Study On Relationship Between TCM Syndrome Type Of Chronic Hepatitis B And Liver Fibrosis Index Of Real-time Tissue Elastography

Objective:To explore the relationship between the TCM syndrome distribution of chronic hepatitis B and liver fibrosis index of real-time tissue elastography, and perfect Chronic hepatitis B objective indicator of TCM syndrome differentiation, which will provide theoretical basis on combine traditional Chinese and western medicine diagnosis, treat chronic hepatitis B, and hepatitis B hepatic fibrosis.Method:219 patients with CHB were enrolled between January 2015 and January 2016. Then collect TCM symptom information, which based on the Chinese medical syndrome differentiation standards, divided into"Damp heat syndrome, liver stagnation and spleen deficiency syndrome, liver kidney yin deficiency syndrome, blood stasis syndrome and spleen kidney yang deficiency syndrome". What’s more, we were used the real-time tissue elastography to detect the patients’LF index, and collected the information of ALT, AFT, Alb, PLT, HA, LN, PCⅢ, Ⅳ-C and pathological examination for patients with liver biopsy. Software SPSS13.0 will be used for collecting the data. If p<0.05, the research had statistical significance, and bilateral inspection will be applied for hypothesis testing.Results:219 patients were analysed, including in TCM distribution such as:liver stagnation and spleen deficiency syndrome> damp heat syndrome> blood stasis syndrome> liver kidney yin deficiency syndrome>spleen kidney yang deficiency syndrome. The distribution of LF index is:blood stasis syndrome> liver kidney yin deficiency syndrome> spleen kidney yang deficiency syndrome> damp heat syndrome> liver stagnation and spleen deficiency syndrome. The differences between the two groups are significant (F=58.566,P=0.000). The differences on Chinese medicine syndrome among Alb、ALT、HA、LN、PCⅢ、Ⅳ-C are significant (p=0.000、0.034、0.000、0.000、0.020、0.000). There has a correlation between LF and Alb、 HA、LN、PCⅢ、Ⅳ-C (p<0.05). But value between them is low (R2=0.139、0.141、0.069、 0.052、0.101), and the values between LF and ALT、AST have no obvious association (P>0.05).There are 40 liver biopsy results, including 13 for S0,4 for S1,4 for S2,10 for S3, and 9 for S4. The LF index for different fibrosis stages have statistical significance (x 2=33.227, P=0.000), and correlation is obvious(r=0.922, bilateral P=0.000). The areas under the receiver operating characteristic curves for LF, APRI, and FIB-4 are 0.899、0.794、0.740 for predicting substantial fibrosis (scores ≥S2), respectively.Conclusion:1.The chronic hepatitis B patients with TCM distribution as follows:liver stagnation and spleen deficiency syndrome> damp heat syndrome> blood stasis syndrome> liver kidney yin deficiency syndrome>spleen kidney yang deficiency syndrome.2.The LF index are different for different TCM syndrome types of chronic hepatitis B, that’s as follows: blood stasis syndrome> liver kidney yin deficiency syndrome> spleen kidney yang deficiency syndrome> damp heat syndrome> liver stagnation and spleen deficiency syndrome.3.Alb % ALT、HA、LN、PCⅢ、Ⅳ-C for different TCM syndrome are variant.4.There has a correlation between LF and Alb、HA、LN、PCⅢ、Ⅳ-C, but has no obvious association between LF and ALT、AST.5.The LF index for different liver fibrosis stages are variant, and correlation is obvious.6.LF index calculated by RTE is useful for predicting liver fibrosis, and diagnostic accuracy of LF index is superior to APRI and FIB-4 index.