HBeAg阳性与阴性慢性乙型肝炎患者中医辨证及其相关指标的比较

目的探讨HBeAg阳性与阴性慢性乙型肝炎(慢乙肝)患者中医辨证及其相关指标的相关性。方法对226例慢乙肝患者进行中医辨证分型,检测乙肝两对半、乙肝病毒DNA定量和肝功能、肝纤维化指标。结果各证型的乙型肝炎病毒(HBV)水平呈一定规律性,肝郁脾虚型>肝肾阴虚型>湿热中阻型>脾肾阳虚型>瘀血阻络型,随着病情的活动、病程的推延,HBV水平逐渐下降。无论HBeAg阳性与阴性,慢乙肝患者肝郁脾虚、肝肾阴虚、脾肾阳虚、瘀血阻络各型与湿热中阻型相比肝功能和肝纤维化指标均存在显著性差异。结论各证型的HBV水平呈一定规律性,提示病毒滴度与中医病因病机的转化有一定关系。湿热中阻和瘀血阻络是肝纤维化的关键。

Comparison of differential diagnosis and correlated indexes in patients with chronic hepatitis b with HBeAg positive or negative

Objective It is to explore the differential diagnosis and its relationship with correlated indexes in patients with chronic hepatitis b with HBeAg positive or negative.Methods 226 patients with chronic hepatitis b were diagnosed with differential diagnosis,and their indexes of hepatitis b five items,HBV-DNA quantitation,liver function and hepatic fibrosis were determined.Results The level of HBV in every syndrome showed some regularity: stagnation of liver-energy and asthenia of spleen>deficiency of liver-Yin and kidney-Yin>middle-stagnation of wetness-heat>deficiency of spleen and kidney Yang> blood stasis obstruction of collaterals.The level of HBV gradually low down along with the development of the disease.Whether HBeAg was positive or negative,there were significant differences in indexes of liver function and hepatic fibrosis in patients with chronic hepatitis b with middle-stagnation of wetness-heat compared with ones with other syndromes.Conclusion The level of HBV in every syndrome shows some regularity,which indicates that there is some relationship between titer of the virus and the changes of traditional Chinese medical disease cause and pathogenesis.Middle-stagnation of wetness-heat and blood stasis obstruction of collaterals are the key point of hepatic fibrosis.