Study On Correlation Between TCM Syndrome Types And Liver Pathology As Well As IL-6, IL-8, TNF-α In Chronic Hepatitis B Patients

Objective:To study on correlation between TCM syndrome types and fibrosis stage and the inflammation grade of liver tissue pathology as well as immunology molecule(IL-6,IL-8,TNF-α)in chronic hepatitis B(CHB) patients,in order to provide some objective evidence for the syndrome differentiation and diagnosis.Methods:Firstly,to elect 90 hospitalized patients with CHB from Fuzhou Infectious Disease Hospital,who were typed into Gan-qi stagnation and Pi-deficiency type(typeⅠ),inner damp-heat retention type(typeⅡ),obstruction of collaterals by blood stasis type(typeⅡ).The cases of each of these three syndrome types are all 30.And then,liver biopsy was performed on these patients as to determine liver pathological grading and staging.The cases of control group are 30 out-patient clinic people of medical examination,who are all consistent with the conditions of HBsAb(+),normal hepatic function,with the elimination of other viral hepatitis, other liver disease and immunologic disease.Finally,detecting the levels of IL-6,IL-8,TNF-αin all types to find out the correlation of these three TCM types and liver pathological changes as well as IL-6,IL-8,TNF-α.Results:(1) The grade of liver inflammation was mainly G1 and G2 in patients of Gan-qi stagnation and Pi-deficiency type(typeⅠ);G2 in patients of inner damp-heat retention type(typeⅡ);while G3,G4 occurred mainly in patients of blood stasis blocking collateral type(typeⅢ),showing significant difference(P＜0.01) as compared with the other syndrome types.(2) There is significant difference(P＜0.01) among three types.The liver pathological stsges in patients of typeⅠis S1;typeⅡis S2,while S3 and S4 occurred mainly in patients of typeⅢ(3)The pathological change was mainly G3-G4 and S3-S4 in blood stasis syndrome, while it was mainly G-G2 and S1-S2 in non-blood stasis syndrome.(4)Most of the patients in these three types are light type,medium and gravis types are less.In the light type, comparison between typeⅠand typeⅡhas no significant difference(P＞0.05).Most of the medium type patients are typeⅢ.All of the gravis type patients are typeⅢ.(5)There is significant difference(P＜0.01) in the TCM syndrome integration among these three types.(6) There is significant difference(P＜0.01) in the comparison of the liver pathological photos among these three types.(7) The comparison of the level of IL-6,IL-8,TNF-αshows significant difference(P＜0.01) between typeⅢand control group,as well as with typeⅡ, while also shows significant difference(P＜0.05) between typeⅠand typeⅡ.Conclusions:(1) There is correlation in some degree between the three types and liver pathological changes. Both of typeⅠand typeⅡgenerally happen on the early stage of chronic hepatitis B,of which the inflammation and fibrosis are light,typeⅢgenerally happen on intermediate and advanced stage,of which the inflammation and fibrosis are the most serious.(2) Along with the aggravating of liver pathological injury,the syndrome type of CHB patients developed from typeⅠto typeⅡ,and finally to typeⅢ.Among three types,syndrome with or without blood stasis showed the closest correlation.The result of liver tissue pathology provide a reference standard to typeⅢ.(3)The levels of IL-6,IL-8,TNF-αof three types show significant difference,which heighten along with the aggravation of the patient's condition. The extent of heightening shows the order,typeⅢ,typeⅡ,typeⅠ.So,the levels of IL-6,IL-8,TNF-αcan be used as one of the reference standards of TCM syndrome type diagnosis of CHB.