自身抗体阳性慢性乙型病毒性肝炎中医体质与肝组织学的分布特点  

The distribution characteristics of TCM constitution and liver histology of autoantibody positive chronic hepatitis B

作　　者：林立[1] 杨嘉恩[1] 陈少东[2] 刘垚昱 吴昦辰 黄稚真 郑燕茹 胡敏[3] 梁惠卿[1] LIN Li

机构地区：[1]厦门市中医院,福建厦门361009 [2]厦门大学医学院,福建厦门361002 [3]福建中医药大学,福建福州351012

出　　处：《中医临床研究》2022年第17期24-27,共4页Clinical Journal Of Chinese Medicine

基　　金：国家级自然科学基金资助项目(81873242,82174141);国家中医药管理局青年岐黄学者支持项目(国中医药办人教函〔2021〕200号);厦门康氏肝病学术流派传承工作室。

摘　　要：目的:观察伴或不伴自身抗体阳性的慢性乙型病毒性肝炎(Chronic Hepatitis B,CHB)患者中医体质分布及肝组织学等相关指标,获得自身抗体阳性CHB的中医体质及肝组织学等指标的分布特点,指导临床辨证论治。方法:选取厦门市中医院2019年6月-2021年6月住院的自身抗体阳性CHB患者216例,同期纳入单纯CHB患者216例,对比两组一般情况、中医体质分布、血清学、肝组织学指标。数据采用统计软件SPSS 20.0进行统计分析。结果:自身抗体阳性CHB组患者的中医体质分布中湿热质占比最高,两组中医体质分布的差异有统计学意义(P<0.05)。自身抗体阳性CHB组患者丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)、天门冬氨酸氨基转移酶(Aspartate Aminotransferase,AST)、谷氨酰转移酶(Glutamyltransferase,GGT)、碱性磷酸酶(Alkaline Phosphatase,ALP)水平显著高于单纯CHB组,两组患者上述生化指标水平的差异均有统计学意义(均P<0.05)。两组患者血清HBV DNA载量、乙型病毒性肝炎病毒表面抗原(Hepatitis B surface antigen,HBsAg)滴度及乙型病毒性肝炎e抗原(Hepatitis B e Antigen,HBeAg)状态分布的差异均无统计学意义(均P>0.05)。自身抗体阳性CHB组患者肝组织学纤维化分期>1者较单纯CHB组占比更高,且差异有统计学意义(P<0.05)。结论:自身抗体阳性CHB组患者中医体质分布中湿热质占比较高,肝组织纤维化占比较高,对于此类患者应注意监测病情变化、积极护肝抗病毒治疗,警惕病情的进展。Objective:To observe the distribution characteristics of TCM constitution and liver histology and other relevant indicators of CHB patients with or without positive autoantibody so as to guide clinical syndrome differentiation and treatment of the disease.Methods:Two hundred and sixteen CHB patients with positive autoantibody from June 2019 to June 2021 were selected and included in the research,and 216 CHB patients with negative autoantibody were included in the same period.Statisticall software SPSS 20.0 was used for data statistical analysis.Results:The proportion of dampness-heat of TCM constitution distribution types in the CHB with positive autoantibody group was the highest,and the difference between the groups was statistically significant(P<0.05).The ALT,AST,GGT,ALP and GLB levels in the CHB with positive autoantibody group were significantly higher than the CHB with negative autoantibody group,and P<0.05.There was no significant difference in serum HBV DNA load,HBsAg titer and HBeAg status distribution between the two groups(all P>0.05).The proportion of liver tissue histology S>1 in the CHB positive autoantibody group was higher than the CHB with negative autoantibody group(P<0.05).Conclusion:CHB patients with autoantibody positive accounts for a high proportion of dampnessheat constitution and liver fibrosis.It is necessary to pay attention to monitoring the change of the condition of the disease,actively protect the liver and anti-virus treat to alert the progress of the disease.

关 键 词：慢性乙型病毒性肝炎 自身抗体 分布特点 中医体质 

分 类 号：R512.62[医药卫生—内科学]