Correlation Study Of Sublingual-threads And Hepatocirrhosis

Background:There area number of Chinese who suffer from hepatitis,each year a large number of hepatitis patients progress to cirrhosis,hepatocirrhosis has become a common disease in China and one of the main causes of death,seriously endangering the health of our nationals,and is becoming currently a serious social and medical problems.Laparoscopy technology is increasingly matured and is used to the early morphology diagnosis of the hepatocirrhosis,and has the unparalleled advantage (especially clinical diagnostic criteria that can not yet be confirmed but the morphology of the clinical diagnosis of cirrhosis of the liver pre - Sclerosis). Chinese medicine believes that in the various stages of development of hepatocirrhosis,blood stasis is an important element of TCM Syndrome,as a sublingual sequence of varicose blood stasis tongue inspection of the objective indicators,easily observed,it may reflect the degree of blood stasis,and the study has found that hepatocirrhosis is closely related to varicose Sublingual-threads in different stages of cirrhosis(pre-clinical,compensated and decompensated period).TCM Syndrome distribution and sequence of changes in laws and sublingual sublingual Changes in the context of the diagnosis of cirrhosis are of great significance.Objective:In order to understand the the relevance of Chinese tongue inspection indicators (Sublingual-threads changes)and cirrhosis,it is to:(1)discover the syndrome Distribution of TCM and Chinese medicine-based elements in there stages of cirrhosis(pre-clinical,compensated and decompensated period);(2)fould the Sublingual-threads' distribution and existence of differences among healthy people,patients with chronic hepatitis and cirrhosis,compared with liver-palms and Spider-burst;(3)The indicators Sublingual-threads are of great value to the cirrhosis Diagnostic and as good as the indicators of liver-palms and Spider-burst.Methods:It is to study the distribution of the TCM and TCM Syndrome elements in different stages of cirrhosis(pre-clinical,compensated and decompensated period);and is to study the distribution of Sublingual-threads,liver-palms and Spider-burst in the five groupapplying diagnostic tests on the method Healthy people,patients with chronic hepatitis and cirrhosis in,Sublingual-threads of classification indicators palm and liver,Spider-burst indicators for the diagnosis of cirrhosis,by the method of clinical Epidemiology investigation and.Study subjects were divided into cirrhosis group(pre-clinical hepatocirrhosis group,Group decompensated cirrhosis,hepatocirrhosis decompensated period),non-cirrhosis control group(healthy control group,chronic hepatitis),a total of 139 cases. Watchlist detailed records of patients with Sublingual-threads,liver-palms, Spider-burst,the main card,Syndromes elements,morphology diagnosis and clinical diagnostic data,and other data,including Sublingual-threads,liver and palm Spider-burst,and other signs by hand the use of digital cameras Under the conditions of shooting in the reunificationand preservation.SPSS13.0 the use of statistical data analysis software package,count data rate,a ratio that compared withχ2 test;measurement data to mean±standard deviation,compared with t-test; grade rank test by comparison,the standard test a = 0.05.Sensitivity,specificity, accuracy,positive likelihood ratio and negative likelihood ratio are used to evaluate the diagnostic value.Results:(1)Among TCM type,cirrhosis three to Ganqi blues,bleeding resistance Tongxinluo,Shuishi internal resistance,hot and humid Yunjie are four card-based (96.6%);pre-clinical hepatocirrhosis group to Ganqi blues(61.5%)And the hot and humid Yunjie(30.8%);decompensated cirrhosis to Ganqi Depression(54.2%)and bleeding resistance Tongxinluo(25.0%);decompensated cirrhosis in the group phase, in order to Shuishi Resistance(35.3%),bleeding resistance Tongxinluo(29.4%)and Ganqi Depression(21.6%):theχ2 test,P＜0.01,all three cards in hepatocirrhosis of the distribution are differences,with statistical significance.Elements of Chinese medicine syndrome,cirrhosis of the period are,"Yu","stasis" and "spleen deficiency," the main,followed by the "wet" and "hot" and "Yu","stasis," "spleen deficiency" in hepatocirrhosis No difference between the three(P＞0.05);"wet" and "hot" in the proportion of cirrhosis three were on the rise.(2)sublingual threads grade,liver-palms,Spider-burst,and combinations as observed in the observation of patients with chronic liver disease found that the difference:With the progress of chronic liver disease,sublingual sequence of normal and the proportion of ClassⅠgradually decreased,ClassⅡ,Ⅲlevel,Ⅱ-Ⅲ-class level andⅠ-Ⅲthe proportion is rising gradually,decompensated cirrhosis period when the ratio reached 58.8%,25.5%,84.3%and 98.0%of which Sublingual-threadsⅡ-Ⅲ-Decompensated cirrhosis of the group and the other four groups of February 2,the Sublingual-threadsⅠ-Ⅲlevel in the respective period of decompensated cirrhosis and non-cirrhosis group when,P＜0.01,Sublingual-threadsⅠ-ⅢDecompensated cirrhosis in-class group and non-cirrhosis group,decompensated cirrhosis of hepatocirrhosis group and pre-clinical comparison group,P＜0.05,the difference was significant.Liver-palms,and its joint Spider-burst(liver-palms or Spider-burst)in the healthy control group,chronic hepatitis and cirrhosis decompensated group,decompensated cirrhosis of differences between the groups(P＜0.01),which The combination in patients with chronic hepatitis and cirrhosis of pre-group differences(P＜0.05).(3)observe the Sublingual-threads changes, liver-palms,Spider-burst,and combinations observed in cirrhosis of the differences found three:Sublingual-threadsⅠ-Ⅲhigh level of sensitivity (0.9545),the lowest negative likelihood ratio(0.1658),The accuracy of 0.7050; Sublingual-threadsⅢlevel,liver-palms,Spider-burst,and combinations are 0.9804 specificity,and positive likelihood higher than(≥9.8571),which accuracy to the highest liyer-palms or Spider-burst,0.6547.Conclusion:(1)TCM Syndrome as a factor,"Yu","stasis" and "spleen deficiency" has always run through hepatocirrhosis."Stasis" gradually plays a leading role on the progress of hepatocirrhosis."Wet","hot" and "Stasis" are likely to progress to hepatocirrhosis;"Deficiency Syndrome" may be the reasons for its protracted impaired.These syndromes can be good indicators of elements of Chinese medicine to reflect features of the syndrome.(2)The extent of varicose Sublingual-threads with chronic hepatitis,hepatocirrhosis of the liver's condition has become increasingly evident progress;Spider-burst liver or the palm of chronic hepatitis may be prompted to enter pre-clinical hepatocirrhosis.(3)From the integrated sensitivity and specificity of the accuracy of the index,the Sublingual-threads grade better than liver-palms,Spider-burst indicators.Chinese tongue inspection indicators(Sublingual-threads of the change)can be considered as a objective indicators to the diagnosis of hepatocirrhosis as well as liver-palms and Spider-burst.