慢性乙肝不同证型与凝血相关指标、HBV-DNA相关性研究

【作者】 谢磊；

【导师】 赵莺；

【作者基本信息】 成都中医药大学 ， 中医诊断学， 2006， 硕士

【摘要】 目的：通过观察、分析127例慢性乙肝病例活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血浆凝血酶时间(TT)及乙肝脱氧核糖核酸(HBV-DNA)与中医辨证分型相关性，以期找出一些对辨证分型有特异性的指标，使中医对慢性乙肝辨证分型更加规范化、客观化，从而为指导临床治疗提供可靠依据。 方法： 1．按《中医新药临床研究指导原则(试行)》2002版标准，搜集慢性乙肝病例150例，再从中选择接受HBV-DNA、APTT、FIB等指标检测的病例127例作为观察组，同时与15名健康人作对照。 2．按《中医新药临床研究指导原则(试行)》2002版准设计调查表，准确填写临床资料。 3．请两名中级以上职称的医师根据上述临床资料并参照《中医新药临床研究指导原则(试行)》2002版有关慢性乙肝的中医证侯诊断标准进行辨证，得出证侯结论。 4．采用SPSS12.0统计软件包，用单因素方差分析方法和完全随机设计多样本比较的秩和检验，对试验组不同证型之间及试验组与对照组进行比较。 结果： 1．APTT在慢性乙肝不同证型以肝郁血瘀证延长最明显。肝郁血瘀证、脾肾阳虚证与正常组比较有显著性差异(P＜0.01)。肝胆湿热证、湿邪困脾证、肝郁脾虚证与肝郁血瘀证比较有显著性差异(P＜0.01)。肝胆湿热证、肝郁脾虚证与脾肾阳虚证组比较有差异(P＜0.05)。 2．FIB在慢性乙肝不同证型之间以脾肾阳虚证下降最明显。脾肾阳虚证与正常组相比有显著性差异(P＜0.01)。肝胆湿热证、湿邪困脾证、肝郁脾虚证与脾肾阳虚证相比有统计学意义(P＜0.05)。 3．TT在慢性乙肝不同证型之间之间以脾肾阳虚证延长最明显。脾肾阳虚证、肝郁血瘀证与正常组相比较有显著性差异(P＜0.01)。 4．HBV-DNA在慢性乙肝不同证型中病毒复制状态不同。高复制主要集中在更多还原

【Abstract】 Objective:To observe 127 chronic type B hepatitis patients and to explore the dependability of differentiation of symptoms and signs for classification of syndrome of Traditional Chinese Medicine on the patients’ APTT、FIB、TT、HBV-DNA, we aim to explore the specific index of differentiation of symptoms and signs for classification of syndrome. So to standardize differentiation of symptoms and signs for classification of syndrome makes it possible to diagnose chronic type B hepatitis in clinical processings. Methods:1 .Refer to Directions of new drugs clinical research (try out) 2002, we collected 150 chronic type B hepatitis patients. Then selected 127 patients who have received APTT、 FIB、 TT、 HBV-DNA analysis as case group. Meanwhile, we selected 15 healthy people as control group,2.Refer to Directions of new drugs clinical research (try out) 2002, we designed the measuring scale and collected the clinical data.3.Refer to Directions of new drugs clinical research (try out) 2002, two intermediate professional title doctors did differentiation of symptoms and signs, and come to a conclusion,4.Via SPSS 12.0, using ANOVA and rank sum test, we did comparison. Results:1 .Once the syndrome of liver congestion occurred in chronic type B hepatitis patients, APTT increased the most obviously. And it came to a different result compared to patients encountered the syndrome of hepatochlic hygropyrexia, damp pathogen obstruction the spleen, stagnation of liver-QI with deficiency of the spleen the syndrome of hepatochlic hygropyrexia, damp pathogen obstruction the spleen and normal people. P<0.01,So was the result that patients encountered asdthenic splenonephro-yang compared to those encountered the syndrome of hepatochlic更多还原