Study On The Relationship Of Chronic Hepatitis B Fibrosis And Traditional Chinese Medicine Type Of Syndrome

Objective:Chronic hepatitis B is a common disease, as the statistic showed, there are about 120 million who are carrying HBV, and more than thirty million who are suffering from hepatitis B virus. And among them, about 25% to 40% willdevelop to liver cirrhosis or HCC. Chronic Hepatitis----liver cirrhosis——HCC is the three steps course of chronic liver diseases, and liver fibrosis is the mid-course of developing to liver cirrhosis. The dissertation about liver fibrosis of TCM is found in jaundice, flank pain, and so on. Deficiency of healthy energy and cementation of evil is the common pathogenesis of much chronic liver diseases, and the root is deficient but the symptom is sthenic, deficiency and excess coexist. Because of the pathogenic factor affected, and it is strong, but the anti-pathogenic factor is weak, so the pathogenic factor is cementation in the body, and viscera will be injured, and what' s more, it will develop. Liver fibrosis is a dynamic course, and the pathogenesis is complicated and individual. Although stagnation of liver-anergy and dysfunction of the spleen in transporting and distributing nutrients and water run through the whole course, pathogenesis is a dynamic course too. In the different step, the pathogenesis of liver fibrosis is different. In order to find the relationship of fibrosis serologic target and Traditional Chinese Medicine Type of syndrome, the characteristic of syndrome, and the most common syndrome type of chronic hepatitis B fibrosis, we do this study. After that, we can open out the essential of syndrome and the rule of syndrome and external target with the method of integration of syndrome differentiation and disease differentiation, and make a base for drawing up a standard and canonical diagnosis and treatment system with TCM, which will make TCM develop along the modern medicine, and give full play to the characteristic and superiorityof TCM, to prevent or interdict liver fibrosis and improve survival quality integrating of macrocosmic and microcosmic, distinguish hiberarchy and steps, primary and secondary, or cooperative, supporting the vital energy and removing the evil. Methods:Adopt the method of observing cases and laboratory detect. The cases were 152 altogether who were from clinic and in-patient department in May 2004 to Nov. 2005. And they were diagnosed as chronic hepatitis B and liver fibrosis. Write down the detail information including the medical record, symptoms, syndrome type, and the laboratory results as ALT, AST, HBV-DNA, and PCIH, Cl-IV, LN, HA, etc. And then, collect all the information and make a database, and make the result by SPSS13. 0 software, manage descriptive statistics, use rank sum test to manage ordinal data, use analysis of variance for quantitative data, and rank sum test if it is not homogeneity of variance, 2-tail, a=0.05. Results:Of the whole 152 cases of chronic hepatitis B, 112 cases is the stagnation of liver-energy and spleen deficiency type, it is 73.68% of all;and the sequence of the retention of evil wetness-heat type, accumulated blood stasis Type, the liver and the kidney yin-deficiency type, the spleen and the kidney yang-deficiency type are respective 20(13.16%), 16(10. 53%), 3(1. 97%), 1(0. 66%). The stagnation of liver-energy and spleen deficiency type is the most in the masculine cases of PCITJ, Cl-IV, LN, HA. The sequence of the masculine cases of PCITJ, LN, HA is stagnation of liver-energy and spleen deficiency type, the retention of evil wetness-heat type, accumulated blood stasis type, the liver and the kidney yin-deficiency type and the spleen and the kidney yang-deficiency type. The sequence of Cl-IV is stagnation of liver-energy and spleen deficiency type, the retention of evil wetness-heat type, accumulated blood stasis type, and the spleen and the kidney yang-deficiency type the liver and the kidney yin-deficiency type. Of the four liver-fibrosis target, the liver and the kidney yin-deficiency type elevates highest in PCITJ, followed by stagnation of liver-energy and spleen deficiency type and the retention of evil wetness-heat type the last. The ascending sequence of Cl-IV is accumulated blood stasis type, stagnation of liver-energy and spleen deficiency type, retention of evil wetness-heat type, and the liver and the kidney yin-deficiency type;that of LN and HA is respectively stagnation ofliver-energy and spleen deficiency type, retention of evil wetness-heat type, the liver and the kidney yin-deficiency type, accumulated blood stasis type and accumulated blood stasis type, stagnation of liver-energy and spleen deficiency type, the liver and the kidney yin-deficiency type, the retention of evil wetness-heat type. But there is no significant difference in groups compared (P>0. OS). In the relationship of liver function, Cl-JV is significant difference in different liver function groups (P<0. OS). It is considered that different degree liver function impacted Cl-IV, Cl-IV would increase as liver function became worse. But PCm, LN, HA were no significant difference in groups of different liver function (P>0. OS). In correlation analysis, ALT and AST had low correlation with Cl-IV, and no correlation with PCHI, LN and HA. About the relationship of replication of HBV-DNA and the four liver fibrosis targets, there is no obvious difference in Cl-IV, LN, HA when different quantitative HBV-DNA groups. In PCITJ, there is obvious difference in the middle replicate group and the normal group(P<0. OS). The correlation analysis of quantitative HBV-DNA and the four liver-fibrosis target showed no correlation in quantitative HBV-DNA and liver-f ibrosis target (P>0.0S). Conclusions:Stagnation of liver-energy and spleen deficiency type is the most common in chronic hepatitis B with liver fibrosis. Stagnation of liver-energy and spleen deficiency, retention of evil wetness-heat, accumulated blood stasis, the liver and the kidney yin-deficiency and the spleen and the kidney yang-deficiency are the different phases of chronic hepatitis B and liver fibrosis as disease develops. As the state aggravating, the degree of liver fibrosis was increasing, but the cases decreased. Liver function and replication of HBV-DNA are the two targets which reflect the inflammation of liver, and they reflect the liver inflammation in a way, but they can' t reflect liver fibrosis, so, we can' t consider there is no liver fibrosis because of the normal liver function or low replicate of HBV-DNA, in the same way, we can' t consider that liver fibrosis is occurring when we see the abnormal liver function or high replicate of HBV-DNA.