慢性乙型肝炎患者血清和胃黏膜乙型肝炎病毒与肝胃不和证的关系

目的:探讨慢性乙型肝炎患者胃黏膜乙型肝炎病毒(hepatitis B virus,HBV)与中医肝胃不和证的关系.方法:选择符合条件的慢性乙型肝炎肝胃不和证患者30例,并以慢性胃炎肝胃不和证患者30例为对照,采集空腹血液标本,进行电子胃镜检查,取胃窦、胃体、胃底黏膜;用核酸扩增荧光定量法检测血清、胃黏膜HBV-DNA,综合分析各检测值对肝胃不和证积分的意义.结果:(1)慢性乙型肝炎肝胃不和证组的脘胁胀闷疼痛、嗳气呃逆以及肝胃不和证总积分明显低于慢性胃炎肝胃不和证组(P＜0.01).(2)慢性乙型肝炎组患者血清和胃窦、胃体、胃底黏膜HBV-DNA检出率分别为56.7%、76.7%、76.7%、70.0%,血清、各处胃黏膜HBV-DNA滴度呈正相关(r=0.66～0.94,P＜0.01),且与肝胃不和总分呈正相关(r=0.36～0.52,P＜0.05),以胃体HBV-DNA与肝胃不和总分相关性最密切(r=0.52,P＜0.01).结论:慢性乙型肝炎患者肝胃不和证与胃黏膜HBV感染有关.

Relationship between hepatitis B virus in gastric mucosa and syndrome of disharmony between liver and stomach in patients with chronic hepatitis B

Objective: To study the relationship between the infection of hepatitis B virus (HBV) in gastric mucosa and the syndrome of disharmony bet ween liver and stomach. Methods: Subjects were divided into 2 grou ps: 30 patients with chronic hepatitis B (CHB) and the syndrome of disharmony between liver and stomach in hepatitis group, and 30 patients with chronic g astritis and the syndrome of disharmony between liver and stomach in gastritis g roup. Liver function and the markers of HBV were detected. The contents of HBV- DNA in serum and in gastric mucosa were assayed respectively by fluorescence qua ntitative polymerase chain reaction (FQ-PCR). Results: (1)The incid ence of gastric mucosal lesion in hepatitis group was up to 96.7% (29/30). (2)Sc ores of the syndrome of disharmony between liver and stomach in hepatitis group were significantly lower than those in gastritis group (P<0.05). The positiv e rates of HBV-DNA in serum, gastric fundus, body and antrum were 56.7%, 76.7%, 76.7% and 70.0%, respectively. (3)A positive correlation was found not only among the content of HBV-DNA in serum and the contents of HBV-DNA in gas tric mucosa (r=0.66- 0.94, P< 0.01), but also among the conte nts of HBV-DNA in serum, gastric mucosa and the total score of the syndrome of disharmony between liver and stomach in hepatitis group (r=0.36-0.52,P< 0.05). Conclusion: The infection of HBV is involved in the syndr ome of disharmony between liver and stomach. Gastric mucosal lesion is u niversal in CHB patients with the syndrome of disharmony between liver and stoma ch.