Study On TCM Constitutional Type Of Hepatitis B Virus Carriers And Its Relationship With The B Lymphocyte Percentages And Fibroscan Value

BackgroundChina is a high prevalence of hepatitis B virus, estimate has a population of nearly 100 million long-term hepatitis B virus. Because the signs and symptoms of such patients are often not significant, so they often ignore the virus on the liver internal chronic slight injury. As the lesions progressed, it may develop into chronic hepatitis B, liver fibrosis and even hepatocellular carcinoma (HCC).The cause of the hepatitis B virus carrier is the decline in the immune function of the human body, the immune system can’t completely clear the hepatitis B virus from the body, the body produces the immune tolerance, so become the person that a hepatitis B virus carriers. In recent years, The cellular immune function in patients with chronic hepatitis B, that is the study of T lymphocytes has become more widely but the related study on humoral immunity mediated by B lymphocytes carried out less. Our study by measuring different physical carriers of hepatitis B virus B lymphocyte count, looking for the part of patients with different constitution classification and correlation of the humoral immune response, to explore the treatment methods of traditional Chinese medicine from the aspects of the regulation of humoral immunity, to optimize scheme of the Chinese and Western medicine treatment in those patients. Liver fibrosis is a kind of liver cell damage repair mechanisms. The further development of liver fibrosis may eventually become cirrhosis.The early stage of liver fibrosis is reversible. therefore Liver fibrosis examination is very important to evaluate the severity and prognosis, determine the therapeutic schedule, evaluate the effectiveness of treatment. FibroScan is a new kind of examination method, it can quantify accurately determine the degree of liver fibrosis. Currently FibrosScan for assessing hepatitis B carriers of liver stiffness study relatively rare, traditional Chinese medicine understanding of hepatitis B virus carriers is still in a deepening process. The related research about the hepatitis B virus carriers physical distribution is less. Considering the hepatitis B virus carriers may have certain differences in constitution, By studying the differences in physical distribution, in order to understand the physical characteristics of the patients, to provide a new way for hepatitis B virus carriers conditioning and health care.ObjectivesTo classify the constitutions and analyze its distribution characteristics of hepatitis B virus by TCM constitution classification Criteria, and research its relationship with the quantification of HBV DNA, B lymphocyte percentage and FibroScan(FS) value, to help clinicians understand hepatitis B virus carriers constitution distribution characteristics and have a reasonable adjustment method for the hepatitis B virus carriers with biased constitution. By analyzing the relationship between the constitution distribution characteristics and the quantification of HBV DNA, B lymphocyte percentage and FS value, in order to understand the relationship between the different constitution and the level of HBV DNA, resolving different physical humoral immune status, liver fibrosis extent by FibroScan noninvasive detection means, and guiding clinicians to intervene in hepatitis B virus carriers by regulating humoral immune function. Through the analysis of the physical distribution hepatitis B virus carriers and HBV DNA capacity, B lymphocyte percentage, FS value of the correlation, in order to understand the physical hepatitis B virus carriers classification and HBV DNA level which the relationship between the different constitution and analytic hepatitis B virus carriers humoral immune status, liver fibrosis degree, further discussed through the FibroScan noninvasive detection means to understand the hepatitis B virus carriers liver fibrosis degree and guide clinicians from regulating humoral immune function to intervene in hepatitis B virus carriers. The study will also help the hepatitis B virus carriers looking for more reasonable inspection method, and striving to lay the foundation of a more optimized treatment on this part of patients, deepening the hepatitis B virus carriers theory of "Preventive treatment of disease".MethodsUsing the method of questionnaire. According to the TCM constitution classification and decisiontable. The study included 139 cases of hepatitis B virus carriers Guangdong Province Traditional Chinese Medical Hospital Department of hepatopathy and outpatient. Judging their TCM constitution and collecting some lab examination results such as quantification of HBV DNA、 B lymphocyte percentages and liver stiffness. Creating database. Using SPSS19.0 software to process datas.Results1. The constitutional types of the 139 samples from high to low rankings were Damp-heat type, Qi-deficiency type, Gentleness type, Qi-depression type, Blood-stasis type, Yang-deficiency type, Yin-deficiency type, Phlegm-wetness type and Special intrinsic type. Among them, The constitutional types of HBeAg positive hepatitis B virus carriers from high to low rankings were Damp-heat type, Qi-deficiency type and Gentleness type, Blood-stasis type, Qi-depression type, Yang-deficiency type and, Phlegm-wetness type, Yin-deficiency type. The constitutional types of HBeAg negative hepatitis B virus carriers from high to low rankings were Qi-deficiency type, Gentleness type, Qi-depression type, Yang-deficiency type and Yin-deficiency type, Damp-heat type,, Phlegm-wetness type, Blood-stasis type, Special intrinsic type.2. The relationship between TCM constitutional types and quantification of HBV DNA were:when the range of quantification of HBV DNA greater than or equal to 106 IU/ml, the frequency of Damp-heat type was higher than other types.3. The relationship between TCM constitutional types and the percentages of B lymphocyte:the percentages of CD5+B cell within in Damp-heat type, Qi-deficiency type, Gentleness type, Yang-deficiency type, Blood-stasis type was comparative differences. Yang-deficiency type, Yin-deficiency type, Qi-deficiency type, Qi-depression type was comparative differences.All TCM constitutional types’ CD19+B lymphocyte levels in the normal range, Damp-heat type compared with Gentleness type, Qi-deficiency type, Yang-deficiency type, Yin-deficiency type, Phlegm-wetness type, Qi-depression type have differeces. Blood-stasis type compared with Gentleness type, Qi-deficiency type, Yang-deficiency type, Qi-deficiency type have differences.4. The relationship between percentages of B lymphocyte and quantification of HBV DNA were:there was no significant differences between percentages of B lymphocyte and quantification of HBV DNA.5. The relationships between TCM constitutional types and Stiffiness: the average Stiffiness within Blood-stasis type was higer than which within other constitutional types. Damp-heat type was different with Qi-deficiency type.6. The relationship between Stiffiness and quantification of HBV DNA were: while significant relationship was found between HBV DNA quantification and Stiffiness.7. The relationship between B lymphocyte、Stiffiness and HBeAg were:HBeAg positive chronic hepatitis B virus carriers CD19 B lymphocyte percentage level higher than that of HBeAg negative hepatitis B virus carriers. Stiffiness changes had nothing to do with HBeAg positive or not.ConclusionThe characteristics of TCM constitutional type of Hepatitis B virus carriers had certain distribution law. There were some relationship between characteristics of TCM constitutional type and the quantification of HBV DNA、 B lymphocyte percentages and stiffiness. Liver stiffness value and HBV DNA load has a certain correlation.