慢性乙型肝炎病毒感染不同免疫状态主要证候的研究

Study of different immune status of main TCM syndromes of chronic HBV infection

目的:通过对慢性乙型肝炎病毒(HBV)感染不同免疫状态证候的研究,了解各不同免疫状态的主要证候。方法:采用免疫学分类、证候分型及临床流行病学调查等方法,选择慢性HBV感染免疫耐受、免疫清除和免疫不全3个状态各200例,进行主要证候分析。结果:慢性HBV感染3个不同免疫状态出现的证候均有肝郁脾虚、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。不同免疫状态中免疫耐受组肝郁脾虚、脾气虚及心肝郁热证高于其他两组(P<0.05);免疫清除组湿热内蕴和肝郁气滞证高于其他两组(P<0.05)。免疫不全组肝肾阴虚、气阴不足和肝血虚证高于其他两组(P<0.05)。结论:慢性HBV感染各免疫状态组涉及的中医证候有11个,不同免疫状态主要证候分布有差异。

Objective： Through the research of different immune state syndromes of chronic HBV infection, to understand the different immune status of TCM syndrome distribution. Methods： Using immunological classification, syndromes and clinical epidemiology survey method, select 200 HBV patients of different states among immune tolerance, immune clearance and immune deficiency respectively, and have a main syndrome analysis. Results： Three different immune states of chronic HBV infection all have syndromes of liver depression and spleen deficiency, yin deficiency of liver and kidney, liver qi stagnation, accumulation of damp-heat, spleen qi deficiency, qi and yin deficiency, heart and liver stagnated heat, deficiency of liver blood, lung and spleen qi deficiency, blood stasis, deficiency of spleen and kidney yang. In immune tolerance group, incidences of liver depression spleen deficiency, spleen qi deficiency and heart liver stagnated heat syndromes are higher than the other two groups （P〈0.05）; immune clearance state group, heat and humidness retention, liver depression and qi stagnation syndromes are frequent, compared with the other （P〈0.05）, immune deficiency state group, yin deficiency of liver and kidney, Qi and yin deficiency and liver blood deficiency syndromes are more than the other two groups （P〈0.05）. Conclusion： Chronic HBV infection immunity group involves 11 syndromes of traditional Chinese medicine, and different immune status of main syndromes distributes differently.