Research Of The Correlation On Clinical Grading With Tongue Demonstration And Syndrome Differentiation In Chronic B-type Hepatitis

Background:Chronic B-type hepatitis(CBH),a kind of chronic injury of liver caused by the interaction of the host' s immune system with hepatitis B virus(HBV)or the liver cells to be infected with HBV,is a common disease effecting human' s health.Nowadays,a large number of clinical researches indicate that tongue demonstration follows a rule in CBH;the change of tongue demonstration is correlative with the targets of liver function,virus load,pathological change;we can observe the state and progression of the illness and predict its prognosis by the Change of tongue demonstration. A current tendency of the research on integrated Chinese and Western Medicine is the objective research on syndrome differentiation. It refers to the domain of virology,pathology,biochemistry,immunology,endocrinology in CBH already.Some researches indicate that syndrome differentiation in CBH is correlative with clinical grading,the targets of liver function,virus load and activity.Purpose:To summarize the rule of syndrome differentiation and the characteristic of tongue demonstration in CBH,and to deduce the correlation of clinical grading with tongue demonstration and syndrome differentiation.Methods:Based on the literature unscrambling and research in advance,a cross-sectional survey was carried out on 110 patients with CBH. Investigation,data analysis and statistic by computer were applied to summarize the rule of syndrome differentiation and the characteristic of tongue demonstration in CBH,and to deduce the correlation of clinical grading with tongue demonstration and syndrome differentiation.Results:1.Considering the colour of tongue,red tongue is to be seen most frequently,accounting 34.5%.The distribution is:red tongue＞carmoisine tongue＞light white tongue＞crimson tongue＞purple tongue.Considering the size of corpus linguae,glossacele appears most frequently,accounting 65%.The distribution is:glossacele＞lean tongue＞normal tongue. Considering the colour of the coated tongue,the yellow coated tongue is the most common,accounting 50.9%.The distribution is:The distribution is:yellow coated tongue＞white tongue fur＞brown tongue.Considering the thickness of coated tongue,the greasy tongue fur is the most common, accounting 60.9%.The distribution is:greasy tongue fur＞thin tongue fur＞exfoliative tongue fur.2.The color depth of the tongue(Pearson contingency coefficient r=0.4599,P＜0.05),the size of the corpus linguae(Pearson contingency coefficient r=0.3310,P＜0.01),the color depth of the coated tongue (Pearson contingency coefficient r=0.4612,P＜0.01),and the thickness of coated tongue(Pearson contingency coefficient r=0.4119,P＜0.01)are positively correlated with clinical grading.3.Sthenia syndrome is the most common type of syndrome,accounting 64.5%. Sthenia syndrome is the most common in the mild group.It exceeds the asthenia syndrome in quantity significantly(P＜0.05).It is also the most common in the moderate group,isthenia syndrome is the most common in the severe group.The different distribution of sthenia syndrome and asthenia syndrome is significant in the mild group(P＜0.01).But it is not significant(P＞0.05)in the moderate group and the severe group.4.The distribution of syndrome differentiation is:the syndrome of dampness-heat of the liver＞the syndrome of stagnation of liver-QI with deficiency of the spleen＞the syndrome of hepatic and renal yin deficiency＞the syndrome of syndrome of deficiency of kidney-YANG＞the syndrome of obstruction of collaterals by blood stasis.The syndrome of dampness-heat of the liver appears most frequently,accounting 60%.5.Mild level is the most common in the syndrome of dampness-heat of the liver,with state following,then comes the moderate level.Severe level is the less common,the different distribution of the clinical grading is significant(P＜0.01).Mild level is the most common in the syndrome of stagnation of liver-QI with deficiency of the spleen.It exceeds the severe group in quantity significantly(P＜0.05).Severe level is the most common in the syndrome of hepatic and renal yin deficiency,the syndrome of deficiency of kidney-YANG and the syndrome of obstruction of collaterals by blood stasis,the different distribution of the clinical grading is not significant(P＞0.05).Conclusion:1.The characteristic of tongue demonstration in CBH is:the detection rate of the greasy tongue fur is high.The most common type of tongue is red,glossacele,yellowish greasy tongue.2.The color depth of the tongue,the size of the corpus linguae,the color depth of the coated tongue and the thickness of coated tongue are positively correlated with clinical grading.To some extent,they can respond the state of an illness. 3.Syndrome differentiation distribution follows a rule in CBH,that is, sthenia syndrome prevails and the syndrome of dampness-heat of the liver appears most frequently.The illness is slight in sthenia syndrome but fairly dangerous in asthenia syndrome.The illness is slight in the syndrome of dampness-heat of the liver and the syndrome of stagnation of liver-QI with deficiency of the spleen,but fairly dangerous in the syndrome of hepatic and renal yin deficiency,the syndrome of deficiency of kidney-YANG, and the syndrome of obstruction of collaterals by blood stasis.