Clinical Study On TCM Pathogenesis Factors Distribution Characteristics In Different Course Of Chronic Liver Disease

"Chronic liver disease(CLD),liver fibrosis,liver cirrhosis or hepatocellular carcinoma" is many patients with chronic liver disease most fear.How to block or delay the process of the CLD,is the most important scientific problems of the CLD in TCM and western medicine.After30years,people more had studied on the objective and the standardization of the CLD syndrome,or on a medicine effect assessment and mechanism research.The researches on the CLD in the process of evolution law are the lack of depth.lt is not able to guide formed more clinical application of the syndrome differentiation and treatment of the CLD ideas and methods.Therefore,this study is aimed at these problems,which is supported by the nature science fund project of Jiangsu Province(BK2010563) and Nanjing University of TCM basic research and cultivate special fund project(09XJC03).Objective:Through the prospective, large sample clinical epidemiology investigation, this paper discusses the pathogenesis syndrome factors of the dampness,heat,blood stasis,toxin,depression and liver and spleen and kidney in the process of the distribution characteristics of the CLD different stages, and the correlation between them,thus the combination and transformation law of CLD pathogenesis factors.So as to prove the "dampness-heat-blood-stasis-toxin"composite pathogenesis is the CLD pathogenesis of basic features.Methods:(1)Theory study:Of TCM and western medicine were about the CLD in the process of the research literature review,based on the overall concept of TCM and syndrome differentiation idea.This research expatiate on the dampness,heat,blood stasis,toxin,depression and deficiency of qi and ying and yang of the CLD,such as main pathogenesis factors’ transformation and compound of a precise definition of learning mechanism.(2)Clinical research:①In reference to the <TCM Syndrome Differentiation Standards of the Viral Hepatitis>,<the Chinese herbal medicine new medicine clinical research guiding principle>,<the syndrome factor dialectical study> writed by Zhu Wenfeng Professor,and expert experience.On the basis of the survey through,this research establishes the main pathogenesis factors identification method of the CLD.②Employing the multi-center,large sample,the prospective clinical epidemiological study,this research chooses six different course stage patients of the CLD,investigating the four diagnostic informations and laboratory indicators,etc.By the Epidata database software basing on the "chronic liver disease pathogenesis syndrome factor and clinical investigation information collection system", the Stata9and SPSS17.0statistical analyzing software, this paper discusses the different stages of the CLD pathogenesis factor distribution characteristics and relevance.Results:(1)The survey each model in1003patients with CLD, the men and women than1.8:1, with young age35to65years mainly, the course of1～5years to for the most, followed by5～10years;(2)Chronic liver disease of different stage has the common syndromes:such as fatigues,anorexia,dry mouth,chest hypochondriac pain and yellow urine;(3)The clinical syndrome characteristics of dampness,heat,blood stasis,toxin,depression exist objectively,as the extension of course or the deterioration of the illness,blood stasis-heat pathogenesis and kidney yin deficiency syndrome factor proportion are increasing gradually,and they have nothing to do with age and sex.(4)Involving pathogenesis factors,as dampness,heat,qi depression,qi deficiency are given priority to, appearing frequency in turn is heat>qi deficiency>yin deficiency>dampness> qi depression>yang deficiency>blood stasis. Among them,the dampness,heat, blood stasis in proportion of80.86%, 88.63%and66.30%respectively;(5)spleen-stomach qi deficiency syndrome factors in the age of less than65-year-old patients is always in the top three, but in65after the age of spleen-stomach qi deficiency, blood stasis, liver-kidney Yin deficiency the pathogenesis syndrome factors are similar proportion.(6) by physical and chemical index, anti-retroviral therapy and pathogenesis, syndrome factor are no significant correlation among them.Conclusions:(1)Among the CLD patients,men are more than women,more common in young and middle-aged.The CLD has a long course.(2)The common informations of the CLD syndrome characteristics in order:fatigues,anorexia,dry mouth,hypochondriac pain in stomach and chest,yellow urine,irritable,irritability,insomnia,bitter taste,chest dull pain,abdominal distension,looking gloomy,etc.(3)The longer the duration,the performances of blood stasis and liver-kidney yin deficiency are the more proportion.(4)The heat syndrome such as dry mouth,bitter taste,irritable,exists in the course of the whole,and in serious condition levels.(5)In the pathogenesis syndrome factor "heat" and "qi deficiency" accounting for primary status, the second is "dampness", dampness-heat exists in the whole process of the CLD.Blood stasis-heat pathogenesis and severe disease degree and course are closely related.(6)The study found that CLD pathogenesis syndrome factor and physical and chemical examination index has some correlations between, but are not specific.(7)The CLD clinical features are:main syndrome is multifarious, it is difficult to use a single factor to explain all of its clinical manifestations.(8)The CLD of different stages of the basic pathogenesis evolution features are: dampness-heat-blood-stasis-toxin composite pathogenesis is always existed throughout.All in all, this study proves that the activation of the CLD is caused by multiple factors.Dampness-heat-blood-stasis-toxin composite pathogenesis is always existed throughout,and it is each CLD pathogenesis basic characteristics.