慢性乙型肝炎"大三阳"舌象与免疫功能关系的探讨

目的 探讨慢性乙肝“大三阳”患者舌象在疾病发展过程中，其动态演化过程与机体免疫功能改变的相关性。方法 300例“大三阳”患者来自专科门诊和健康普查，其中200例为慢性肝炎，100例为乙肝病毒携带者。另选30名正常者为健康组。比较分析各组舌象与植物血凝素（PHA）皮肤试验，IgG,IgA,IgM的关系。结果 慢性乙肝患者中，随着病情加重，免疫功能严重失调，正常舌象越来越少，出现相应的病理舌象。在常见的红舌，黄腻苔，黄苔等异常舌象中，无情加重，免疫功能严重失调，正常舌象越来越少，出现相应的病理舌象。在常见的红舌，黄腻苔，黄苔等异常舌象中，无论舌象是单个还是三种混合，许多情况下都提示机体免疫功能亢进；淡白，胖大舌，白腻苔等舌象则相反；暗紫舌常只提示免疫功能异常，其中观察舌形及色泽比观察舌苔更有统计学意义（P＜0．05）。结论 在慢性乙肝“大三阳”患者中，舌象与免疫功能有一定的相关性。

Relationship Between Tongue Manifestations and Immune Function in Chronic Hepatitis B with HBsAg, HBeAg and HBcAb Positive

[ Objective ] To investigate the relationship between tongue manifestations and immune function in chronic hepatitis B with HBsAg, HBeAg and HBcAb positive. [Methods] Among the cases of HBsAg, HBeAg and HBcAb positive from the out - patient department and health screening survey, 200 chronic hepatitis patients and 100 asymptomatic HBV carriers with glumatic - pyruvic transaminase at normal level were included. Thirty healthy volunteers served as control. Relationship of tongue manifestations with phytohemagglutinin (PHA) skin test and the serum levels of immunoglobulin (Ig) G, IgA and IgM was analyzed. [Results] With the development of chronic hepatitis, the immune function became disordered and tongue manifestations abnormal. Reddish tongue with or without yellowish greasy fur or yellowish fur showed the hyperactivity of immune function; whitish swollen tongue with or without whitish greasy fur indicated the hypoactivity of immune function; dull purplish tongue was the sign of disordered immune function. The shape and color of tongue was superior to tongue fur in showing the condition of immune function ( P < 0.05) . [Conclusion] There is a correlation between tongue manifestations and immune function in chronic hepatitis B with HBsAg, HBeAg and HBcAb positive.