| Objective:It aimed at understanding the distribution of serum CHI3L1 in CHB patients with different TCM constitutional types by carrying out research on if there were differences among CHB patients with different TCM constitutional types regarding their serum CHI3L1levels.Moreover,it also discussed and explored the correlation among CHI3L1 index,differences of TCM constitutional types for CHB patients in a preliminary way.In this way,it was conductive to offering the new thoughts and ideas for treatment based on syndrome differentiation,assisting the relevant clinical diagnosis and treatment,as well as offering the breakthrough point for the prevention and treatment of CHB from both traditional Chinese and western medicine perspectives.Method:There were totally 180 CHB patients being taken as the study objects,then,they were respectively divided into the following groups after undergoing physique identification in accordance with“Classification and Judgment of TCM constitutional types”(2009):30cases of gentleness,10 cases of qi deficiency,10 cases of yang deficiency,32 cases of yin deficiency,7 cases of phlegm dampness,43 cases of damp heat,20 cases of blood stasis,and28 cases of qi-stagnation.Additionally,the correlation between physiques in traditional Chinese medicine and CHI3L1 levels was analyzed after carrying out quantitative measurement of CHI3L1.Results:1.A total of 180 CHB patients were included in this study,30 cases of gentleness quality(16.7%),32 cases of yin deficiency quality(17.8%),43 cases of damp heat quality(23.9%),20 cases of blood stasis quality(11.1%),28 cases of qi-stagnation quality(15.6%)were classified as common TCM Constitutional types of CHB patients with different TCM constitution types。2.Among CHB patients with different TCM constitution types,there were significant differences in the distribution of serum ALT(χ~2=94.420,P<0.001),AST(χ~2=80.754,P<0.001),HBV DNA(χ~2=25.223,P=0.001),liver tissue inflammation and necrosis grade(χ~2=52.305,P<0.001),and liver fibrosis stage(χ~2=84.954,P<0.001).3.The CHI3L1 levels of patients with quality of qi-stagnation,gentleness,yin deficiency,damp heat,yang deficiency,phlegm dampness,qi deficiency and blood stasis were respectively:69.12(54.65-169.01)ng/ml,79.51(58.99-132.07)ng/ml,93.94(74.72-138.76)ng/ml,94.69(67.56-129.41)ng/ml,108.67(58.60-120.36)ng/ml,122.95(65.36-149.32)ng/ml,160.99(114.46-176.31)ng/ml and173.68(107.56-377.19)ng/ml,and there was a significant difference in CHI3L1 distribution among the CHB patients with different TCM constitution types(χ~2=24.142,P=0.001).Among them,there was statistical significance for the CHI3L1level differences of patients with blood stasis and gentleness(χ~2=60.617,P=0.002),yin deficiency(χ~2=50.709,P=0.018),damp heat(χ~2=49.838,P=0.011)and qi-stagnation(χ~2=54.261,P=0.011).4.Among CHB patients with different TCM constitution types,the correlation degree between serum CHI3L1 levels and patient age,ALT,AST levels,inflammatory necrosis grade and liver fibrosis stage,serum HBe Ag,HBV DNA and HBs Ag quantification is different.Conclusions:1.There were differences in the distribution of serum CHI3L1 levels between different TCM constitutions types,with the highest CHI3L1 level in blood stasis quality.2.This study showed that CHI3L1 is correlated with the stage of liver fibrosis and could be used for the diagnosis of liver fibrosis in clinical practice to some extent.The correlation degree between serum CHI3L1 levels and patient age,ALT,AST levels,inflammatory necrosis grade and liver fibrosis stage,serum HBe Ag,HBV DNA and HBs Ag quantification is different between different TCM constitution types,combining CHI3L1 with TCM constitution types and other other physical and chemical indicators is of certain value in assessing liver fibrosis in patients. |
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