卢冬冬 张翼宙

【摘 要】 目的：觀察不同Child-Pugh分级肝硬化患者中医体质类型分布。 方法：以王琦《中医体质分类与判定》为标准，对肝硬化患者通过问卷调查的方式收集相关资料。利用Epidate 3.1建立数据库，通过SPSS19.0软件进行统计分析。结果：Child-Pugh A级的肝硬化患者中医体质以平和质（41.03%）和气郁质（20.51%）居多。Child-Pugh B级的肝硬化患者中医体质以气虚质（26.92%）、阳虚质（21.82%）居多；Child-Pugh C级的肝硬化患者中医体质以气虚质（28.57%）、阴虚质（25.71%）、湿热质（17.14%）居多。结论：①气虚质、阳虚质、阴虚质为肝硬化患者最常见偏颇体质。②Child-Pugh A级肝硬化患者正气或阴阳损及不明显。③Child-Pugh B级肝硬化患者已损及正气和阳气。④Child-Pugh C级肝硬化患者已损及到正气和阴液，或湿困日久化热。⑤对于Child-PughA级肝硬化患者可予调和阴阳，强身健体或疏肝理气，解郁散结；Child-Pugh B级肝硬化患者可予益气健脾，益火温阳；Child-Pugh C级肝硬化患者则以健脾补气，滋阴补肾或清热利湿。

【关键词】 肝硬化；Child-Pugh分级；中医体质

【中图分类号】R575.2 【文献标志码】 A【文章编号】1007-8517（2018）15-0001-04

Abstract：Objective This research aims to study the TCM constitution of liver cirrhosis patients with different Child-Pugh grading. Methods Questionnaire survey was used for the research， and questionnaire was designed to use “Chinese constitution classification and determination” as the standard. Patients with liver cirrhosis were investigated by way of questionnaires to collect research data. After the data were collected and arranged， a database was established by using Epidate 3.1 software and analyzed by using SPSS19.0 software. Results Child-Pugh A degree patients with liver cirrhosis mainly appeared normal constitution （41.03%）， followed by qi stagnation constitution（20.51%）. Child-Pugh B degree patients with liver cirrhosis mainly appeared qi deficiency constitution （26.92%）， followed by yang deficiency constitution （21.82%）. Child-Pugh C degree patients with liver cirrhosis mainly appeared qi deficiency constitution （28.57%）， followed by yin deficiency constitution（25.71%） and dampness heat constitution（17.14%）. Conclusion ① Qi deficiency， yang deficiency and yin deficiency are most common biased constitution of sick person with liver cirrhosis. ②Child-Pugh A degree patients with liver cirrhosis are not hurted to Vital qi or Yin and Yang. ③Child-Pugh B degree patients with liver cirrhosis are harmed to Vital qi and Yang. ④Child-Pugh C degree patients with liver cirrhosis are injured to Vital qi and Yin，or heat on account of damp.⑤The Child-Pugh A degree patients with liver cirrhosis are interfered with regulating Yin and Yang， build their body or soothing liver qi， resolve depression fights； The Child-Pugh B degree patients are nursed with nourishing qi to invigorate spleen， warming yang； The Child-Pugh C degree patients are interfered with nourishing qi， enriching Yin or clearing heat and promoting diuresis.

Keywords：Liver Cirrhosis； Child-Pugh Grade； TCM Constitution

肝硬化是各种慢性肝病发展的最终阶段，具有起病隐匿，发展缓慢，后期常出现多种并发症，具有发病率高、病程长、预后差的特点。在世界范围内，其年发病率为100（25～400）/10万[1]。早期由于肝脏的代偿功能，可无明显临床症状，失代偿期则会出现由肝功能障碍和门脉高压症所引起的一系列临床症状。目前常用的评估肝硬化患者肝脏储备功能的方法为Child-Pugh分级法，其分级的确立对临床防治肝硬化有重要意义。肝硬化患者病情持续进展，积极采取能预防肝硬化的发生、延缓肝硬化病情进展的方法，则尤为重要。……