| BackgroundHepatic cirrhosis is a common chronic progressive disease caused by one or several factors, its pathology is characterized by liver fibrosis, pseudolobule, macronodular,and portal hypertension and liver function failure are the clinic character. Hundreds of thousands of people die of hepatic cirrhosis every year over the world.Studing the TCM syndrome differentiation types can reveal the essence of "TCM syndrome" in hepatic cirrhosis, whose law of evolution may reflect the pathology changes in different periods of cirrhosis. When the hepatic factors injury the hepatic cells, the cells damage and edema, sustainable or repeated inflammation gives rise to the proliferation of hepatic fiber. As it cannot degrade completely, it progresses to hepatic fibrosis, and it becomes hepatic cirrhosis finally. So the hepatic fiber proliferation is one of the characters of the pathology changes in hepatic cirrhosis. Therefore, we use stereological techniques to quantify the degree of hepatic fiber proliferation in different periods of cirrhosis, and we explore the relationship between it and TCM syndrome differentiation types.ObjectiveThe study is to explore the correlation between the degree of hepatic fiber proliferation and TCM syndrome differentiation types in different periods of cirrhosis.Methods41researching subjects were admitted,31men and10women, whose average age was49years old.29cases in hepatic cirrhosis group(13cases in compensatory period of pre-clinical group (CPPG),12cases in compensated period of clinical group (CPCG),4cases in decompensated period group (DPG)) and9cases in non-liver disease group (NLDG),3cases in chronic hepatitis group (CHG). The TCM experts give the TCM syndrome differentiation types. By way of laparoscope or laparotomy, the liver tissues were available, then HE and Masson stained before observed under the light microscope. At last, we used the Image Pro Premier V9.0to analyze the ratio of the area of hepatic fiber proliferation, that is to say the percentage of the area of hepatic fiber proliferation in one view. We mainly used descriptive statistics method, ratio or constituent ratio was showed in the enumeration data, mean±tandard deviation was showed in the measurement data, rank correlation ananlysis was used to analyze the relationship, the test level a is=0.05.ResultsWith regard to the ratio of the area of hepatic fiber proliferation in cirrhosis group, the ratio of hepatic fiber proliferation in "DPG" is the largest (20.72±18.46) and "CPCG" followed by (17.96±11.38),"CPPG" lower (17.64±10.26). The data above reveals that the degree of hepatic fiber proliferation varies from "CPPG" to "DPG". It is relevant to the different periods of cirrhosis, which demonstrates the progression in hepatic cirrhosis.With regard to the relationship between TCM syndrome differentiation types and the degree of hepatic fiber proliferation in different periods of cirrhosis, In the "CPPG", the ratio of the area of hepatic fiber proliferation from large to small is,"obstruction of collaterals by blood stasis (OCBS)"(28.96±0.00),"endoretention of damp heat (ERDH)"(26.17±10.82),"depression of liver-QI(DOL-QI)"(13.02±7.61). In the "CPCG", the ratio of the area of hepatic fiber proliferation from large to small is,"asdthenic splenonephro-yang (ASN-yang)"(42.23±0.00),"depression of liver-QI(DOL-QI)"(20.75±6.60),"obstruction of collaterals by blood stasis (OCBS)"(16.76±10.53),"stagnation of fluid-dampness (SFD)"(6.81±4.47). In the "DPG", the ratio of the area of hepatic fiber proliferation from large to small is,"hepatic and renal yin deficiency (HRYD)"(36.71±0.18),"depression of liver-QI(DOL-QI)"(5.28±0.00),"asdthenic splenonephro-yang (ASN-yang)"(4.19±0.00). The data above reveals that the people in the "CPPG" with "endoretention of damp heat (ERDH)" or "obstruction of collaterals by blood stasis (OCBS)" may have the larger the ratio of the area of hepatic fiber proliferation, the people in the "CPCG" with "asdthenic splenonephro-yang(ASN-yang)" may have the larger the ratio of the area of hepatic fiber proliferation and the people in the "DPG" with "hepatic and renal yin deficiency (HRYD)" may have the larger the ratio of the area of hepatic fiber proliferation.Conclusion1. This study uses the ratio of the area of hepatic fiber proliferation for measurement index, it fits well with the clinical periods of cirrhosis, which can reveal the clinical degree of hepatic cirrhosis and makes sense to clinical practice.2. In this study, when the patients who suffer from the hepatic cirrhosis present clinical symptoms of "depression of liver-QI(DOL-QI)" or "stagnation of fluid-dampness (SFD)", it reflects the slight degree of hepatic fiber proliferation. When they present clinical symptoms of "endoretention of damp heat(ERDH)" or "obstruction of collaterals by blood stasis(OGBS)", it reflects the obvious degree of hepatic fiber proliferation. When they present clinical symptoms of "asdthenic splenonephro-yang(ASN-yang)" or "hepatic and renal yin deficiency (HRYD)", it reflects the serious degree of hepatic fiber proliferation. In the different periods of cirrhosis,the relationship may be similar to the above between the characters of TCM syndrome differentiation types and the degree of hepatic fiber proliferation. |
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