| 引用本文:刘丽丽1，张国梁1，刘永华1，窦红漫2，武松3.慢性乙型肝炎患者中医证型与ALT、HBV DNA及肝组织病理的关系[J].世界中医药,2017,(03):. |
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| 慢性乙型肝炎患者中医证型与ALT、HBV DNA及肝组织病理的关系 |
| The Relationship between TCM Syndrome Types and ALT, DNA HBV and Liver Tissue Pathology in Patients with Chronic Hepatitis B |
| 投稿时间：2016-07-25 |
| DOI：10.3969/j.issn.1673-7202.2017.03.021 |
| 中文关键词: 慢性乙型肝炎 中医证型 肝功能 HBV DNA 肝组织病理 |
| English Keywords:Chronic hepatitis B TCM syndromes Lliver function HBV DNA Liver histopathology |
| 基金项目:安徽省自然科学基金项目（编号：1408085QH185） |
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| 中文摘要: |
| 目的：探讨慢性乙型肝炎(CHB)患者中医证型与肝功能、血清病毒学、免疫组化HBsAg、HBcAg检出率及肝组织病理之间的关系及对CHB的诊断意义。方法：选择2013年6月至2016年8月在我科住院的58例CHB患者，比较不同中医证型与肝功能、HBVDNA水平、免疫组化HBsAg、HBcAg检出率及肝组织病理的关系。结果：1）中医辨证分型:肝郁脾虚证（26/58，31%）和湿热中阻证（15/58，30%）出现频次最高，其他依次为肝肾阴虚证（7/58，15%），脾肾阳虚证（6/58，12%）和瘀血阻络证（4/58，12%）；2）不同中医证型和ALT有明显相关性，各证型之间比较有统计学意义，P<0.05；不同中医证型和AST、TBIL无明显相关性，差异无统计学意义，P>0.05；3）不同中医证型和HBV DNA有明显相关性，各证型之间比较有统计学意义，P<0.05;不同中医证型和HBsAg、HBeAg无明显相关性，差异无统计学意义，P>0.05；4）不同中医证型与免疫组化HBcAg检出率有明显相关性，各组间比较有统计学意义，P<0.05；不同中医证型与免疫组化HBsAg检出率无相关性，P>0.05；5）CHB患者肝脏炎性反应G及纤维化程度S存在高度相关性，r=0.758，P<0.01；不同中医证型和肝脏炎性反应G有明显相关性，P<0.05；不同中医证型和纤维化程度S有明显相关性，P<0.01。结论：CHB患者ALT、HBV DNA、免疫组化HBcAg检出率及肝脏炎性反应G及纤维化程度S检测与中医证型间有显著相关性,对指导CHB患者临床诊断治疗有重要指导意义。 |
| English Summary: |
| To investigate the relationship between TCM syndromes and liver function, serum virology, immunohistochemical HBsAg, HBcAg detection rate and liver histopathology in patients with chronic hepatitis B (CHB) and its diagnostic significance for CHB. Methods:Fifty-eight cases of CHB patients who were hospitalized in our department from June 2013 to August 2016 were selected, comparing the relationship between different TCM syndromes and liver function, HBVDNA level, immunohistochemical HBsAg, HBcAg detection rate and liver histopathology. Results:1)TCM syndrome differentiation：liver depression and spleen deficiency syndrome (26 / 58,31%) and damp-heat syndrome (15 / 58,30%) appeared with the highest frequency, followed by liver and kidney yin deficiency syndrome (7/58, 15%), spleen and kidney yang deficiency (6 / 58,12%) and blood stasis in collaterals syndrome (4 / 58,12%); 2)different TCM syndromes and ALT were significantly correlated, with significant difference in comparison (P<0.05); there was no significant correlation between different TCM syndromes and AST and TBIL, and no statistical difference (P>0.05); 3)different TCM syndromes and HBV DNA were significantly correlated, with significant difference in comparison (P<0.05); there was no significant correlation between HBsAg and HBeAg in different TCM syndromes, with no statistical difference (P<0.05); 4)there was correlation between different TCM syndromes and immunohistochemical HBcAg detection rate (P<0.05) with various groups shared significant difference, while not between different TCM syndromes and immunohistochemical HBsAg detection rate (P>0.05); 5)liver inflammation G and fibrosis degree S of CHB patients were highly correlated,( r=0.758, P<0.01); different TCM syndromes and liver inflammation G were significantly correlated (P<0.05); different TCM syndromes and fibrosis Degree S was significantly correlated ( P<0.01). Conclusion:The detection rate of ALT, HBV DNA, immunohistochemical HBcAg and liver inflammation G and fibrosis degree S in CHB patients are significantly correlated with TCM syndromes, which is of great significance to guide the clinical diagnosis and treatment of CHB patients. |
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