慢性乙型肝炎患者肝组织炎症及纤维化与中医体质关系的研究

Study on the Relationship between Liver inflammation and fibrosis and TCM constitution Types in Chronic Hepatitis B Patients

目的:探讨慢性乙型肝炎患者(CHB)肝组织炎症及纤维化程度与中医体质的相关性,为临床治疗和预防疾病的进展提供指导。方法:对250例慢性乙型肝炎患者的中医体质类型、肝组织炎症及纤维化程度的构成进行描述性统计,并分析不同中医体质类型患者肝组织炎症和纤维化程度的差异。结果:CHB中医体质以湿热质(27.20%)、气虚质(23.20%)、气郁质(15.20%)和阴虚质(14.40%)为主。平和质患者肝组织以轻度炎症及纤维化为主(G1,S1);湿热质、气虚质以及气郁质患者肝组织以中度炎症及纤维化为主(G2-3,S2-3);阴虚质和血瘀质患者肝组织以中重度炎症及纤维化(G2-4,S2-4)为主。与平和质患者相比,湿热、气虚、气郁和阴虚质患者肝组织炎症程度升高的累积OR值为26.67(P<0.01),血瘀质患者炎症程度升高的累积OR值为206.96(P<0.01),湿热、气虚或气郁质患者肝组织纤维化程度升高的累积OR值为18.75(P<0.01),阴虚或血瘀质患者纤维化程度升高的累积OR值为246.09(P<0.01)。结论:慢性乙型肝炎患者中医体质与肝组织炎症和纤维化程度均有一定的相关性,阴虚质和血瘀质患者肝组织炎症和纤维化程度偏重。

Objective：To investigate the relationship between the degree of liver inflammation and fibrosis and TCM constitution types in chronic hepatitis B patients, and to provide the guidance for clinic treatment and prevention of diseases progression. Methods： Descriptive statistics were used to describe the degree of liver inflammation and fibrosis in 250 patients, and the differences of the inflammation and fibro- sis degree in patients with different TCM constitution types were analyzed. Results： The majority TCM constitution types in chronic hepatitis B patients were Damp-heat constitution （27.20%）, Qi deficiency constitution （23.20%）, Qi-stagnation constitution （ 15.20% ） and Yin-de- ficiency constitution （ 14.40% ）. The inflammation and fibrosis in patients with Gentler constitution were mild （ G1, S1 ）, while patients with Damp-heat, Qi-deficiency or Qi-stagnation constitution were moderate （ （32-3, $2-3 ）, and inflammation and fibrosis in patients with Yin-defi- ciency or Blood-stasis constitution were moderate to severe （G2-4, $2-4）. Compared with Gentler constitution, the cumulative OR of in- creased inflammation in Damp-heat, Qi-deficiency, Qi-stagnation or Yin-deficiency constitution was 26.67 （P 〈0.01 ）, and in Blood-stasis constitution patients, the cumulative OR of increased inflammation was 206.96 （ P 〈 0.01 ）, and the cumulative OR of increased fibrosis in patients with Damp-heat, Qi-deficiency or Qi-stagnation constitution was 18.75 （P 〈0.01 ）, and relative cumulative OR in patients with Yin- deficiency or Blood-stasis constitution was 246.09 （P 〈 0.01 ）. Conclusion： There was a certain correlation between the degree of liver in- flanlmation and fibrosis and TCM constitution types in chronic hepatitis B patients, inflammation and fibrosis in patients with Yin-defieieney or Blood-stasis constitution are more likely to increase.