Research On Relationship Between Syndrome Discrimination Of Hepatic Cirrhosis And Assays, PGA Index

Project:Aim to explore the relationship between TCM Syndromes classification and serum liver function,hepatic fibrosis,PGA index,Child-pugh classification and the changes in imaging in patients with liver cirrhosis,and provide further clinical syndrome differentiation criteria standardization of research ideas and methods.Methods:In this study,with reference to the diagnostic criteria of liver cirrhosis revised in the National Symposium on liver disease by the Chinese Medical Association Society of infectious and parasitic diseases and liver disease.this investigation selected 300 cases of patients from the inpatient and out-patient of infectious disease dept of Jiangsu provincial hospital of TCM in October 2006 October 2008,investigating the clinical performance characteristics syndrome, syndrome type,according to traditional Chinese and western medicine in China Institute of Professional Committee of digestive diseases in the November 1993 meeting of the fifth in Luoyang academic exchange at the development of clinical diagnosis of livuuuuuuer cirrhosis,and efficacy of TCM program standards amended Syndrome identification,collection of serum indicators of liver function,hepatic fibrosis,PGA index calculated,Child-pugh classification,the use of color Doppler Observation of blood flow in patients with liver and hemodynamics were measured. And efforts to identify these relationship among syndromes,the liver function,hepatic fibrosis,PGA index and image changes.Result:This study investigated 300 cases of patients with liver cirrhosis, including 190 cases of men(or 63.3%),female 110 cases(36.4%),patients with 22-year-old minimum age,maximum age 70 years old,the average age of 50.4 years old,patients with liver cirrhosis more concentrated in 40 to 60-year-old stage.215 cases of HBV,hepatitis C virus infection in 82 cases,three cases of hepatitis C infection and hepatitis B;a clear family history of the 204 cases,a clear history of 51 cases of blood transfusion,infection 45 cases of unknown.174 cases of decompensated patients,patients with decompensated 126 cases;Child A class patients with 98 cases,Child B class 92 cases,C-class 110 cases;there have been 43 cases of patients with splenectomy;108 patients the first attending was diagnosed cirrhosis,which in 58 cases of decompensation period;those 153 cases of ascites due to cirrhosis is definite.The most often clinical symptoms observed in this study was weak,with 91.0%of patients with different levels of performance,perhaps even more evident in 51%;knee flabby or low back pain accounted for 83.7%;237 cases of pulse string,accounting for 75%;pain accounted for 67.7%.Occuring more frequently with yellow skin and yellow urine accout for 66.0%;flank exertion pain 61.3%;yellow greasy moss 54.7%, 54.0%short urine;tongue thin white 48.3%;the 40.7%of eyes dry;mamillata less cover on the tongue 34%;pulse slip or slide string account for 95 cases,accounting for 31.7%;thin and fast pulse accounted for 31.3%;oliguria accounted for 31.0%;upper abdomen bloating and nausea 30%;hot or low fever 29%;flank burning sore accounted for 28.7%.There are 55.7%of patients change in stool traits,of which 84 cases have pond,accounting for 28%,then dry and hard or sticky 83 cases of discrepancy,accounting for 27.7%;the rest have symptoms of lower extremity edema, nausea,vomiting evil face Leahey dark,dark purple tongue or blockage point, Shibuya or hollow fine veins,swelling of the liver swell flank pain.Chinese medicine diagnosis is divided into six types,and its distribution is as follows:24 cases of liver pent-up syndrome,accounting for 8%;42 cases of spleen deficiency wet syndrome, accounting for 14%;66 cases of intrinsic heat and damp,accounting for 22%; liver-yin and kidney-yin deficiency 70 cases,accounting for 23.3%;36 cases of Spleen-Yang and Kidney-Yang Deficiency 12%;62 cases of blood stasis syndrome, accounting for 20.7%.Comparison of TCM Syndrome Types with the Child-pugh suggested that liver pent-up lied in A class,accounting for 88.9%,with other significant difference(P＜0.05),no C-class patients;and liver-yin and kidney-yin deficiency,spleen and kidney yang deficiency,blood stasis mainly concluded to C-grade,accounted for 61.52%,83.3%,75%,respectively,with another three syndromes were significantly different(P＜0.05).ALT,AST of patients with intrinsic heat increased than those of other significantly,compared with patients with blood stasis syndrome,the difference was statistically significant(P＜0.01);Alb of liver pent-up had no reduction in the normal,while Alb of the others decrease,particularly of liver-yin kidney-yin deficiency and syndorme of spleen-yang and kidney yang deficiency.HA binding to blood stasis and syndrome of heat and damp were significantly different(P＜0.05) compared with other symptoms,but the two groups had no significant difference(P＞0.05),there was no difference between spleen-yang and kidney-yang deficiency, liver-yin and kidney yin deficiency.PⅢP,C-Ⅳand HA have similar features,there is no parallel relationship.PGA index between the various syndromes were significaatly different,particularly supremly in the liver-yin and kidney-yin deficiency,blood stasis is followed,and the heat is not the highest intrinsic evidence,this is different between the indicator of liver fibrosis.Conclusion:The syndrome of intrinsic heat and damp in hepatic cirrhosis patients mostly get along with clear multi-period,active immune response,severe liver cell damage,resulting in transaminase increased significantly.Liver-yin and kidney-yin deficiency and syndrome of spleen-yang and kidney-Yang deficiency are often found in end-stage liver disease due to prolonged,lingering illness,liver synthetic function, digestion and absorption dysfunction also prevented the supply of human normal nutrition,resulting in the albumin in patients with two types of syndromes than the other types,and the syndrome of pent-up liver disease was particularly prevalent in shorter in patients with less severe diseases,decompensated liver function is still better than the normal albumin levels,and had no significant decline.Syndrome Types of cirrhosis of TCM with laboratory indicators,liver function,hepatic fibrosis, PGA index and the changes in imaging is intrinsically linked to each other.Those values can significantly increase the detection of objective sensitivity and specificity of liver cirrhosis syndrome differentiation,it also can use to guide our clinical differentiation.