摘要
目的:回顾性调查急性肝衰竭(ALF)、亚急性肝衰竭(SALF)的病因病机、中医证候规律及预后转归,为本病的中医诊治提供科学依据。方法:采用回顾性研究方法,对2002年至2013年期间广西地区448例ALF、SALF患者进行病因、中医证候及预后分析。结果:广西地区ALF、SALF最常见的病因是病毒(尤其是HBV)、药物、外伤及手术;前3位的中医证型主要集中在毒热炽盛证、毒入营(血)证、热入心包证,与其他证型相比明显多见(P<0.05);ALF、SALF患者总病死率为55.58%,其中Child-Pugh B级患者的病死率明显低于Child-Pugh C级患者(P<0.01);且SALF患者的中医证候改善程度要优于ALF患者(P<0.05)。结论:广西地区ALF、SALF的病因主要是HBV,毒热炽盛证是其中医证候的主要类型,ALF、SALF的病死率均非常高,以辨证论治为基础的中医药介入可望对结局有所改善。
Objective： To retrospectively investigate the etiology,pathogenesis,traditional Chinese medicine（ TCM） syndrome patterns,and prognosis of acute liver failure（ ALF） and subacute liver failure（ SALF）,and to provide a scientific basis for TCM diagnosis and treatment of this disease. Methods： A retrospective study was conducted in 448 patients with ALF or SALF from 2002 to 2013 in Guangxi,China,and a statistical analysis was performed to investigate etiology,TCM syndrome,and prognosis. Results： The most common causes of ALF and SALF were virus（ especially HBV）,medicine,trauma,and surgery in Guangxi,China. The top three TCM syndromes were exuberance of toxin and heat,invasion of construction（ blood） by toxin,and invasion of pericardium by heat,and they were significantly more common than other syndromes（ P 〈0. 05）. The overall mortality of patients with ALF or SALF was 55. 58%,and the patients with Child- Pugh class B had a significantly lower mortality than those with Child- Pugh class C（ P 〈0. 01）. And the patients with SALF had significantly more improvement in TCM syndromes than those with ALF（ P〈 0. 05）. Conclusion： The major cause of ALF and SALF is HBV in Guangxi,China. The major TCM syndrome is exuberance of toxin and heat. The mortality of ALF and SALF is very high. TCM syndrome differentiation- based treatment may improve the outcome of ALF and SALF.
出处
《湖南中医杂志》
2015年第10期1-3,共3页
Hunan Journal of Traditional Chinese Medicine
基金
国家"十二五"传染病重大科技专项(编号:2012ZX10005005-001-002)
2012年广西自然科学基金资助项目(编号:2012GXNSFAA053121)
广西高等学校高水平创新团队及卓越学者计划资助项目
