Study On The Correlation Between The Ultrasonic Feature Or Lab-measuing Indexes And The Syndrome Types Of TCM Of Hepatic Cirrhosis

Objective: This study is due to investigate the relationship between ultrasound sonogram feature, lab-measuing indexes, Child-Pugh degree of patients with hepatic cirrhosis and syndrome differentiation of TCM, and approach the correlation between "syndromes" of TCM and modern medical objective indexes of patients with cirrhosis.Methods: One hundred and fifty cases of hepatic cirrhosis with different syndromes were included in the study. The diagnostic standard of patients with hepatic cirrhosis refered to the proposal of prevention and cure of viral hepatitis, and syndrome differentiation of TCM refered to the stand-ard that was formulated by the fifth Chinese academy of integrated tradi-tional and western medicine on special committee of disease of digestive system, including six syndromes, stagnation of liver Qi, internal accumu-lafion of damp-heat, superabounce of dampness due to spleen,asthenia, asthenia of liver and kidney Yin, asthenia of spleen and kidney Yang and the blood stasis syndrome. The largest occipitomental diameter and anteroposterior diameter Of right hepatic lobe, the length and anteroposterior diameter of left hepatic lobe, the diameters and average blood flow velocity of the portal vein and splenic vein, the thickness and length of spleen and hydr-operitoneum were tested by color Doppler sonarography. As well as the volumes of blood flow of hepatic portal vein and splenic vein were calcu-lated. Lab-measuing indexes included alanine aminotransferase (ALT), aspartate aminotransferase (AST),serum total biiirubin (STB), serum total protein(STP),aibumin(ALB),A/G and prothrombin activity (PTA). Hepatic functional assessment was graded according to Child- Pugh score. The quantitated indexes were analyzed with one-factor analysis of variance of statistical software of SPSS 11.5 edition. The analyses of rate apply to chi-square test.Results: 1. To study the size of liver and spleen in hepatic cirrhosis patients with different syndromes showed: The largest oblique diameter and anteroposterior diameter of right hepatic lobe, and the length diameter of left hepatic lobe in hepatic cirrhosis patients with different syndromes were not different. The antero-posterior diameter of left hepatic lobe in patients with the blood stasis syndrome was significantly different to that of stag-nation of liver Qi and asthenia of liver and kidney Yin, respectively (p<0.05).The thickness of spleen in patients with internal accumulation of damp-heat syndrome was different to that of the blood stasis syndrome.2. To study the portal venous flow kinetic parameter in patients with different syndromes showed: The diameter of the main portal vein in patients with internal accumulation of damp-heat was significantly different to that of the hepatic and renal Yin deficiency, or the asthenia of spleen and kidney Yang, or the blood stasis syndrome, respectively (p<0.05).The blood flow velocities and the flow volumes of the portal vein in patients with the blood stasis syndrome were significantly different to those of the stagnation of liver Qi(p<0.01).The diameters ,the blood flow velocities and flow volumes of the splenic vein in patients with different syndromes were not significantly different. 3. To study the relationship between syndrome in hepatic cirrhosis patients and Child-Pugh grade showed: hepatic cirrhosis patients with internal accumulation of damp-heat or stagnation of liver Qi were mostly in grade A, and had significant difference to the patients with asthenia of spleen and kidney Yang and the blood stasis syndrome(p<0.05). Hepatic cirrhosis patients with asthenia of spleen and kidney Yang and the blood stasis syndrome were mostly in grade C, and had significant difference to the patients with internal accumulation of damp-heat(p<0.05).4. To study hepatic function in cirrhosis patients with different syndromes showed: ALT and AST were both increased, and those in patients with internal accumulation of damp-heat syndrome were highest. TP in patients with stagnation of liver Qi were different to that of the blood stasis syndrome. ALB in patients with asthenia of liver and kidney Yin and asthenia of spleen and kidney Yang were different to that of stagnation of liver Qi and internal accumulation of damp-heat syndromes. A/G in patients with the blood stasis syndrome were different to that of asthenia of liver and kidney Yin and asthenia of spleen and kidney Yang syndromes.Conclusion: Ultrasonograph and lab-measuing indexes had an important guide sense to the syndrome differentiation of hepatic cirrhosis. The types of syndrome in hepatic cirrhosis patients were different, as well as the degree of hepatic lesion was inequality. Kinetics of the venous flow, hepatic function and Child-Pugh grading changed ccorrespondingly. And those changes were coincident to the changes of syndromes in hepatic cirrhosis patients. In earlier period, the patients with hepatic cirrhosis were mainly in internal accumulation of damp-heat, stagnation of liver Qi. In advanced stage, the patients with hepatic cirrhosis were mainly in the blood stasis syndrome and asthenia of spleen and kidney Yang . The diameters of the portal vein were gradually widen, and the blood flow velocity the diameters and average blood flow velocity of portal vein stped down gradually. In hepatic cirrhosis patients with blood stasis syndrome, the thickness of the spleen were significantly different. According to the changes of pathogenetic condition and the development of syndromes, hepatic function of patients were gradually aggravated.