The Relationship Between The Distribution Of TCM Syndrome And The Levels Of Serum HBV RNA In Patients With Chronic Hepatitis B

Objective:to determine the serum hepatitis B virus ribonucleic acid in patients with chronic hepatitis B(CHB),Objective to explore the expression characteristics and distribution differences of serum HBV RNA in CHB patients with different TCM syndrome types,and to seek the objective indicators of TCM syndrome differentiation,so as to provide reference for the diagnosis and treatment of CHB patients with integrated traditional Chinese and Western medicine.Methods:131 patients with CHB were selected and classified according to TCM syndrome differentiation through four diagnostic methods.The general data and laboratory indexes of patients were collected,and the serum HBV RNA level was detected.The expression characteristics and distribution differences of serum HBV RNA in patients with CHB of different TCM syndrome types were analyzed,and the relationship between them and TCM syndrome types was discussed.result:1.In 131 cases of CHB,the distribution of each syndrome type was liver depression and spleen deficiency>liver gallbladder damp heat>liver kidney yin deficiency>blood stasis obstructing collaterals>spleen kidney yang deficiency,in which liver depression and spleen deficiency accounted for 44.3%and dampness heat syndrome accounted for 39.7%.2.The distribution of serum HBV RNA level in CHB patients with different TCM syndrome types was statistically significant(P<0.05).3.There were significant differences in the distribution of serum ALT level,HBsAg quantitative,HBV DNA level,liver inflammation grade(g)and fibrosis stage(s)among CHB patients with different TCM syndrome types(P<0.05).4.There was significant difference in the distribution of serum HBV RNA level among the natural course stages of chronic HBV infection(χ~2=104.974,P<0.001).The mean level of HBV RNA was 6.72 log10 IU/ml in immune tolerance phase,6.50 log10 IU/ml in immune clearance phase,4.16 log10 IU/ml in reactivation phase and 1.69 log10 IU/ml in immune control phase.5.There was a positive correlation between serum HBV RNA level and serum HBV DNA level(r=0.824,P<0.001).Among them,there were correlations between serum HBV RNA level and serum HBV DNA level in immune tolerance stage(r=0.389,P=0.031),immune clearance stage(r=0.598,P<0.001)and reactivation stage(r=0.876,P<0.001).6.There was rank correlation between serum HBV RNA level and ALT level and HBsAg level in CHB patients,and the correlation coefficients were 0.336 and 0.465,respectively,P<0.001.7.There were significant differences in the distribution of serum HBV RNA in different liver tissue inflammation grades(P<0.001)and fibrosis stages(P=0.004).Conclusion:1.There is correlation between serum HBV RNA level and TCM Syndrome Types in CHB patients,and the positive rate of liver depression and spleen deficiency syndrome is the highest.2.The expression of serum HBV RNA level in each natural course stage of chronic HBV infection was as follows:immune tolerance stage>immune clearance stage>reactivation stage>immune control stage.3.There was a positive correlation between serum HBV RNA level and HBV DNA level in immune tolerance period,immune clearance period and reactivation period.4.The serum HBV RNA level of CHB patients was correlated with ALT level,HBsAg quantity,HBV DNA level,liver inflammation grade and fibrosis.