500例不同年龄段慢性乙型肝炎病毒携带者中医证候调查

The Investigation of the TCM Syndrome Differentiation of Five Hundreds Chronic Hepatitis B Virus Carriers with Different Age

目的:观察不同年龄段慢性乙型肝炎病毒携带者的证候规律。方法:选择500例慢性乙肝携带者,分为7～14岁组、15～20岁组、21～30岁组、31～40岁组、41～65岁5组。5组患者分别填写证候调查表,进行辨证。结果:7～30岁患者以HBeAg阳性为主(68%),30～65岁以HbeAg阴性为主(83.4%)。7～14岁,证型以不典型证为最常见,脾虚次之;15～20岁,以脾气虚证型为最常见,湿热或中阻次之;21～30岁,以脾气虚证型为最常见,肝气郁结及肝胆湿热次之;31～40岁及41～65岁均以肾阴虚较常见,血瘀阻络次之。HBeAg阳性患者以脾虚证型最常见,肝胆湿热及湿热中阻次之;HBeAg阴性患者的证型以血瘀阻络最常见,肾阴虚次之。结论:30岁以上HBeAg阴性的慢性乙肝病毒携带人群可能存在一定程度的肝纤维化,需进行积极干预。

Objective：To observe the type of TCM syndrome differentiation of chronic hepatitis B virus carriers with different age. Methods：Select five hundreds chronic hepatitis B carriers and divide them into five groups according to the age,they are seven to fourteen years old,fifteen to twenty years old,twenty-one to thirty years old,thirty -one to forty years old and forty-one to sixty-five years old. Full in the investigation table about the TCM syndrome differentiation respectively. Results：68 percent of the patients with age from 7 to 13 are HbeAg positive,while 83. 4 percent with age from 31 to 65 are HbeAg negative. For the age from seven to four-teen,the atypical type is more common than the other type,and the type of spleen deficiency takes the second place; For the age from fifteen to twenty,the common type of syndrome is the spleen deficiency,and the type of dampheat obstructing the middle-energize takes the second place; for the age from twenty-one to thirty,the common type of syndrome is the spleen deficiency type,and the type of liver depression and liver-cholecyst damp -heat are taken second place; for the age from thirty-one to forty and forty-one to sixty-five,the common type of syndrome is kidney-yin deficiency,and the tpye of stagnant -blood obstructing collaterals taks second place. For the group of HbeAg positive,the common type of syndrome is the spleen deficiency,the type of liver -cholecyst damp -heat and damp-heat obstructing the middle-energize are taken second place; For the group of HbeAg negative,the common type of syndrome is stagnant -blood obstructing collaterals,the type of kidney-yin deficiency takes the second place. Conclusion：Fibrosis may exist in chronic hepatitis B virus carriers with age over thirty in some degree even though they are HbeAg Negative,so pisitive intervention should be given to them.