Study On Distribution Characteristics Of TCM Syndromes In 1868 Patients With Chronic Hepatitis B Based On Retrospective Epidemiological Survey

Objective:To explore the law of the Chronic Hepatitis B syndromes distribution, and discuss the correlation between main syndromes of Chronic Hepatitis B and representative laboratory indexes.Methods:The medical records of1868patients with chronic hepatitis B, which came from infectious disease department of five Third-level grade A hospitals between January1,2010to January1,2013, were collected based on epidemiological and cross-sectional survey method, and filled the collection table refer to chronic hepatitis B patients’ medical records of TCM. Then we explored the law of the Chronic Hepatitis B syndromes distribution through data processing and statistical analysis, as well as the correlation between main syndromes of Chronic Hepatitis B and representative laboratory indexes. The study site were:the first affiliated hospital of Shandong university of TCM, Xinjiang autonomous region hospital, the first affiliated hospital of Guangxi institute of TCM, Shuguang hospital affiliated to Shanghai university of TCM and the first affiliated hospital of Hunan university of TCM.Results:①Distribution characteristics:The constituent ratio of the syndromedistribution was decreasing as liver depression-spleen deficiency syndrome(LDSDS,42.3%),damp-hot accumulate knot syndrome(DHAKS,23.1%), stagnation of the liver-qi syndrome(SLS,11.9%), yin deficiency of liver-kidney syndrome(YDLS,5.7%),blood stasis syndrome(BSS,5.3%)and yang deficiency of spleen-kidney syndrome (YDSS,3.4%),deficiency of qi and blood syndrome(DQBS,2.7%),phlegm-stasis syndrome(PSS,2.5%),stagnation of qi and retention of dampness syndrome (SQRDS2.1%),others(2.1%)in the1787cases of patients with chronic hepatitis B.②Influences:Gender, age, course of the disease, history of vaccination, transmission routes and residence might not be the influence factors of syndrome types involved1868CHB patients (P>0.05). Some specific symptoms or signs to a certain extent can influence the distribution of CHB syndrome type.③Correlation between main syndromes of CHB and virus indicator:HBeAg was positively related with DHAKS (OR=9.010,P<0.01),HBeAg showed negative correlation with SLS (OR=0.335,P<0.01),YDLS(OR=0.215,P<0.01)and BSS (OR=0.506,P<0.05) and YDSS(OR=0.111,P<0.01);HBeAb showed positive correlation with DHAKS (OR=3.489,P<0.01), and negatively correlated with YDLS(OR=0.356, P<0.01), YDSS (OR=0.108,P<0.01).④Correlation between main syndromes of CHB and liver function index:The ALT value of LDSDS patients fluctuated from100to200u, TBIL value fluctuated between34.2to51.3umol/L, and both had statistically significant differences compared with other syndromes(P<0.01); The ALT(>200u) and TBIL(>51.3umol/L) value of DHAKS patients were significantly higher than other five groups(P<0.01); YDSS patients’ALT(<100u) and TBIL(<34.2umol/L) value were lower compared with other types, also had significant differences(P<0.01); The ALT.value of SLS, YDLS and BSS patients basically below200u, TBIL below51.3umol/L, there were no significant difference among the groups(P>0.05).⑤Correlation between main syndromes of CHB and abdominal ultrasonography examination results:A nearly equal percentage of normal and abnormal patients in group LDSDS, and there was statistically significant differences compared with others (P<0.01). The abnormal rate of DHAKS patients increased significantly higher than other five groups (P<0.01); Abnormal patients dominate in the remaining groups, and there were no significant difference among the groups (P>0.05).Conclusion:①The main of TCM syndrome types were liver depression-spleen deficiency syndrome, damp-hot accumulate knot syndrome, stagnation of the liver-qi syndrome, yin deficiency of liver-kidney syndrome, blood stasis syndrome and yang deficiency of spleen-kidney syndrome.②There exist correlation between TCM syndrome types of CHB and representative laboratory indexes.