中医体质理论在慢性乙型肝炎诊治中的应用

Clinical application of traditional Chinese medicine constitution theory in diagnosis and treatment of chronic hepatitis B

中医体质学是从中医角度揭示宿主个体遗传特征的重要手段,中医体质类型可影响HBV慢性感染者的肝脏病理进展和疾病转归,还与以人类白细胞抗原(HLA)II类基因为代表的免疫调节基因多态性一定程度相关;其中阴虚质与慢性HBV感染者多种不良临床转归有关,并与HLA-DQA1*0501等基因型存在关联;初步数据还显示阴虚质慢性乙型肝炎(CHB)患者干扰素治疗应答较差。对中医体质理论在CHB诊治中的应用现状和潜在价值及存在的主要问题作一评述。

The traditional Chinese medicine（ TCM） constitution theory is an important means to reveal the host＇s genetic characteristics from the perspective of TCM. The types of constitution can influence liver pathological changes and the prognosis of disease in patients with chronic hepatitis B virus infection,and to a certain degree,they are associated with the polymorphisms of genes involved in immunoregulation,for example,human leukocyte antigen（ HLA） class Ⅱ gene. Yin- deficiency constitution is associated with various adverse clinical outcomes,as well as the genotypes of genes including HLA- DQA1 ＊ 0501. Preliminary data also show that the chronic hepatitis B（ CHB） patients with yin- deficiency constitution have a poor response to interferon therapy. This article reviews the current application of TCM constitution theory in the diagnosis and treatment of CHB,its potential value,and existing problems.