慢性乙型肝炎中医证型分布与免疫学指标、HBV-DNA定量关系的研究

目的探讨慢性乙型肝炎中医证型分布规律及各证型与实验室指标的关系。方法选取合格研究对象300例,观察其HBV-DNA、T细胞亚群等实验室指标。结果肝郁脾虚型为最常见证型;外周血中T细胞免疫功能在不同证型之间存在统计学差异;HBV-DNA高拷贝占拷贝患者数依次为肝郁脾虚型(41.1%)>湿热中阻型(22.6%)>瘀血阻络型(21.2%)>肝肾阴虚型(8.5%)>脾肾阳虚型(5.6%);随着病毒拷贝数的增加,CD4+T细胞百分率及CD4+/CD8+比值减少;CD8+T细胞百分率则与HBV-DNA拷贝数的增加成正比。CD3+和CD4+T细胞百分率在患者各组之间无明显差异,但DNA阴性组CD8+T细胞百分率明显低于DNA阳性组。结论慢性乙型肝炎的中医证型分布具有一定的规律;外周血淋巴细胞免疫功能检测结果(如CD3+、CD4+、CD8+及CD4+/CD8+)、HBV-DNA载量可以作为临床辨证分型的客观参考依据。

Quantitative relationship between TCM syndrome distribution and immunological parameters and HBV-DNA in chronic hepatitis B

Objective To investigate the relationship between TCM syndrome distribution laws and certificate of chronic hepatitis B-type and laboratory indicators.Methods A total of 300 eligible subjects were enrolled in the study.The HBV-DNA,T cell subsets and other laboratory parameters were observed.Results Stagnation and spleen deficiency is the most common type.T-cell immune function in the peripheral blood had significant difference between different syndrome types.The HBV-DNA high copy accounting for copy number of patients: liver and spleen deficiency(41.1%)>damp heat resistance type(22.6%)>blood stasis type(21.2%)>liver-kidney(8.5%)>spleen and kidney yang(5.6%).With the increase of the virus copy number,CD4+ T cell percentages and CD4+/CD8+ ratio decreased.CD8+ T cell percentage and HBV-DNA copy number increased proportionally.CD3+ and CD4+ T cell percentage between groups showed no significant difference DNA negative group.CD8+ T cell percentage was significantly lower than the DNA-positive group.Conclusion TCM syndromes of chronic hepatitis B with a certain regularity.Peripheral blood lymphocyte immune function test results(Eg,of CD3+,of CD4+,CD8+ and of CD4+/CD8+),HBV-DNA load can be used as the objective reference of the type of clinical syndrome.