慢性乙型肝炎中医证型与肝脏病理变化的相关性研究

目的探讨慢性乙型肝炎中医的肝郁脾虚、湿热中阻、瘀血阻络证与肝组织炎症分级及纤维化分期的关系，为中医辨证提供客观依据。方法随机选取慢性乙型肝炎肝郁脾虚、湿热中阻、瘀血阻络3种证型各30例，对其进行肝脏活体组织检查，确定肝组织炎症分级（G）及纤维化分期（s）。结果肝郁脾虚证组以G1、s1为主，湿热中阻证组以G2、s2为主，瘀血阻络证组以G3～G4、S3～S4为主。结论慢性乙型肝炎3种中医证型中，从肝郁脾虚证到湿热中阻证再到瘀血阻络证，肝组织病理损害有逐渐加重的趋势。

Correlation between traditional Chinese medicine syndromes and liver pathology in patients with chronic hepatitis B

Objective To investigate the correlation between traditional Chinese medicine （TCM） syndromes and inflammation grades of liver tissue and liver fibrosis stages in the patients with chronic hepatitis B （CHB）, and provide evidence for TCM syndrome differentiation. Methods Thirty CHB patients with stagnation of liver-qi with deficiency of the spleen, 30 with dampness-heat syn- drome and 30 with obstruction of collaterals by blood stasis were randomly selected. Liver biopsy was performed to determine inflam- mation grades of liver tissue and liver fibrosis stages. Results The patients with stagnation of liver-qi with deficiency of the spleen were identified with inflammation grade 1 and liver fibrosis stage 1, those with dampness-heat syndrome with inflammation grade 2 and liver fibrosis stage 2, and those with obstruction of collaterals by blood stasis with inflammation grade 3-4 and liver fibrosis stage 3-4. Conclusion There is a trend of more and more severe pathological lesions from stagnation of liver-qi with deficiency of the spleen, to dampness-heat syndrome, and then to obstruction of collaterals by blood stasis.