Study On Correlation Between The Different TCM Constitutional Types And Liver Pathological Changes In HBeAg Positive Chronic Hepatitis B Patients

Objective:To analyze the correlation between constitutional types of Traditional Chinese medicine(TCM)and liver pathological changes in HBeAg positive chronic hepatitis B patients,to discuss the immune states of different TCM constitution and to provide references for the prevention,treatment and preventive treatment of disease of CHB.Methods:A total of 299 HBeAg positive CHB patients were included in this study.The TCM constitutions were investigated according to WANG Qi’s constitution classification standards.All statistical analyses were performed using SPSS software package version 23.0.Results:1.Having Collected 299 cases with HBeAg positive CHB patients,their constitutional types of TCM frequency distribution:Damp-heat constitution(26.8%)>Qi-depression constitution(23.1%)>Yin-deficiency constitution(12.7%)>Gentleness constitution 10%)>Phlegm-wetness constitution(8.7%)>Yang-deficiency constitution(8.4%)>Qi-deficiency constitution(5%)>Blood-stasis constitution(4%)>Special intrinsic constitution(1.3%),Based on biased quality;2.The relationship between constitutional types of TCM and levels of HBV DNA and HBeAg varies in HBeAg positive CHB patients:the levels of HBV DNA(Χ2=15.814,P=0.045),HBeAg varies(Χ2=15.966,P=0.043)between different TCM constitution were statistically significant.With the HBV DNA levels increased,Damp-heat constitution and Qi-depression constitution gradually increased;3.The relationship between constitutional types of TCM and liver function,alphafetoprotein(AFP)in HBeAg positive CHB patients:levels of alanine aminotransferase(ALT)(Χ2=20.736,P=0.008),aspartate transaminase(AST)(Χ2=25.589,P=0.001),total bilirubin(TBIL)(Χ2=17.089,P=0.029),direct bilimbin(DBIL)(Χ2=22.808,P=0.004),y-glutamyl transpeptidase(y-GT)(Χ2=21.570,P=0.006),alkaline phosphatase(ALP)(F=3.112,P=0.002),AFP(Χ2=19.559,P=0.012)were statistically significant;4.The relationship between constitutional types of TCM and the liver pathological changes in HBeAg positive CHB patients:inflammation grading were mainly in G1-G2,fibrosis were mainly in S1-S2,and inflammation grading(G)(Χ2= 33.484,P<0.001)and fibrosis(S)(Χ2=36.979,P<0.001)distribution in different TCM constitution were statistically significant.5.Inflammation grading of Gentleness constitution was mainly in G1-G2,Qi-deficiency constitution was mainly in G2,Yang-deficiency constitution was mainly in G1-G3,Phlegm-wetness constitution,Yin-deficiency constitution,Damp-heat constitution and Qi-depression constitution were mainly in G2-G3,fibrosis of Gentleness constitution were mainly in S1-S2,Qi-deficiency constitution and Yang-deficiency constitution were mainly in S1,Phlegm-wetness constitution,Yin-deficiency constitution,Damp-heat constitution and Qi-depression constitution were mainly in S1-S2;inflammation grading and fibrosis of Blood-stasis constitution were respectively mainly G2-G4 and S3-S4.Conclusion:The mainly composed constitutions of the 299 HBeAg positive chronic hepatitis B patients were Qi-depression constitution,Damp-heat constitution and Yin-deficiency constitution.The analysis showed that the significant correlations existed between constitutional types of TCM and liver pathological changes,HBV DNA levels,HBeAg varies,liver function and AFP in HBeAg positive chronic hepatitis B patients.Yin-deficiency,Phlegm-wetness,Damp-heat,Qi-depression and Blood-stasis were associated with significant necroinflammation.Damp-heat and Blood-stasis were correlated with significant fibrosis.The results suggested that the immune states of different TCM constitution could be different in HBeAg positive CHB patients.