摘要
目的:探讨慢性乙型肝炎中医证型的相关因素。方法:检侧符合诊断标准的381例慢性乙型肝炎患者透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层粘连蛋白(LN)、肿瘤坏死因子-α(TNF-α)、转化生长因子β1(TGF-β1)等指标的水平及208例患者肝组织病理,观察上述指标与中医证型的关系。结果:瘀血阻络组HA、PCⅢ、LN、Ⅳ-C、TGF-β1高于其它各型(P<0.01);肝郁脾虚型HA、PCⅢ、LN、Ⅳ-C、TGF-β1、TNF-α高于正常水平(P<0.01或P<0.05),明显低于其他各型(P<0.01);湿热中阻、瘀血阻络组TNFα、TGF-β1高于肝肾阴虚、脾肾阳虚组(P<0.01),而湿热中阻组TNF-α高于瘀血阻络组(P<0.01);肝郁脾虚、湿热中阻型S1~S2级G1~G2期较多,肝肾阴虚型和脾肾阳虚型S3级G2~G3期较多,瘀血阻络型以S3~S4级G3~G4期为主。结论:慢性乙肝的肝组织病理改变、HA、PCⅢ、LN、Ⅳ-C、TGF-β1、TNF-α等指标的异常变化与中医证型之间存在一定相关性。
Objective:The aim of this study is to investigate the factors related to TCM dialectical of chronic hepatitis B(CHB).Methods:381 cases of CHB patients were tested blood parameter including hyaluronic acid(HA),Ⅲ procollagen type(PC Ⅲ),Ⅳ collagen(Ⅳ-C),laminin(LN),tumor necrosis Factor-α(TNF-α)and transforming growth factor β1(TGF-β1).208cases of patients were liver biopsy.We observed the relationship of the above-mentioned targets with TCM diactical.Results:Comparision among the different syndrome types revealed that in static blood obstructing the Channels and collaterals patients,HA,PC Ⅲ,Ⅳ-C,LN and TNF-α were significantly higher than the other type(P0.01).In Liver depression and spleen deficiency patients,HA,PC Ⅲ,LN,Ⅳ-C,TGF-β1 and TNF-α higher than normal levels(P0.01or P0.05)Spleen-kidney yang deficiency patients all that blood parameter were obviously lower than other TCM dialectical type.However in damp-heat obstracting the center and tatic blood obstructing the Channels and collaterals patients,TNF-α,TGF-β1 were higher than that of kidney-yin deficiency and liver and spleen Yang Deficiency patients.(P0.01)In damp-heat obstracting the center patients TNFα was higher than that in static blood obstructing the Channels and collaterals patients.(P0.01)In liver depression and spleen deficiency,damp-heat obstracting the center patients liver pathologcal change were class S1~S2 and G1~G2 period.most liver-kidney-yin deficiency type and spleen and kidney-yang deficiency patients belong to class S3 and G2~G3 period.Static blood obstructing the Channels and collaterals patients liver pathologcal change were class S3~S4 and G3~G4 period.Conclusion:It is related that CHB patients liver pathology change,HA,PCⅢ,LN,Ⅳ-C,TGF-β1,TNF-α and TCM dialectical type.
出处
《辽宁中医杂志》
CAS
北大核心
2011年第6期1036-1038,共3页
Liaoning Journal of Traditional Chinese Medicine
基金
慢性乙型肝炎中医辨证分型微观量化研究(0632007-2)
关键词
慢性乙型肝炎
中医证型
微观辨证
辨证规范化
CHB
TCM dialectical type
micro-differentiation
standardization Differentiation