| ObjectiveWhen WD to decompensated cirrhosis, ascites is one of the common complications,easy to induce fatal complications, mortality is high, seriously affecting the quality of life and survival of patients with WD. Through this project we aim to liver cirrhosis WD clinically relevant research and data analysis, observation WD cirrhotic ascites syndromes distribution characteristics discussed WD TCM liver cirrhosis and clinical epidemiology, laboratory parameters, imaging characteristics, Child-Pugh classification and type of complications and TCM Links typing valuable indicator, and through these indicators to help determine the objective of TCM, for further study and reference WD liver cirrhosis.valuable indicator, and through these indicators to help determine TCM objective to provide references for further study WD cirrhotic ascites.MethodsFrom 106 cases in our hospital diagnosis are treated from January 2013 to December 2014 as decompensated cirrhosis and ascites by ultrasound confirmed the presence of WD patients met the inclusion criteria of the clinical symptoms according to Western medicine medical clinical type, and the use of Chinese medicine theory of the four diagnostic parameters TCM syndrome type, its line of biochemical tests(blood,liver and kidney function, copper biochemistry, coagulation, etc.), ultrasound imaging,recording detect early indicators of admission, and apply the Child-Pugh classification standard grading, then use SPSS17.0 software to analyze the clinical features of liver cirrhosis summary, TCM Syndrome Distribution, will be general information, and other relevant indicators of liver and kidney function, abdominal B-ultrasound indicators,Child- Pugh classification, complications and TCM Syndrome do cross analysis to explore these patients detected TCM type and objective indicators of internal relations.Results1.106 cases patients in terms of gender composition, male 55 cases(51.89%),female 51 cases(48.11%), male to female ratio of 1.08: 1, no significant gender difference(P> 0.05). In terms of age distribution, the youngest 9 years old, maximum age 51 years, mean age 18.23 4.01 years old with disabilities. From the distribution of the age, the time of occurrence WD common liver cirrhosis is between 14-19 years old.2. TCM diagnosis of 106 cases patients: shireneiyun type most, accounting for47.17 percent, followed by ganshenkuixu type, accounting for 26.42 percent, followed by ganshenyinxu type(15.09%), qixueliangkui type(11.32%).3. TCM diagnosis of 106 cases of patients in heat Accumulation card, Western classification between theshireneiyun type、ganshenkuixu type 、qixueliangkui type and ganshenyinxu type,the group of four similar, Western medicine and TCM clinical classification type distribution is no direct correlation.4 106 cases patients, according to the frequency of symptoms and signs from more to less, before 10 were: fuzhang、nadai, xiazhishuizhong、shengmuhuangran、fali、niaoshao、xiaobianhuangchi、biantangbianmi、chiniubiniu、exinoutu. Cirrhotic ascites signs and symptoms related to systemic widely distributed, and used the abdomen,digestive symptoms.5.Among the106 cases patients,the Syndrome Type and biochemical indicators of copper means comparison, there was no significant difference(P> 0.05).6.Comparative the 106 cases patients between the Syndrome Type and the mean of liver fibrosis, was not statistically significant(P> 0.05).7.The comparison of 106 cases patients between the TCM type and renal function mean: the mean creatinine, ganshenyinxu type> ganshenkuixu type>qixueliangkui type> shireneiyun type. Ganshenyinxu type, were significantly different(P <0.05) ganshenkuixu type and shireneiyun type. On the average urea nitrogen, according to ganshenkuixu type> qixuekuixu type> ganshenyinxu type>shireneiyun type, among the groups were not statistically significant((P> 0.05). In the mean uric acid, Press the qixuekuixu type> ganshenkuixu type> ganshenyinxu type>shireneiyun type decline, there was no significant difference between the groups(P>0.05).8.The comparison of 106 cases patients between the TCM Syndrome and liver function: 106 cases WD of patients with liver cirrhosis Syndrome: On ALB mean,ganshenyinxu type> ganshenkuixu type> qixuekuixu type> shireneiyun type,ganshenyinxu type, ganshenkuixu type and shireneiyun type was statistically significant(P <0.05), there are differences ganshenyinxu type and qixuekuixu type( P<0.05). On TBA mean, shireneiyun type> qixuekuixu type> ganshenkuixu type>ganshenyingxu type, ganshenyinxu type, ganshenyinxu type and shireneiyun type were significant differences(P <0.05). On CHE mean, according to shireneiyun type>ganshenkuixu type> ganshenyinxu type>qixueliangkui type, ganshenyinxu type,ganshenkuixu type and shireneiyun type were significantly different( P <0.05), there are differences between(P <0.05) ganshenyinxu type and qixuekuixu type. On ALT mean, shireneiyun type> ganshenkuixu type> qixueliangkuitype>ganshenyinxu type,no significant difference(P> 0.05) between the groups. On DBIL mean, according to ganshenkuixu type <ganshenyinxu type<qixueliangkui type <shireneiyuntype,ganshenyinxu, ganshenkuixu type and shireneiyun type were significantly different( P<0.05). On IBIL mean, ganshenkuixu type <ganshenyinxu type <qixueliangkui type<shireneiyun type,ganhsenkuixu type andshireneiyun type comparative statistical difference(P <0.05). On the mean AST, ganshenyinxu type <qixueliangkui type<ganshenkuixu type <shireneiyun type, ganshenkuixu type andshireneiyun type comparative statistical difference(P <0.05).9.The comparison of 106 cases patients between the TCM Syndrome and blood indicators: 106 cases WD of patients with liver cirrhosis Syndrome: On WBC mean,ganshenyinxu type>ganshenkuixu type> shireneiyun type> qixuekuixu type, no significant difference(P> 0.05) between the groups. On HGB mean, ganhsenkuixu type> ganshenyinxu type> shireneiyun type> qixuekuixu type. Ganshenkuixu type,ganhsenyinxu type between damp and statistically significant(P <0.05). On PLT mean,ganhsenyinxu type>ganshenkuixu type> qixue kuixu type> shireneiyun type, no significant difference(P> 0.05) between the groups.10. The comparison of 106 cases patients between the TCM Syndrome and coagulation parameters: the PT mean, ganshenkuixu type> ganshenyinxu type>qixuekuixu type> shireneiyun type, ganshenkui type, ganshenyinxu type and shireneiyun type was statistically significant(p <0.05). On the FIB value, ganshenyinxu type<ganshenkuixu type <qixuekuixu type <shireneiyun type. Between the groups was not statistically significant(P> 0.05).11. The comparison of 106 cases patients between the Syndrome Type and ascites indexing, n the mean diameter of the portal vein: a small amount of ascites of 67patients(63.2%), in the amount of ascites in 19 cases(17.9%), massive ascites 20 cases(18.9%). Heat Accumulation syndrome, liver and kidney deficiency syndrome, blood loss and the degree of ascites syndrome in patients with liver and kidney syndrome are a large number of mainly. TCM between the mean diameter of portal-type group, no significant difference in the distribution of ascites(P>0.05).12. The comparison of 106 cases patients between the TCM Syndrome and the Child-Pugh classification: 106 patients with mainly A grade, followed by B-class and C-class, and in various syndromes are distributed; Child- Pugh class A mainly in the liver and kidney deficiency syndrome, heat Accumulation syndrome, liver and kidney syndrome, and the highest proportion in the liver and kidney deficiency syndrome;Child-Pugh grade B, and C are mainly distributed in the heat Accumulation card, liver and kidney deficiency syndrome, and both the highest proportion in the hot and humid Accumulation card. With the heat Accumulation syndromes syndrome, liver and kidney deficiency, blood loss goes to the liver and kidney syndrome, their Child-Pugh grade B,C grade gradually reduced the proportion gradually increased the proportion of A-level.13. The comparison of 106 cases patients between TCM syndromes and complications: Damp type of electrolyte imbalance, spontaneous bacterial peritonitis,abdominal hernia were significantly higher than other syndromes; liver and kidneydeficiency, damp type hypoproteinemia significantly higher than other syndromes. But not statistically significant(P> 0.05).ConclusionThere was no difference between and urea nitrogen, uric acid, FIB, ALT, WBC,PLT, portal diameter between WD and cirrhosis ascites patients(P<0.05). There was no intrinsic relation between them.. At the same time, the TCM syndromes were statistically significant(P<0.05) with the creatinine, TBA, CHE, ALB, DBIL, IBIL,AST,, PT, HGB. Concrete performance is as follows... |
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