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目的:在辨证与辨病相结合的基础上探究垂体甲状腺轴激素指标与肝炎肝硬化辨证分型及Child-Pugh分级的相关性。方法:选取120例肝炎肝硬化患者进行辨证分型并按Child-Pugh分级法进行分级,分组检测T3、T4r、T3、FT3、FT4及TSH水平并与正常对照组30例相应指标进行比较。结果:脾虚湿盛、湿热内蕴、脾肾阳虚组T3、FT3降低及rT3升高,与肝肾阴虚组、肝气郁结组、对照组比较具有显著性差异(P<0.01);T3、FT3、FT4水平在Child-pugh A、B、C 3级中呈逐渐下降趋势,rT3水平呈逐级上升趋势,各组间有显著性差异(P<0.01或0.05)。结论:血清垂体甲状腺轴激素与肝硬化中医证型具有一定的相关性。垂体甲状腺轴激素水平的变化可以反映肝硬化患者的病情程度及预后。
OBJECTIVE: To explore the correlation between pituitary thyroid axis hormones and syndrome differentiation of liver cirrhosis and Child-Pugh classification based on the combination of syndrome differentiation and disease differentiation. Methods: One hundred and twenty patients with cirrhosis of liver were selected for syndrome differentiation and classified according to Child-Pugh classification. The levels of T3, T4r, T3, FT3, FT4 and TSH were detected by grouping and compared with those of normal control group. Results: The spleen deficiency, damp-heat content, spleen and kidney yang deficiency group T3, FT3 decreased and rT3 increased, and liver and kidney yin deficiency group, liver qi stagnation group and the control group had significant difference (P <0.01) FT3 and FT4 levels gradually decreased in Child-pugh A, B and C 3 levels, while rT3 levels showed a gradual upward trend with significant differences (P <0.01 or 0.05). Conclusion: Serum pituitary thyroid hormone and cirrhosis of the TCM syndrome has a certain correlation. Pituitary thyroid axis hormone levels can reflect the severity of patients with cirrhosis and prognosis.