The Investigation Of Risk Factors And The Distribution Of TCM Symptoms About MHE

Objective: Through the clinical investigation and literature research,understand the incidence of minimal hepatic encephalopathy in patients with Cirrhosis(minimal hepatic encephalopathy,MHE),and analyze the related risk factors;Observe the traditional chinese medicine(traditional chinese medicine,TCM)syndrome type distribution characteristics of MHE,summed up the law,to guide clinical treatment.Methods: Selecte the 354 cases with cirrhosis met the inclusion criteria and exclusion criteria,refer to the 2013 china consensus opinion of diagnosis and treatment of hepatic encephalopathy in the diagnosis of MHE, including digital connection test-A(number connection test A,NCT-A)and digit symbol test,digit symbol test,DST), Determine which one conform to the MHE.Collect the related data of clinical laboratory examination, including routine blood,liver and kidney function,blood coagulation function,blood ammonia,abdominal imaging,clear cirrhosis diagnosis and determine the presence of ascites,carry on the classification combined with the clinical manifestation and the liver function, including grade A, B, C, combined with the presence of complications can be divided into compensation period and decompensation period.Combined with Logistic regression analysis to analyze the related risk factors for MHE.Patients diagnosed with MHE, give the four diagnostic parameter, and combination of disease and syndrome differentiation,according to the consensus opinion of liver cirrhosis combined with traditional Chinese and western medicine diagnosis and treatment about 2011 decision of TCM syndrome types,observe the MHE TCM syndrome distribution. Results: 1. A diagnosis method for NCT- A, DST, the Positive rate about this group of MHE in patients with cirrhosis is 35.30%;The incidence of Child- Pugh A is 24.30%;The Child- Pugh class B incidence is 39.60%;Incidence of Child- Pugh C level is 60.90%;Compensatory phase cirrhosis MHE positive rate was 14.80%, and patients with decompensated cirrhosis MHE positive rate was 46.90%.2.χ2 test results:Liver function Child- Pugh,class B and C,decompensation period,and higher blood ammonia,Compared with Child- Pugh,grade A level, compensatory period, and when blood ammonia is normal,the MHE positive increased significantly(each χ2 test P < 0.05);Logistic regression analysis results show: blood ammonia and MHE are correlate(P < 0.05).But the correlation of sex, age, cause of cirrhosis of the liver and the MHE has no statistical significance(P > 0.05).3.This study about 125 cases of patients diagnosed with MHE through two groups of psychometric test,and the syndromes distribution respectively: Type diseases with ease35 cases(28.00%), wet resistance type 34 cases(27.20%), damp and hot accumulate knot type 26 cases(20.80%), blood stasis resistance type winding 19 cases(15.20%), 10 cases of liver and kidney Yin deficiency type(8.00%), spleen and kidney Yang deficiency type 1 case(0.80%).4.Though the internal symptoms of TCM,the MHE positive rate:Blood stasis resistance winding type are 27 cases, but 19 cases are diagnosed with MHE, positive rate is 70.37%; MHE is 34 cases about 68 cases of wet resistance type, positive rate is 50.00%;52 cases of damp and hot accumulate knot type, MHE is 26 patients, positive rate is 50.00%;Liver and kidney Yin deficiency type of 27 cases, 10 cases of MHE positie,positive rate is 37.04%;The spleen kidney Yang deficiency type 4 cases,1 case of MHE positie, positive rate is 25.00%;Type of diseases with ease 176 cases, 35 cases of MHE positie, positive rate was 19.89%.Conclusion: 1. This study found that the age of patients with liver cirrhosis is concentrated in the 46 years of age or older, accounted for 71.75%, and more men than women obviously.2.This study found that the virus infection(hepatitis b virus(HBV), hepatitis c virus(HCV) in 297 patients, leading to cirrhosis of the liver(83.90%), mainly liver cirrhosis after HBV infection;Other reasons lead to cirrhosis of the liver only 57 cases, accounting for 16.10%,which consistent with the reality of our country is biggest with HBV.3.A diagnosis method for NCT- A, DST, this group of patients with cirrhosis MHE positive rate was 35.30%;One Child- pugh, grade A MHE positive rate was 24.30%, the class B is 39.60%, class C is 60.90%;Compensatory phase cirrhosis MHE positive rate was 14.80%, and patients with decompensated cirrhosis MHE positive rate was 46.90%.4.Combined with single factor chi-square and multiariate Logistic regression analysis, the result shows: the blood ammonia, stage compensated or decompensated cirrhosis is positively correlated with MHE;Liver Child- Pugh score in a certain extent, affects the MHE disease;The age, sex, causes of cirrhosis of the liver, and cultural degree with MHE has no correlation.5.In this study,354 patients with cirrhosis of TCM syndrome types of frequency from high to low in turn: type of diseases with ease(49.72%), water wet resistance type(19.21%), damp and hot accumulate knot type(14.69%), blood stasis resistance winding type(7.63%), liver and kidney Yin deficiency type(7.63%), spleen and kidney Yang deficiency type(1.13%).By 125 patients diagnosed with MHE clearly, the frequencies of the syndrome types from high to low in turn: type of diseases with ease(28.00%),wet resistance type(27.20%),damp and hot accumulate knot type(20.80%), blood stasis resistance winding type(15.20%), liver and kidney Yin deficiency type(8.00%), spleen and kidney Yang deficiency type(0.80%).And this study TCM syndrome type distribution of patients with liver cirrhosis with consistency.6.Analysis of various symptoms MHE positive rate of blood stasis type winding resistance(a total of 27 cases, MHE 19 cases, positive rate was 70.37%), water wet resistance type(a total of 68 cases, MHE 34 cases, positive rate was 50.00%), damp and hot accumulate knot type(a total of 52 cases, MHE 26 patients, positive rate was 50.00%), liver and kidney Yin deficiency type(a total of 27 cases, 10 cases of MHE, positive rate was 37.04%), spleen kidney Yang deficiency type(4 cases, 1 case was MHE, positive rate is 25%), diseases with ease type(a total of 176 cases, MHE 35 cases, positive rate was 19.89%).clearly, blood stasis type wet type winding resistance, water resistance and damp and hot accumulate knot are more likely to merge MHE, speculated that blood stasis, wet, wet and heat was the main pathology of pathogenic factors.7.MHE of high incidence status in patients with cirrhosis should get the The attention of the corresponding, should be filtered for MHE high-risk groups, do not disease prevention first, both Hyman, effectively prevent its further development to HE, improve prognosis, reduce the acute event related.