乙型肝炎病毒C基因启动子双变异患者中医证型特点研究

A clinical study on the characteristics of TCM types in patients with basic core promoter united mutation of HBV

目的:探讨HBVC基因启动子(BCP)双变异慢性乙型肝炎患者的中医证型特点。方法:选择HBsAg阳性慢性乙型肝炎患者168例进行观察。中医证型分为湿热中阻、肝郁脾虚、肝肾阴虚、瘀血阻络、脾肾阳虚5型;BCP双变异检测,采用微板核酸杂交法。结果:BCP双变异的总检出率为36·31%(61/168),其中,湿热中阻型BCP双变异检出率最高(54·24%),与其他各型比较差异均有显著性意义(P<0·052);肝郁脾虚型BCP双变异检出率(36·36%)虽低于湿热中阻型(P<0·025),但却明显高于肝肾阴虚型(13·04%)及瘀血阻络型(10·53%),且差异有显著性意义(P<0·05);肝肾阴虚与瘀血阻络两型BCP双变异检出率均较低,两者比较差异有显著性意义(P>0·05)。结论:HBVBCP双变异的慢性乙型肝炎患者中医证型特点以湿热中阻为主,肝郁脾虚居次,临床治疗要重视清热利湿,舒肝健脾治法或方药的选用。

Objective： To study on the characteristics of TCM types in patients with BCP united mutation of HBV. Methods： One hundred and sixty-eight patients with chronic hepatitis B were selected and divided into five TCM types dampheat hindering in the middle-jiao, stagnation of liver-Qi and insufficiency of spleen, deficiency of liver-Yin and kidney-Yin, blood statis hindering in the channels, deficiency of spleen-Yang and kidney-Yang, The BCP united mutations of HBV were detected using microplates and wichhybridization. Results： The united mutations of BCP were detected in 36. 31% in these paients. Among them, the united mutations of BCP were detected in 54. 24% in the type of damp-heat hindering in the middlejiao, and had a high detectable rate contasted with that in the other TCM types （ P 〈 0. 025 ）, The united mutations of BCP were detected in 36. 36% in the type of stagnation of liver-Qi and insufficieney of spleen, in which, the detectable in 36. 36% in the type. of stagnation of liver-Qi and insufficiency of spleen, in which , the detectable rate was lower than that in the type of dampheat hindering in the middle-jiao, but it was higher than that in the deficiency of liver-Yin and kidney-Yin or in the blood statis hindering in the channels （ P 〈 0. 005 ） . Alower detectable rate of the united mutations of BCP were showed in the type of deficiency of liver-Yin and kidney-Yin （ 13.04% ） and the type of blood statis hindering in the channels （ 10. 53% ）, and no marked difference about the detectable rate of BCP united mutation was showed between tham （ P 〉 0. 05 ） . Conclusion： The major characteristics of TCM type in patients with BCP united mutation of HBV is the camp-heat hindering in the middle-jiao, and is the stagnation of liver-Qi and insufficiency of spleen, secondarily. Therefore, the principle of TCM treatment-elearing away heat and promoting diuresis, soothing the liver and strengthening the spleen, must be pay more attention.