慢性乙型肝炎患者中医证型与HBV病毒载量及血清肝纤维化指标的关系探究  

Relationship between Traditional Chinese Medicine Syndromes and HBV Load and Serum Liver Fibrosis Indexes in Patients with Chronic Hepatitis B

作　　者：王延峰 柯荣湖[2] WANG Yanfeng;KE Ronghu(The People's Hospital of Zhuxi County,Zhuxi Hubei 442300,China;The Fifth Hospital of Huangshi City,Huangshi Hubei 435001,China)

机构地区：[1]竹溪县人民医院,湖北竹溪442300 [2]黄石市第五医院,湖北黄石435001

出　　处：《四川中医》2022年第8期63-67,共5页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探讨慢性乙型肝炎(CHB)患者中医证型与其血清乙型肝炎病毒DNA(HBV-DNA)载量及肝纤维化指标的关系。方法:回顾性收集2018年2月-2021年2月我院收治的169例CHB患者资料,对其中医证型进行评估,比较不同中医证型CHB患者性别、年龄、血清HBV-DNA载量及肝纤维化指标[透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原肽(PCⅢ)和Ⅳ型胶原(CⅣ)]差异,分析CHB中医证型与其他指标的关系。结果:169例CHB患者中医证型以湿热内结型(27.22%)为主,其次为肝郁脾虚型(24.26%)、淤血阻络型(21.30%)、肝肾阴虚型(14.79%)和脾肾阳虚型(12.43%);CHB患病人群以20~60岁为主,且男性略高于女性,不同中医证型患者性别、年龄差异无统计学意义(P>0.05);各证型CHB患者HBV-DNA(定量)≥5×10^(2)IU/ml比例由小到大排列依次为肝郁脾虚型(56.10%)、湿热内结型(65.22%)、肝肾阴虚型(72.00%)、脾肾阳虚型(80.95%)、淤血阻络型(86.11%),差异有统计学意义(P<0.05),且淤血阻络型HBV-DNA(定量)≥5×10^(2)IU/ml的患者比例与肝郁脾虚型和湿热内结型比较有显著性差异(χ^(2)=7.429、4.628,P<0.05);肝纤维化指标在不同中医证型CHB患者血清中的表达具有差异性(P<0.05);且湿热内结型、肝肾阴虚型、淤血阻络型、脾肾阳虚型HA、LN、CⅣ水平较高,肝肾阴虚型、淤血阻络型、脾肾阳虚型PCⅢ水平较高,组间差异有统计学意义(P<0.05)。结论:HBV-DNA载量及肝纤维化指标在不同中医证型CHB患者血清中表达均有差异,可为CHB的中医辨证分型提供参考。Objective:To explore the relationship between TCM syndromes and serum hepatitis B virus DNA(HBV-DNA)load,liver fibrosis indexes in patients with chronic hepatitis B(CHB).Methods:A retrospective collection was performed on the data of 169 patients with CHB admitted to the hospital between February 2018 and February 2021.TCM syndromes in CHB were evaluated.The differences in gender,age,serum HBV-DNA load and liver fibrosis indexes[hyaluronic acid(HA),laminin(LN),type III procollagen peptide(PCIII),type IV collagen(CIV)]among CHB patients with different TCM syndromes were compared.The relationship between TCM syndromes and the other indexes was analyzed.Results:The main TCM syndrome in the 169 CHB patients was damp-heat internal accumulation type(27.22%),followed by liver-stagnation spleen deficiency type(24.26%),blood-stasis block type(21.30%),liver-kidney Yin-deficiency type(14.79%)and spleen-kidney Yang-deficiency type(12.43%).The age group in CHB patients was mainly within 20~60 years.CHB patients in males were slightly more than those in females.There was no significant difference in gender or age among CHB patients with different TCM syndromes(P>0.05).Arranging the proportion of cases with HBV-DNA(quantitation)≥5×10^(2)IU/ml from low to high,the corresponding order was as follows:liver-stagnation spleen deficiency type(56.10%),damp-heat internal accumulation type(65.22%),liver-kidney Yin-deficiency type(72.00%),spleen-kidney Yang-deficiency type(80.95%)and blood-stasis block type(86.11%).The differences in proportion of cases with HBV-DNA(quantitation)≥5×10^(2)IU/ml in blood-stasis block type was significantly different from that of liver-stagnation and spleen-deficiency type and damp-heat internal knot type(χ^(2)=7.429,4.628,P<0.05).There were significant differences in levels of serum liver fibrosis indexes among CHB patients with different TCM syndromes(P<0.05).The levels of HA,LN and CIV were higher in patients with damp-heat internal accumulation type,liver-kidney Yin-deficiency type,blood-stasis b

关 键 词：慢性乙型肝炎 中医证型 病毒载量 血清肝纤维化指标 

分 类 号：R259[医药卫生—中西医结合]