| Hepatic cirrhosis is a common type of chronic hepatopathy that is characteristic of hepatic lobule damage and circulatory disturbance in liver caused by diffuse hepatic cells leading to diffuse hyperplasia fiber texture and tubercles. Hepatic cirrhosis suffers usually accompany bleeding tendency, whosespecific manifestation is gum bleeding, nosebleed, skin ecchymosis, haematemesis, hematochezia, etc. The ruptured esophageal gastric varices bleeding is a serious bleeding endanger the patient lives. Through literature research, blood platelet count(PLT),the reducing platelet count (PLT) and the severity of the dysfunction of blood coagulation system can be used as judgment bleeding tendency to judge condition and prognosis of patients with liver cirrhosis. Research of traditional Chinese medicine thinks the platelet count and blood coagulation system function index of abnormal most closely relationship with temper deficiency and blood stasis. But traditional Chinese medicine lacks of large sample of clinical epidemiological investigation. Hense through this study collected 787 patients with hepatitis cirrhosis PLT and 758 patients with hepatitis cirrhosis prothrombin time (PT) prothrombin activity (PTA), prothrombin time ratio (INR), and other laboratory index, and record the patients symptoms (general symptoms, tongue manifestation, pulse condition), find symptoms distribution characteristics of the abnormity of platelet count and blood coagulation system function, further search for its pathogenesis in TCM.ObjectiveThrough the system fully for clinical symptoms collection in patients with cirrhosis of the liver, explore the characteristics of distribution of sympotom in the platelet count and blood coagulation system index between normal and abnormal in the abnormal platelet and blood coagulation system function in patients with hepatitis cirrhosisMethodBy adopting the method of clinical epidemiological cross-sectional survey, in the research, we developed TCM four diagnostic information collection table, selected standard hepatitis cirrhosis, recorded its general symptoms TCM four diagnostic information, detected and recorded the platelet count and blood coagulation indexes. Then, we seted up a database, analyzed data by SPSS2.0 statistical software, and analyzed the single symptom(general symptoms, tongue manifestation,pulse condition)by chi-square rank and non-parametric test between the various indicators. Finally, summarize the characteristics of distribution of sympotom in the platelet count and blood coagulation system index between normal and abnormal in the abnormal platelet and blood coagulation system function in patients with hepatitis cirrhosisResult1. Symptoms of distribution between patients with hepatitis cirrhosis whose PLT decreasing and not reducing.1.1 Generally (patients with hepatitis cirrhosis of the liver weren’t satratified by compensatory or decompensation)General symptoms:The frequency or degree of greenish yellow complexion, dark complexion, edema, liver palms, spiritlessness, weakness, laziness to speak, skin itching, gloomy complexion, nausea, stomach heaviness, abdominal heaviness, anorexia, anaerobic greasy, hypourocrinia, night urination much, sex hypoplasia in the patients with PLT decreasing were higher or more serious; The frequency or degree of rib-side distention, hypochondriac pain, irascibility, tinnitus in the patients who were not reduced in PLT were higher or more serious.Tongue manifestation:The frequency of fissured tongue in the patients with PLT decreasing was higher or more serious.Pulse condition:Two groups of pulse condition was no statistical significance.1.2 Compensated stageGeneral symptoms:The frequency or degree of dark complexion, liver palms, spiritlessness, gloomy complexion, anorexia in the patients with PLT decreasing were higher or more serious.Tongue manifestation:The frequency of purple-red tongue and thin tongue in the patients with PLT decreasing was higher.Pulse condition:The frequency of relaxed pulse in the patients with PLT decreasing was higher.1.3 Decompensated stageGeneral symptoms:The frequency or degree of fever feeling, spider nevus, rib-side distention, emaciation, night sweat, tinnitus, vomit, tastelessness in the mouth, salty taste in the patients with PLT decreasing were higher or more serious.Tongue manifestation:The frequency of pale tongue and old tongue in the patients with PLT decreasing was higher; The frequency of teeth-printed tongue and ecchymosis tongue in the patients with PLT no decreasing was higher.Pulse condition:Two groups of pulse condition was no statistical significance.2. Symptoms of distribution between patients with hepatitis cirrhosis whose blood coagulation function normal and abnormal.2. lSymptoms of distribution between patients with hepatitis cirrhosis whose PT prolonging and not prolonging2.1. lGenerally (patients with hepatitis cirrhosis of the liver weren’t satratified by compensatory or decompensation)General symptoms:The frequency or degree of fever, greenish yellow complexion, yellowish black complexion, edema, spider nevus, stool irregularities, deep yellow color of urine, spiritlessness, weakness, laziness to speak, emaciation, gloomy complexion, dizzy, nausea, vomit, stomach heaviness, abdominal heaviness, anorexia, anaerobic greasy, constipation, loose stool, hypourocrinia, night urination much,sex hypoplasia in the patients with PT prolonging were higher or more serious; The frequency or degree of fever feeling, red complexion, light black complexion, rib-side distention, hypochondriac pain, spontaneous perspiration, night sweat, irascibility, dry eye, tinnitus in the patients with PT not prolonging were higher or more serious.Tongue manifestation:The frequency of pale tongue and bulgy tongue, thick fur in the patients with PT prolonging was higher; The frequency of thin tonguein the patients with PT not prolonging was higher.Pulse conditionThe frequency of rapidpulse and slipperypulse in the patients with PT prolonging was higher; The frequency of relaxed pulse in the patients with PT not prolonging was higher.2.1.2CompensatedstageGeneral symptoms:The frequency or degree of edema, abdominal heaviness, anorexia, anaerobic greasy, hypourocriniain the patients with PT prolonging were higher or more serious; The degree of spontaneous perspirationin the patients with PT prolonging was more serious.Tongue manifestation:Two groups of tongue condition was no statistical significance. Pulse condition:Two groups of pulse condition was no statistical significance.2.1.3DecompensatedstageGeneral symptoms:The frequency or degree of yellowish black complexion,edema,deep yellow color of urine, spiritlessness, weakness, gloomy complexion, dizzy, nausea, abdominal heaviness, anorexia, insomnia, hypourocrinia in the patients with PT prolonging were higher or more serious; The frequency or degree of fever feeling, rib-side distention, hypochondriacpain, stool irregularities, night sweat, irascibility, dry eye, tinnitusin the patients with PT not prolonging were higher or more serious.Tongue manifestation:The frequency of pale tongue in the patients with PT prolonging was higher; The frequency of purple-red tongue, thin tongue and ecchymosis tongue in the patients with PT not prolonging was higher.Pulse condition:The frequency of slipperypulsein the patients with PT prolonging was higher; The frequency of tight pulse in the patients with PT not prolonging was higher.2.2 Symptoms of distribution between patients with hepatitis cirrhosis whose PTA reducing and not reducing.2.2.1 Generally(patients with hepatitis cirrhosis of the liver weren’t satratified by compensatory or decompensation)General symptoms:The frequency or degree of susceptible to colds, fever, bluish yellowcomplexion, yellowish black complexion, edema, spidernevus, thirst, Deep yellow color of urine, spiritlessness, weakness, laziness to speak,emaciation,scaly dry skin, Skin itching, gloomycomplexion, dizzy, sigh, nausea, vomit, belching, stomach heaviness, abdominal heaviness, anorexia, anaerobic greasy, tastelessnessinthemouth, oropharyngeal drying, diarrhoea,constipation,loose stool,hypourocrinia,night urination much in the patients with PTA reducing were higher or more serious; The frequency or degree of red complexion, hypochondriacpain, irascibility in the patients with PTA not reducing were higher or more serious.Tongue manifestation:The frequency of old tongue, teeth-printed tongue, fissured tongue, abnormal sublingual collaterals (obvious/long/thick/ circuitous/sad colored sublingual collaterals), yellow tongue fur and thick fur in the patients with PTA reducing was higher.Pulse condition:The frequency of rapid pulse and slippery pulse in the patients with PTA reducing was higher.2.2.2CompensatedstageGeneral symptoms:The frequency or degree of edema,spider nevus, liver palms,rib-side distention, spiritlessness, lazinesstospeak, tinnitus, abdominal heaviness, anorexia, anaerobic greasy, loosestool, hypourocrinia in the patients with PTA not reducing were higher or more serious.Tongue manifestation:The frequency of pale tongue in the patients with PTA reducing was higher.Pulse condition:Two groups of pulse condition was no statistical significance.2.2.3DecompensatedstageGeneral symptoms:The frequency or degree of yellowish black complexion, edema,spider nevus, deep yellow color of urine, spiritlessness, weaknessness, emaciation, gloomy complexion, dizzy, sigh, belching, stomach heaviness, abdominal heaviness, anorexia, constipation, hypourocrinia in the patients with PTA reducing were higher or more serious.Tongue manifestation:The frequency of fissured tongue and thick fur in the patients with PTA reducing were higher; The frequency of white fur in the patients with PTA not reducing were higherPulse condition:The frequency of slippery pulse in the patients with PTA reducing were higher2.3 Symptoms of distribution between patients with hepatitis cirrhosis whose INR rising or not rising.2.3.1 Generally (patients with hepatitis cirrhosis of the liver weren’t satratified by compensatory or decompensation)General symptoms:The frequency or degree of susceptible to colds, fever, bluish yellowcomplexion,yellowish black complexion, edema, liver palms, spidernevus, thirst, diarrhea with undigested food, deep yellow color of urine, spiritlessness, weakness, laziness to speak, emaciation, depression,anxiety, dread, scaly dry skin, Skin itching, gloomycomplexion, dizzy, dizziness, sigh, nausea, vomit, belching, stomach heaviness, abdominal heaviness, anorexia, anaerobic greasy, tastelessnessinthemouth, bittertaste, oropharyngeal drying, dreaminess, diarrhoea,constipation,hypourocrinia, night urination much in the patients with INR rising were higher or more serious; The frequency of yellowish complexionin the patients with INR not rising was higher.Tongue manifestationThe frequency of old tongue, abnormal sublingual collaterals (obvious/long/thick/circuitous/sad colored sublingual collaterals), yellow fur and thick fur in the patients with INR rising was higher; The frequency of dark purple tongue and whitefur in the patients with INR not rising was higher.Pulse condition:The frequency of thready pulse, slippery pulse and powerful pulse in the patients with INR rising was higher; The frequency of deep pulse and powerless pulse in the patients with INR not rising was higher.2.3.2CompensatedstageGeneral symptoms:The frequency or degree of susceptible to colds, edema, spidernevus, spiritlessness, scaly dry skin, nausea, abdominal heaviness, anorexia, diarrhoea,loose stool,hypourocriniain the patients with INR rising were higher or more serious.Tongue manifestation:The frequency of pale tongue and abnormal sublingual collaterals (obvious/long/thick/circuitous/sad colored sublingual collaterals) in the patients with INR rising was higher; The frequency of dark purple tongue in the patients with INR not rising was higher.Pulse condition:Two groups of pulse condition was no statistical significance.2.3.3 Decompensated stageGeneral symptoms:The frequency or degree of susceptible to colds, bluish yellowcomplexion,yellowish black complexion,edema, spidernevus, thirst, diarrhea with undigested food, viscous stool, deep yellow color of urine, emaciation,anxiety, dread, scaly dry skin, skin itching, gloomy complexion, dizzy,dizziness, nausea, vomit,belching, stomach heaviness, soreness and weakness of waist and knees, anorexia, tastelessness in the mouth, bittertaste, oropharyngeal drying, dreaminess, constipation,loose stool, night urination much in the patients with INR rising were higher or more serious; The frequency of yellowish complexionin the patients with INR not rising was higher.Tongue manifestation:The frequency of yellow fur in the patients with INR rising was higher; The frequency of dark purple tongue, spotted tongue, white fur and ecchymosis tongue in the patients with INR not rising was higher.Pulse condition:The frequency of thready pulse, slippery pulse and powerful pulse in the patients with INR rising was higher; The frequency of deep pulse and powerless pulse in the patients with INR not rising was higher.Conclusion1. Symptoms of distribution between patients with hepatitis cirrhosis whose PLT decreasing and not reducing.Generally speaking, compared with PLT not decreaing patients,the symptoms of blood stasis dark complexion, liver palms, gloomy complexion; water in the wet stop symptoms edema, hypourocrinia; the symptoms of Qi deficiency spiritlessness,weakness,laziness to speak;the symptoms of accumulation of dampness in middle-jiao nausea, stomach heaviness, abdominal heaviness, anorexia, anaerobic greasy; the symptoms of kidney empty night urination much, sex hypoplasia and greenish yellow complexion,skin itching,fissured tongue were more serious in patients PLT decreasing.The symptoms of compensatory phase distribution characteristics and general symptoms distribution is closer. Regardless of compensatory phase or the entirety,dark complexion, liver palms, gloomy complexion, spiritlessness, anorexia were more serious.2. Symptoms of distribution between patients with hepatitis cirrhosis whose blood coagulation function normal and abnormal.2. lSymptoms of distribution between patients with hepatitis cirrhosis whose PT prolonging and not prolonging.Generally speaking,compared with PT not prolonging patients, water and dampness retention symptoms edema, hypourocrinia; the symptoms of blood stasis spider nevus, gloomy complexion; the symptoms of Qi deficiency spiritlessness, weakness, laziness to speak,pale tongue; the symptoms of accumulation of dampness in middle-jiao nausea,vomit,stomach heaviness, abdominal heaviness, anorexia, anaerobic greasy,loose stool,bulgy tongue,thick fur.splippery pulse;the symptoms of kidney deficiency night urination much,heat symptom fever, deep yellow color of urine,rapid pulse,and greenish yellow complexion.yellow black complexion.emaciation,constipation, pond knot,dizzy were more serious in PT prolonging patients.Regardless of the stage compensated or decompensated,compared with PT not prolonging patients,edema, hypourocrinia, abdominal heaviness, anorexia were serious in PT prolonging gruops. In addition, anaerobic greasy was more serious in compensated stage. Spiritlessness, weakness,pale tongue,gloomy complexion, nausea, splippery pulse,deep yellow color of urine,yellow black complexion, dizzy,insomnia were more serious in decompensated stage.2.2 Symptoms of distribution between patients with hepatitis cirrhosis whose PTA decreasing and not decreasing.Generally speaking,compared with PTA not decreasing patients, the symptoms of Qi deficiency susceptible to colds, spiritlessness, weakness, laziness to speak;deficiency of yin symptoms thin skin itching, oropharyngeal drying, dry constipation, fissured tongue; symptoms of internal stagnation of fluid-dampness edema, hypourocrinia,tooth-marked tongue;the symptoms of blood stasis spider nevus, gloomy complexion, squamous and dry skin, abnormal sublingual veins; the symptoms of accumulation of dampness in middle-jiao nausea, vomit,belching,stomach heaviness, abdominal heaviness, anorexia, anaerobic greasy,loose stool,thick fur,slippery pulse;the symptoms of spleen deficient tasteless in the mouth,diarrhoea,tooth-marked tongue,the symptoms of kidney deficient night urination much, the symptoms of heat fever,thirsty, deep yellow color of urine,rapid pulse,yellow fur,and greenish yellow complexion.yellow black complexion, dizzy, old tongue were more serious in PTA decreasing patients.Regardless of the stage compensated or decompensated,compared with PTA not decreasing patients, edema, hypourocrinia, spider nevus,spiritlessness, abdominal heaviness, anorexia were more serious in PTA reducing gruops. In addition, liver palm, fullness in chest and hypochondrium, laziness to speak, pale tongue.anaerobic greasy.loose stools.tinnitus were more serious in compensated stage. gloomy complexion, weakness,emaciation,constipation, fissured tongue,sighing,belching,stomach heaviness, thick fur,slippery pulse, deep yellow color of urine, yellow black complexion, dizzy were more serious in PTA decreasing patients2.3 Symptoms of distribution between patients with hepatitis cirrhosis whose INR rising and not rising.Generally speaking,compared with INR not elevating patients,Qi deficiency symptoms of a cold easily, spiritlessness, weakness, laziness to speak; Yin deficiency symptoms of emaciation, dry skin itching, dry throat and bitter taste mouth, constipation, fine veins; Water and dampness retention symptoms of edema, hypourocrinia, blood stasis symptoms of liver palm, spider nevus, gloomy complexion, squamous and dry skin, abnormal sublingual veins, liver dysfunction symptoms of depression, anxiety, having a deep sigh; accumulation of dampness in middle-Jiao symptoms of nausea, belching, vomiting, stomach distension, abdominal distension, anorexia, anaerobic greasy, loose stools, thick fur, slippery pulse;insufficiency of the spleen symptoms of tastelessness, diarrhea,diarrhea with undigested food; deficiency of the kidney symptoms of fear, the night to urinate more.symptoms of heat fever,thirt, deep yellow color of urine.bitter taste,yellow fur,and greenish yellow complexion.yellow dark complexion, dizzy, dreaminess, old tongue, strong pulse were more serious in patients with INR elevating.Regardless of the stage compensated or decompensated,susceptible to colds,edema, spider nevus,skin itching, anorexia.loose stool were serious in INR rising gruops. In addition, spiritlessness, hypourocrinia, abnormal sublingual veins,abdominal distension.anorexia,diarrhoea,pale tongue in the patients with INR rising was more serious in compensated stage. Gloomy complexion, emaciation, thirst, oropharyngeal drying, constipation,thready pulse, tastelessness, viscous stool,vomiting, belching,stomach distension, anorexia, dreading, soreness and weakness of waist and knees, the night to urinate more, deep yellow color of urine,bitter taste,yellow fur,greenish yellow complexion,skin itching,anxiety, dizzy.dreaminess,strong pulse in the patients with INR rising was more serious in decompensated stage. |
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