慢性HBV感染不同免疫状态证候分布特点的研究

The chronic HBV infection different immune status on Chinese medical syn dromes research

目的:了解慢性HBV感染不同免疫状态证候分布特点。方法:采用临床流行病学调查、免疫状态分类及中医辨证等方法,按HBV感染免疫耐受、免疫清除和免疫不全(包括非活动和再活动期)三个状态分组,各组200例,分析证候分布特点。结果:600例慢性HBV感染出现的证型有肝郁脾虚、肝肾阴虚、肝郁气滞、湿热内蕴、脾气虚、气阴不足、心肝郁热、肝血虚、肺脾气虚、血瘀证、脾肾阳虚等11个,前五型依次为肝郁脾虚(14.33%)、脾气虚(12.0%)、肝郁气滞(11.0%)、肝肾阴虚(10.83%)及湿热内蕴(10.67%)。三个组前五型,免疫耐受状态组依次为肝郁脾虚(20.5%)、脾气虚(14.0%)、心肝郁热(12.5%)、肝肾阴虚(10.5%)及肝郁气滞(10.5%);免疫清除状态组依次为湿热内蕴(21.0%)、肝郁脾虚(16.5%)、肝郁气滞(15.0%)、心肝郁热(9.0%)及气阴不足(8.0%);免疫不全状态组依次为肝肾阴虚(18.0%)、气阴不足(14.5%)、脾气虚(11.5%)、肝血虚(10.5%)及肝郁气滞(7.5%)。结论:慢性HBV感染涉及中医证候11个,不同免疫状态证候分布特点不同。

Objective：To understand the characteristics of syndrome distribution of different immune status with chronic HBV infection.Methods：The clinical epidemiology investigation,the immune status of classification and TCM syndrome differentiation method according to HBV infection,immune tolerance,immune clearance and immune deficiency（including the inactive and active period） three state packets,each group of 200 patients,study the distribution of the characteristics of TCM syndrome syndromes.Results：In 600 patients with chronic HBV infection syndromes with liver stagnation and spleen deficiency,Yin deficiency of liver and kidney,liver Qi stagnation,accumulation of damp-heat,Qi deficiency,yin deficiency,liver and stomach,deficiency of liver blood,lung and spleen deficiency,blood stasis,deficiency of spleen and kidney yang 11,the first five type in stagnation of liver Qi and spleen deficiency（14.33%）,spleen Qi deficiency（12.0%）,stagnation of liver Qi（11.0%）,liver and kidney Yin deficiency（10.83%） and dampness-heat stay inside（10.67%）.Three group of the first five type,immune tolerance is in the state of stagnation of liver Qi and spleen deficiency（20.5%）,spleen Qi deficiency（14.0%）,heart and liver heat stagnation（12.5%）,liver and kidney Yin deficiency（10.5%） and stagnation of liver Qi（10.5%）;immune clearance is in the state of dampness-heat stay inside（21.0%）,stagnation of liver Qi and spleen deficiency（16.5%）,stagnation of liver Qi（15.0%）,heart and liver heat stagnation（9.0%） and deficiency of Qi and Yin（8.0%）;immune incomplete state group is in the liver and kidney Yin deficiency（18.0%）,deficiency of Qi and Yin（14.5%）,spleen Qi deficiency（11.5%）,liver blood deficiency（10.5%） and stagnation of liver Qi（7.5%）.Conclusion：Chronic HBV infection involve the syndromes of traditional Chinese medicine 11,different immune status have different syndromes distribution characteristics.