目的:探讨肝硬化门脉高压性胃病(PHG)中医证型与其胃镜下表现及Child-Pugh分级的相关性.方法:对临床经胃镜确诊为PHG的81例患者进行中医辨证分型,并按Tanoue分类法记录PHG分级及Child-Pugh分级情况进行比较分析,以探讨PHG的中医证型与其胃镜下表现及Child-Pugh分级之间的相关性.结果:在本研究的81例PHG患者中,各证型分布按所占比例大小依次顺序为肝郁脾虚型＞瘀血阻络型＞湿热内蕴型＞肝(脾)肾两虚型,其中肝郁脾虚型、湿热内蕴型患者的胃黏膜以Ⅰ级改变为主,与其他各证型比较差异有统计学意义;瘀血阻络型和肝(脾)肾两虚型患者的胃黏膜以Ⅱ级为主,与其他各证型比较差异有统计学意义.肝功能以Child A级和Child B级分布为主(分别占48.1％和34.6％),在肝郁脾虚型中以Child A级为主占62.5％,与其他各型比较差异有统计学意义;在肝(脾)肾两虚型中以Child C级为常见占55.6％,与其他各型比较差异有统计学意义;而在Child B级中,各证型之间比较差异无统计学意义.经卡方检验以及列联表进行分析,PHG患者中医各证型与其胃镜下表现、Child-Pugh分级之间存在相关性.结论:PHG患者中医各证型和胃镜下表现的分级、Child-Pugh分级之间存在相关性,可作为中医辨证分型和确立治法的客观依据.%Objective:Through observation and study,to explore the Correlation analysis between the TCM syndrome type differentiation of protal hypertensive gastropathy(PHG) and endoscopic manifestations and Child-Pugh classification.Methods:81 cases of PHG diagnosed by endoscopy were divided into TCM syndromes.PHG classification and Child-Pugh classification according to Tanoue classification were compared and analyzed to explore the relationship between TCM syndromes of PHG and gastroscopy and Child-Pugh classification of the correlation.Results:In 81 cases of PHG patients,the distribution of the type of syndromes according to the order of the size of the order:Liver depression and Spleen deficiency ＞ blood stasis syndrome ＞ damp intrinsic type ＞ liver(spleen) kidney deficiency type,The level of gastric mucosa in patients with Liver depression and Spleen deficiency and damp intrinsic type were mainly changed by grade Ⅰ,which were significantly different from those of other syndromes.Blood stasis syndrome and liver(spleen) kidney deficiency in patients with type Ⅱ gastric mucosa is the main,which were significantly different from those of other syndromes.Liver function was mainly in Child A and Child B(respectively,48.1％ and 34.6％),and Child A was the most common type in liver depression and spleen deficiency type(62.5％),which was significantly different from other types.Child C(55.6％)was common in the liver(spleen) kidney deficiency,which was significantly different from other types.In Child B,there was no significant difference between the syndromes.By Chi-square test and cross-tabulation,there are correlation between PHG patients with TCM syndrome type and its endoscopic manifestations and Child-Pugh classification.Conclusion:There are correlation between PHG patients with TCM syndromes and endoscopic grading of performance and Child-Pugh classification,it can be used as TCM syndrome differentiation and the establishment of objective basis for the treatment.
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