乙肝辨证分型与病毒复制关系的初步研究

Primary Study on Relationship between TCM Type of Syndromes and Replication of Virus in Patients with Chronic Hepatitis B

通过大样本的临床调查研究 ,初步探讨乙型慢性病毒性肝炎患者辨证分型与病毒复制程度之间的关系。采用临床流行病学———回顾性研究的方法。结果 ,本次调查资料经数据完整性、诊断规范化、辨证标准化初步筛选。 2 82例乙型慢肝患者 ,各证型的分布为肝郁脾虚 >肝胆湿热 >瘀血阻络 >肝肾阴虚 >脾肾阳虚 ,其中以肝郁脾虚证和肝胆湿热证为其常见证型 ,占所调查对象的 84 75 % ;肝郁脾虚证患者以HBsAg(+)、HBeAb(+)为主 ,病毒处于低复制阶段 (R1=0 938,P <0 0 1) ;而肝胆湿热证多见两种表型(R2 =0 799,P <0 0 1) ,即HBsAg(+)、HBeAg(+)、HBcAb(+)、HBV DNA(+)或HBsAg(+)、HBcAb(+)、HBV DNA(+) ,提示病毒复制高度活跃。肝胆湿热证与病毒高复制状态具有显著相关性。

Objective :To investigate the relationship between TCM type of syndromes and replication of virus in patients with chronic Hepatitis B by the method of survey and study on large samples. Method :The method of clinical epidemiologic study-retrospective study was adapted. Result :The survey materials of 282 cases with chronic hepatitis B were initial selected by perfected data?normal diagnosis and standard syndromes.The distribution of their TCM differentiation of symptoms and signs:stagnation of the liver Qi and deficiency of the spleen>damp-heat of liver and gall>blood stasis vessel obstruction syndrome>deficiency of liver-Yin and kidney-Yin>insufficiency of both the spleen and the kidney,among all cases,the first and second groups were 84 75%;among stagnation of the liver Qi and deficiency spleen the HBsAg(+)?HBeAg(+) are more,the virus are in lower level replication(R_1=0 938, P <0 01);However,dump-heat of liver and gall are seen in two types(R_2=0 799, P <0 01),which are HBsAg(+)?HBeAg(+)?HBcAg(+)?HBVDNA(+) or HBsAg(+)?HBcAg(+),above two suggested that the replication of virus is very active. Conclusion :there was significant correlation between dump-heat of liver and gall and activity replication of HBV.