[J]. Journal of Traditional Chinese Medicine2020, 61(4): 346-350.
[1]叶永安,刘蕊洁,杨先照,李莹,张鹏,梁亦骏.乙型肝炎肝硬化中医证型、证素分布特点文献研究[J].中医杂志,2020,61(04):346-350. DOI: 10.13288/j.11-2166/r.2020.04.016.
YE Yong′an, LIU Ruijie, YANG Xianzhao, et al. Literature Study on Chracteristics of Traditional Chinese Medicine Syndrome Types and Syndrome Elements Distribution of Hepatitis B Virus-Related Hepatocirrhosis[J]. Journal of Traditional Chinese Medicine2020, 61(4): 346-350. DOI: 10.13288/j.11-2166/r.2020.04.016.
目的通过文献回顾分析
探讨乙型肝炎肝硬化中医证型、证素分布特点。方法检索1963年1月1日至2018年12月31日中国期刊全文数据库、中文科技期刊数据库、万方数据库出版平台、中国中医药数据库及MEDLINE、EMBASE、Web of knowledge、Cochrane library数据库
纳入乙型肝炎肝硬化的临床研究文献
对纳入文献中患者的中医证型、证素进特点进行分析。结果共纳入文献81篇
乙型肝炎肝硬化患者11912例
其中有明确肝硬化分期代偿期1780例
失代偿期2942例。中医证型不含兼夹证前5位为湿热内蕴、肝肾阴虚、瘀血阻络、肝郁脾虚、肝郁气滞
累积占比为58.23%;含兼夹证前5位证型依次为湿热内蕴、肝郁脾虚、瘀血阻络、肝肾阴虚、肝郁气滞
累积占比为72.49%;病位证素以肝、脾为主
累积频率为75.53%
病性证素以湿、气滞、气虚、热、血瘀为主
累积频率为86.85%。代偿期主要中医证型为湿热内蕴、肝郁气滞、瘀血阻络
失代偿期主要为湿热内蕴、脾肾阳虚、肝肾阴虚。失代偿期复合证8种、复杂证19种
较代偿期复合证3种、复杂证7种明显增多。结论乙型肝炎肝炎肝硬化核心病机为肝郁脾虚
湿瘀热互结
随病情进展
证型、证素构成逐渐复杂。
Objective To explore the characteristics of traditional Chinese medicine(TCM) syndromes and syndrome elements distribution of hepatitis B virus(HBV)-related hepatocirrhosis by literature review. Methods Chinese Journal Full-text Database
Chinese Sci-tech Periodical Database
Wanfang Database Publishing Platform
China Traditional Chinese Medicine Database and MEDLINE
EMBASE
Web of knowledge
Cochrane library database were searched from January 1
1963 to December 31
2018
and the clinical research literature on HBV-related hepatocirrhosis were included. The characteristics of TCM syndromes and syndrome elements of patients included in the literature were analyzed. Results A total of 81 papers were included. There were 11?912 patients with HBV-related hepatocirrhosis
including 1780 patients with compensated stage and 2942 patients with decompensation stage. The top 5 TCM syndromes without accompanied symptoms were internal accumulation of damp heat
yin deficiency of liver and kidney
blood stasis obstructing the collaterals
liver depression and spleen deficiency
liver depression and qi stagnation
accounting 58.23% in total. Taken accompanied symptoms into consideration
the top 5 was internal accumulation of damp heat
liver depression and spleen deficiency
blood stasis obstructing the collaterals
yin deficiency of liver and kidney and liver depression and qi stagnation
accounting 72.49% in total. The syndrome elements of disease location were the liver and the spleen
with a total frequency of 75.53%. The syndrome elements of the disease nature were dampness
qi stagnation
qi deficiency
heat
blood stasis
accounting 86.85% in total frequency. The major TCM syndromes in compensated stage were internal accumulation of damp heat
liver depression and qi stagnation
blood stasis obstructing the collaterals. The syndromes in decompensated stage were internal accumulation of damp heat
yang deficiency of the spleen and kidney
yin deficiency of the liver and kidney. There were 8 compound syndromes and 19 complex syndromes in the decompensated stage
which were significantly increased than 3 compound syndromes and 7 complex syndromes in the compensated stage. Conclusion The core pathogenesis of HBV-related hepatocirrhosis is liver depression and spleen deficiency and intermingled damp
blood stasis
and heat. The syndromes and syndrome elements are becoming complex.
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