Characteristics Of Shanxi Chronic Hepatitis C Gene Syndromes

Objective:Hepatitis B virus (HBV) infection is a worldwide health problems. HBV factors such as the characteristics and mechanism of host immune disorder lead to chronic HBV infection, and eventually lead to cirrhosis and hepatocellular carcinoma (HCC). There are about1million people worldwide died of liver cirrhosis and HCC each year. The problem of prevention and control about HBV is particularly important because HBV infectious diseases has become a serious threat to human health.After HBV infection, It depends on the difference between the genomes of individual and virus genotype difference to a large extent that the body’s ability to clear the virus and the outcome after infection. The genotype B and C are the most common in our countiy. The Chronic Hepatitis B (CHB) caused by different HBV genotypes have the different incidence for patients. Compared with genotype B, the viral load of the patients with C genotype is higher, the duration of active HBV replication is longer, HBeAg seroconversion time is later, and antiviral effect is poorer by Epidemic survey. Genotype C is one of the high-risk factors for the development of hepatocellular carcinoma and liver cirrhosis. HBV genotype C is main genotype of Shanxi region, which has the high incidence of infection.So it is an urgent need to solve the problem for the reasonable treatment of CHB currently.Chronic hepatitis B belongs to the "Hypochondriac","Jaundice" in the Traditional Chinese Medcine(TCM) category. In recent years, Chinese medicine syndrome differentiation and treatment in the treatment of CHB plays a vital role. Treatment based on syndrome differentiation of TCM is the basic principle of diagnosis and treatment of diseases. The differentiation plays a key role in guiding, and is the foundation of treatment. The same disease appears different clinical manifestations, due to the different stages of disease, patients region, and the patient’s constitution, seasonal factors, and so on.A large number of clinical observation and basic research shows that Chinese medicine has antiviral action, immune regulation, the prevention and treatment of liver fibrosis combination, and improving the clinical symptoms.But there are still many key problems should be solved at present. Due to the complexity of pathogenesis of CHB, and because the advantages of genotype differences around the region, syndrome differentiation standard has not been unity, and curative effect evaluation system is not perfect, especially the TCM syndromes of CHB is not conducive to guide clinicalbecause the lack of standardization research.Considering the shanxi region climate, geography, and host factors impact on the TCM syndrome types of CHB, we will extract the corresponding syndrome elements and carry out the syndrome of Shanxi region by cluster analysis, factor analysis, principal component analysis of multivariate statistical methods, and detect HBV genotype by Sanger nuceic acid method. Finally,we will study the corresponding relationship between TCM syndrome and HBV genotype with clinical indicators. Methods:Based on extensively reviewing the relevant literature, collected the clinical symptoms of TCM of the ascites with CHB, then established an initially clinical epidemiological survey questionnaire. At last, determined the required clinical symptoms of the survey questionnaire item pool in TCM, and made the corresponding classification of quantitative criteria symptoms by relevant expert advice and feasibility analysis, repeated discussions and seminars and clinical research guidelines. Used uniform questionnaire to collect clinical syndromes data of the ascites with CHB. We use the method of factor analysis to investigate its characteristics of TCM syndrome, and to discuss the relationship between the objective indexes with the characteristics of TCM.Results:1The results show that the TCM syndrome in patients with CHB in shanxi region can be summarized five types by multivariate statistical analysis with collected clinical data of420cases,including Unlicensed discernible type, liver stagnation and spleen deficiency, wetness-Heat of Liver and Gallbladder deficiency of liver-yin and kidney-yin and obstruction of collaterals by blood stasis.2HBV genotypes in shanxi region is analyzed by Dideoxy method of nucleic acid suggests genotype C is the most prevalent followed by B/C and B in Shanxi Province.Further analysis showed that patients with genotype C syndrome type of traditional Chinese medicine is given priority to with dampness heat resistance, blood stasis resistance type winding times, TCM syndrome type and hepatitis, is close to the parting and HBVDNA quantitative no significant correlation.3The genotype C in patients with CHB are divided into three groups with light, medium and heavy, the results showed different distribution of TCM syndrome in hepatitis is different. The mild is mainly seen in Unlicensed discernible type, liver stagnation and spleen deficiency, wetness-Heat of Liver and Gallbladder,the severe is mainly seen in deficiency of liver-yin and kidney-yin and obstruction of collaterals by blood stasis, iver stagnation and spleen deficiency,detness-Heat of Liver and Gallbladder can be distributed in each stage, however, as the illness is aggravating, its ratio have gradually decreasing trend. The obstruction of collaterals by blood stasis can be seen mainly in moderate and severe CHB, mild and there’s a small proportion of the involved.Deficiency of liver-yin and kidney-yin is restricted to medium, heavy, not in light.4The TCM syndrome of CHB has no significant correlation with the quantity of HBVDNA.5Genotype C of mild CHB patients with liver tissue inflammation activity and fibrosis degree has obvious correlation with TCM syndrome types, while the syndrome of obstruction of collaterals by blood stasis is most severe in patients with liver injury.Conclusion: Genotype C is the most prevalent followed by B/C and B in Shanxi Province. The syndrome in patients with CHB in shanxi region can be summarized five types by multivariate statistical analysis,including Unlicensed discernible type, liver stagnation and spleen deficiency, wetness-Heat of Liver and Gallbladder,deficiency of liver-yin and kidney-yin and obstruction of collaterals by blood stasis. The syndromes of liver stagnation and spleen deficiency, wetness-Heat of Liver and Gallbladder are the most types of all, The syndromes are closely related to disease and liver tissue pathology,but no significant correlation with te quantity of HBVDNA.