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[脂肪肝中医证型流行病学调查及中医病因病机初探]

[Epidemic survey on TCM syndrome typing and preliminary discussion on TCM etiology and pathogenesis of fatty liver].

作者信息

Wang Yan-xiang, Wang Ling-tai, Gao Yue-qiu, Sun Xue-hua, Zhang Bin, He Jin-yang, Wen Ying-juan, Zhang Xiao-ke, Zhao Yan-ping, Zhao Qing-e

机构信息

Shanghai Hospital of Integrative Traditional Chinese and Western Medicine, Shanghai 200082.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005 Feb;25(2):126-30.

Abstract

OBJECTIVE

To investigate the common TCM syndrome types of fatty liver by way of epidemic questionnaire, their occurrence ratio, and the correlation between various syndrome types and objective indexes.

METHODS

A total of national wide 503 subjects with fatty liver were enrolled, the TCM syndromes, body mass index (BMI), abdominal perimeter/hip circumference, liver function, blood lipids, B ultrasonic examination and CT in them were observed and recorded.

RESULTS

In the 46 symptoms investigated in total, the first ten symptoms in order of appearing rate were lassitude, obese, oral dryness, vertigo, hypochondriac distending pain, soreness and pain in loin, spiritlessness, oral bitterness, aching and weakness in knee and abdominal distention. The mostly appeared tongue figures were pale and corpulent or pale dim tongue proper, white greasy or yellow greasy tongue coating, and the mostly appeared pulse figures were taut, taut-thin and taut slippery. Statistical cluster analysis showed that syndromes of fatty liver could be typed into 4 TCM types, the asthenia Pi-Shen with Gan-stagnation type, the asthenia Pi-Shen type, the asthenia Pi with phlegm-heat type and the unclassified type. Among them the asthenia Pi-Shen with Gan-stagnation type was the commonest one, which accounted to 62.32%.

CONCLUSION

The mostly appeared syndrome type of fatty liver was asthenia Pi-Shen with Gan-stagnation type. The TCM pathogenesis of fatty liver was deficiency of origin, mainly deficiency of Shen, involving Pi, with excess superficiality, the turbid-phlegm and blood stasis.

摘要

目的

通过流行病学调查问卷的方式,研究脂肪肝常见的中医证型、各证型的发生率以及各证型与客观指标之间的相关性。

方法

共纳入全国范围内503例脂肪肝患者,观察并记录其中医证候、体重指数(BMI)、腹围/臀围、肝功能、血脂、B超检查及CT检查结果。

结果

在总共调查的46个症状中,出现率前十位的症状依次为乏力、肥胖、口干、眩晕、胁肋胀痛、腰酸、精神不振、口苦、腰膝酸软、腹胀。出现最多的舌象为舌淡胖或舌体淡暗、苔白腻或黄腻,出现最多的脉象为弦、弦细、弦滑。统计聚类分析显示,脂肪肝的证候可分为4种中医证型,即脾虚肝郁型、脾胃虚弱型、脾虚痰热型和未分型。其中脾虚肝郁型最为常见,占62.32%。

结论

脂肪肝最常见的证型为脾虚肝郁型。脂肪肝的中医病机为本虚标实,以肾虚为主,累及脾,标实主要为痰浊、瘀血。

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