| ObjectiveWith the current increase in patients with chronic liver disease,chronic liver disease is often found in clinical patients with endocrine and metabolic diseases,increasing the complexity of the patient' s disease,increasing the patient's pain and treatment burden,while increasing the difficulty of medical staff treatment At present,there is also a large amount of data in clinical reports that chronic liver diseases including fatty liver,liver cirrhosis and other diseases are often associated with metabolic syndromes,such as impaired glucose tolerance or hypothyroidism.The study of liver diseases and endocrine and metabolic diseases has become a hot topic.The liver serves as a target organ for a variety of endocrine hormones and an organ for the inactivation of a variety of hormones.When the liver functions abnormally or is damaged,it often affects the levels of endocrine hormones in the body.With the persistent high rate of chronic hepatitis B virus infection in China,the aging of chronic hepatitis B patients,the aging of the age of hepatitis B virus,and the incidence of liver cirrhosis and liver cancer progression in patients with chronic hepatitis B At the same time,the annual death rate of liver cirrhosis or liver cancer caused by chronic hepatitis B has reached 650,000.Therefore,it has become an important issue to deeply understand the relationship between chronic hepatitis B cirrhosis and endocrine hormones.In order to further explore the metabolic status between certain hormone levels related to chronic hepatitis B cirrhosis in the clinic,and to explore the characteristics of related hormones in patients with chronic hepatitis B cirrhosis of different TCM syndrome types,it makes clinical treatment slower.Hepatitis B cirrhosis when looking for a relatively objective hormone indicators to reflect the effectiveness of Chinese medicine treatment,as well as to deepen the understanding of chronic hepatitis B liver cirrhosis disease of the dialectical distribution characteristics of TCM.MethodsTwenty patients with chronic hepatitis B cirrhosis who were treated at the Third Hospital of Zhongshan Hospital in Guangzhou and wards in the ward were collected as experimental observation groups.At the same time,30 healthy patients who had no significant difference in age and sex from the experimental group were collected.The use of the French Eagle,s electronic scanning system for interstitial hormonal testing of patients with chronic hepatitis B and healthy subjects,including thyroid hormones,aldosterone,and insulin;and according to traditional Chinese medicine liver routine diagnosis and treatment routinely used for cirrhosis patients Classification of TCM symptoms,and functional grading of liver function reserve(Chilid-Pugh classification)of collected patients,analysis of differences in levels of thyroid hormones,insulin,and aldosterone hormones in different liver function reserve status and different TCM syndrome types.Results1.There were significant differences in interstitial insulin levels,aldosterone hormone levels,and thyroid hormone levels in patients with chronic hepatitis B cirrhosis of different TCM syndrome types compared with the normal control group.The level of interstitial insulin in patients with chronic hepatitis B cirrhosis was higher than that in the normal group,with statistical differences(P<0.05).The distribution of interstitial insulin levels among the TCM syndromes in each group was:spleen and kidney yang deficiency)spleen deficiency and wetness Syndrome)Liver-Kidney Yin-Deficiency Syndrome)Damp-Heat Syndrome)Liver-Qi Stagnation Syndrome)Blood-Stasis Syndrome)Normal Control Group,P<0.05.Among them,there was no significant difference in insulin levels between the damp heat intrinsic group,the spleen deficiency wetness group,and the blood stasis resistance group.2.The level of thyroid hormones in the interstitial of patients with chronic hepatitis B cirrhosis,spleen and kidney yang deficiency syndrome<Spleen deficiency dampness syndrome<Blood stasis syndrome)<Liver and kidney yin deficiency syndrome)liver qi stagnation syndrome<health control group,P<0.05.There was no significant difference in thyroid hormone levels between the spleen deficiency wetness syndrome and the damp heat inner syndrome.There was a statistical difference between each group and the healthy control group.3.The level of aldosterone was not statistically different between the spleen-kidney yang deficiency syndrome and the damp-heat internal syndrome and the spleen-deficiency and dampness syndrome.Spleen-kidney yang deficiency syndrome in six syndromes>Spleen deficiency dampness syndrome>Damp-heat syndrome>Hepatorenal yin deficiency syndrome>Blood stasis syndrome>Liver-qi stagnation syndrome>Health control group,P<0.05.There was no significant difference in the level of aldosterone between the liver qi stagnation syndrome and the stasis and blood stasis syndrome.The interstitial insulin levels in patients with chronic hepatitis B cirrhosis were significantly different between Chilid-Pugh A group and Chilid-Pugh B group,Chilid-Pugh A group and Chilid-Pugh C group,P<0.05,Chilid There was no statistical difference between-Pugh B group and Chilid-Pugh C group,P>0.05;there was significant difference between Chilid-Pugh A group,B group,C group and normal control group,P<0.05.Insulin levels decreased with the decline in liver function reserve function,insulin was higher,and Chilid-Pugh B-level insulin levels were lower than Chilid-Pugh C—level insulin levels,but there was no statistical difference between them.Thyroid hormones were statistically different between Chilid-Pugh A,B,and C grades.Chilid-Pugh C grade<B grade<A grade of thyroid hormones,the difference was statistically significant,P<0.05.The difference between the three groups was lower than the healthy control group,and the difference was statistically significant.Aldosterone hormones were statistically different between Chilid-Pugh A,B,and C grades.Chilid-Pugh A grades were<B grades<C grades.There were statistical differences between the groups and the normal control groups.The mean values of each group were greater than Control group,P<0.05.5.In Child-Pugh grade A cirrhosis patients,the rate of liver qi stagnation syndrome accounted for 38.6%,and the rate of stasis syndrome was 15.8%.It was the main two syndromes;in Child?Pugh class B patients,The proportion of spleen deficiency and dampness syndrome accounted for 22.7%,liver and kidney yin deficiency syndrome accounted for 20.5%,and liver qi stagnation syndrome accounted for 18.2%;in Child-Pugh C grade patients,spleen and kidney yang deficiency accounted for 31.6%,and spleen deficiency wet-survival syndrome.The proportion accounted for 26.3%,the hot and humid intrinsic accounted for 21.1%,and the liver-kidney yin deficiency accounted for 15.8%.There was no significant difference in the distribution of liver qi stagnation syndrome and blood stasis syndrome in liver function classification,P<0.05;there was a statistical difference between liver qi stagnation syndrome and other syndrome types,P<0.05.There is no statistical difference between the other two types of syndromes.ConclusionChronic hepatitis B cirrhosis is a chronic wasting disease.During the early stages of disease progression,liver qi stagnation is the predominant syndrome.As the degree of liver damage increases,the dampness and heat build-up syndrome,and the spleen-hydoxy dampness-producing syndrome and blood are gradually seen.The performance of stopping in water,but also see the internal resistance of blood stasis,with the lack of righteousness can progress to liver and kidney yin deficiency and spleen and kidney yang,reflecting the chronic hepatitis B cirrhosis in Chinese medicine syndrome on the disease Transmission law.The changes of related hormonal levels in chronic hepatitis B cirrhosis often indicate the status of the body's endocrine and metabolic disorders.This study found that the distributions of aldosterone,insulin,and thyroid hormones in different cirrhosis syndromes are different.Insulin,aldosterone,thyroid hormone,etc.can be used as an observational index to evaluate the outcomes of TCM pathogenesis and prognosis in chronic hepatitis B cirrhosis.At the same time,the distribution of TCM syndromes in different grades of liver function reserve Child-Pugh is also The characteristics of TCM pathogenesis of chronic hepatitis B liver cirrhosis at different stages of the disease are suggested.It is expected to provide some help for the treatment of chronic hepatitis B liver cirrhosis with traditional Chinese medicine. |
PDF Full Text Request