慢性乙型肝炎中医证候与实验室指标的相关性研究

目的：探讨慢性乙型肝炎中医证候与实验室指标的相关性。方法将145例慢性乙型肝炎患者按中医辨证分为湿热中阻证、肝郁脾虚证、肝肾阴虚证、瘀血阻络证和脾肾阳虚证5种证候，观察各证候与实验室指标的相关性。结果研究发现湿热中阻证与肝郁脾虚证在5种证候中所占比例最高，分别为53．8％和31．7％；湿热中阻证的总胆红素（TBiL）、间接胆红素（IBiL）阳性率分别为69．4％和68．8％，明显高于其他3组，差异有统计学意义（P＜0．05）；而肝肾阴虚证患者的总胆汁酸（TBA）、丙氨酸氨基转移酶（ALT）及乙肝e抗原（HBeAg）的阳性率明显高于其他3组。湿热中阻证患者 HBV-DNA病毒载量明显高于其他3组（HBV-DNA＞105 copies/mL），病毒复制最为活跃。结论慢性乙型肝炎的中医证候与实验室指标有一定的相关性，实验室指标对慢性乙型肝炎的辨证论治有着较为重要的临床意义。

Study on relationship between TCM syndromes and laboratory indexes of chronic hepatitis B

Objective To discuss the relationship between traditional Chinese medicine （TCM ） syndromes and the laboratory in-dexes in chronic hepatitis B .Methods According to the TCM syndrome differentiation ,145 cases of chronic hepatitis B were divid-ed into the 5 syndromes ：the stagnation of damp-heat in middle-jiao ,the stagnation of liver-QI and deficiency of the spleen ,the spleen-kidney Yang deficiency ,the collaterals obstruction by blood stasis and the liver-kidney Yin deficiency .The correlation be-tween the TCM syndromes and the laboratory indexes was observed .Results The research found that the stagnation of damp-heat in middle-jiao and the stagnation of liver-QI and deficiency of the spleen had the highest proportion in the five kinds of the CM syn-dromes ,which accounted for 53 .8% and 31 .7% ,respectively ;The positive rates of total bile（TBil） and indirect bile（IBil） in the stagnation of damp-heat in middle-jiao were 69 .4% and 68 .8% respectively ,which were significantly higher than those in other 3 groups （P＆lt;0 .05）;However ,the positive rates of total bile acid （TBA） ,alanine aminotransferase（ALT ） and HBeAg in the liver-kidney Yin deficiency were higher than those in other 3 groups .The HBV-DNA viral load in the stagnation of damp-heat in middle-jiao was significantly higher than that in other 3 groups （HBV-DNA＆gt;105 copies/mL） ,and the HBV replication was most active . Conclusion There are some relationships between the TCM syndromes and the laboratory indexes in chronic hepatitis B ,therefore the laboratory indexes have more important clinical significance for the syndrome differentiation and treatment of chronic hepatitis B .