| Objective The research aims to discuss the spectrum of Liver disease and its dynamic change 、 the social demographic distribution of liver disease as well as TCM syndrome distribution. Extraction and analysis of symptoms distribution of different degree of chronic hepatitis b(CHB) and compare the differences and relationship of symptoms among the mild, moderate and severe degree of CHB,as well as to explore the symptoms ’s dynamic change from mild to severe degree. Provide the reference basis to the treatment of liver disease for the hospital authorities.Methods By collecting one TCM hospital’s liver disease Homepage Information of Inpatient Medical Record in 2002-2014. using the method of retrospective survey, epidemiological research methods, classification methods to discuss the spectrum of Liver disease and its dynamic change,as well as the distribution of TCM syndrome.Medical records of patients with chronic hepatitis B were collected, sorting the symptoms from chief complaints,symptoms at the moment when he hospitalized according to "Chinese Diagnostics", "clinical symptoms studies". By using association rules algorithm, descriptive statistics, statistical inference methods, research similarities and differences among mild, moderate, chronic hepatitis B symptoms, meanwhile analyze changes and relationship in symptoms at different degrees of chronic hepatitis B.Result 1) In 2002-2014, viral hepatitis and liver cirrhosis are the majority of the spectrum of Liver disease. Their ratio in the spectrum is as follows: Viral hepatitis(40.10%), liver cirrhosis(31.16%), liver cancer(11.70%), hepatic failure(8.84%), fatty liver(2.26%), drug-induced liver disease(1.23%), alcoholic hepatitis and other liver diseases are accounted for less than 1%.During this years, Viral hepatitis’ s ratio is always higher than the other, but after the slightly increase, there was a decline trend. The ratio is around 40%. Liver Cirrhosis ‘curve has a slight drop after the rising in the first several years, but it’s relatively stable. Liver cancer & liver failure‘s ratio show a decline trend after the first slightly rising. Fatty liver ‘curve though has slight fluctuations, it shows obvious upward trend, the ratio climbed over 1% since 2006.2) In this hospital, male liver disease suffers are more than female. Viral hepatitis in male(72.89%), women accounted for 27.11%.Cirrhosis of the liver male 67.89%, female 67.89%.Liver cancer men accounted for 81.51%, women only 18.49%.Fatty liver male55.38%,female 55.38%. alcoholic liver disease Male 94.12%. Viral hepatitis is concentrated in the young adults(age 18 to 40), middle-aged(41-65 years), theyboth accounted for more than 45%.Liver Cirrhosis mainly concentrated in the middle age(66.55%), followed by the elderly(20.10%).Liver cancer is mainly concentrated in the middle-aged, accounting for 62.44%. Liver failure occurred in middle-aged( 52.06%) is more than it occurred in young(42.14%).Fatty liver is concentrated in the middle-aged, which accounted for 60.77%. Middle-aged Alcoholic liver disease suffers accounted for 80.88%.3) 252 kinds of syndromes, a total of 26 kinds of syndromes class occurred in the 11515 medical cases. The top five syndromes together accounting for 75.64%, those are the liver’s main syndromes: liver and spleen deficiency syndrome(44.37%)> damp syndrome(13.50%)> blood stasis(8.94%)> gallbladder damp-heat syndrome(4.83%)> Spleen water retention syndrome(4.00%). The top five categories of syndromes: Liver Syndrome(56.93%), wet Syndrome(20.14%), gas Syndrome(11.42%), spleen Syndrome(8.08%), phlegm Syndrome(1.04%), together accounting 97.59% of the total. The male patients appeared 216 kinds of syndromes, female 156 kinds of syndrome. In all ages, liver and spleen deficiency’s accounting ratios were higher than the other syndromes. With the growth of age, the follow syndromes’ ratio grows: liver and spleen deficiency, damp heat resistance syndrome. While other syndromes declined like blood stasis, spleen stop water permits.4) 2172 chronic hepatitis b cases has 130 kinds of TCM symptoms, 46 species appeared more than 10 times. The top 15 TCM symptoms accounted for 89.26% of the total. Top 10 symptoms as follows: fatigue, loss of appetite, urine yellow, liver discomfort, dry mouth, abdominal distension, insomnia,hypochondriac pain, body yellow, yellow eyes, bitter mouth, nausea, loose stools, tired of oil, celialgia. Mild chronic hepatitis B has 76 kinds of symptoms, 96 kinds for moderate chronic hepatitis b, 63 kinds for severe. mild and moderate chronic hepatitis b have 63 kinds of common symptoms, moderate and severe chronic hepatitis b have 54 kinds of common symptoms, mild and severe chronic hepatitis b have 42 kinds of common symptoms. 41 kinds of symptoms exist in mild, medium and severe chronic hepatitis b, these common symptoms in different degree has different proportion. Through the association rules algorithm, we dig out strong association rules: 8 rules from mild CHB, 26 rules from moderate CHB, 200 rules from severe CHB. There exist same strong rules in three different degree of CHB, but different in support value, confidence and lift.Conclusion Liver disease spectrum has some changes in this hospital.Viral hepatitis, although in the first place, but its proportion to the overall has showed decline trend. It is noteworthy that the proportion of fatty liver is rising. The liver’s main syndromes: liver and spleen deficiency syndrome、 damp syndrome、 blood stasis、 gallbladder damp-heat syndrome、Spleen water retention syndrome and so on. There exist same strong rules and syndrome sets in three different degree of CHB, but different in support value, confidence and lift. Along with the exacerbation of chronic hepatitis b, associated symptoms increased, which indicate that the treatment of liver disease should be combined with the analysis of the characteristics of different individual. |
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