The Relationship Between The HBeAg Seroconversion And The TCM Type Of Syndromes On Lamivudine Treating Chronic Hepatitis B

Objective:To study the relationship between the rate of HBeAg seroconversion of Lamivudine on chronic hepatitis B patients and the TCM type of syndromes.Evaluate and guide lamivudine to resistant hepatitis B virus in the dialectical theory of Chinese medicine based on the rule.Methods:In accordance with the standards of Western medicine and traditional Chinese medicine diagnosis dialectical standards.Totally 116 patients with HBeAg-positive Chronic Hepatitis B were differentiated with Gan stagnation with Pi deficiency syndrome,damp-heat retention in middle-jiao syndrome,Gan-Shen yin deficiency syndrome,and blood stasis blocking collateral syndrome.All patients were treated with Lamivudine 100mg/day for 52 weeks.HBV-DNA(quantitatively detected by PCR method) and HBV makers were detected for every 3 month.Results:1.The relationship between Pre-treatment ALT,HBV-DNA baseline value in Chronic Hepatitis B patients with different syndrome types:In the ALT baseline value,arranged from high to low order in the four syndrome types were as follows:blood stasis blocking collateral syndrome>damp heat retention in middle-jiao syndrome>Gan-Shen yin deficiency syndrome>Gan stagnation with Pi deficiency syndrome,By one-way ANOVA statistical methods,respectively(P＞0.05),were no significantly different.In the HBV-DNA baseline value,arranged from high to low order in the four syndrome types were as follows:Gan stagnation with Pi deficiency syndrome>Gan-Shen yin deficiency syndrome> blood stasis blocking collateral syndrome>damp heat retention in middle-jiao syndrome,respectively(P＜0.05),were no significantly different. Compared Gan stagnation with Pi deficiency syndrome with damp heat retention in middle-jiao syndrome,P＜0.05.2.The relationship between abnormal degree of Pre-treatment ALT in Chronic Hepatitis B patients with different syndrome types: abnormal degree of Pre-treatment ALT were differentied 3 levels:＜2 ULN,2-5ULN,＞5ULN,By rank sum test of statistical methods,respectively(P＜0.05),were significantly different.Gan stagnation with Pi deficiency syndrome,blood stasis blocking collateral syndrome with damp heat retention in middle-jiao syndrome and Gan-Shen yin deficiency syndrome compared,all respectively P=0.000＜0.05.Gan stagnation with Pi deficiency syndrome and Gan-Shen yin deficiency syndrome to a maximum of 2-5ULN.Damp heat retention in middle-jiao syndrome and blood stasis blocking collateral syndrome to a maximum of(＞5ULN).3.The relationship between state of HBV-DNA replication in Chronic Hepatitis B patients with different syndrome types:state of HBV-DNA replication in Chronic Hepatitis B were differentied 3 levels:<10~6,10~6-10~7,>10~7.By statistical comparison,P＞0.05,were no significantly different.All syndrome types centralized in 10~8 level.4.The relationship between the rate of HBeAg seroconversion and abnormal degree of Pre-treatment ALT in Chronic Hepatitis B patients:the rate of HBeAg seroconversion in abnormal degree of Pre-treatmentALT<2ULN,2-5ULN,>5ULN were 12.1%,24.5%,35.3%.By statistical comparison,P＜0.05,were significantly different.By spearman correlation analysis,there was a positive correlation between the rate of HBeAg seroconversion and abnormal degree of Pre-treatment ALT in Chronic Hepatitis B patients(Spearman correlation coefficient R=0.026,P=0.027＜0.05).5.The relationship between the rate of HBeAg seroconversion and state of HBV-DNA replication in Chronic Hepatitis B patients:the rate of HBeAg seroconversion in state of HBV-DNA replication < 10~6,10~6-10~7,>10~7 were 50.0%,24.1%,5.3%.By statistical comparison,P＜0.05,were significantly different.By spearman correlation analysis,there was a positive correlation between the rate of HBeAg seroconversion and state of HBV-DNA replication in chronic Hepatitis B patients(Spearman correlation coefficient R=0.458,P=0.000＜0.05).6.The relationship between the rate of HBeAg seroconversion and theTCMtypesof syndromes in chronic HepatitisBpatients:the rate of HBeAg seroconversion in the different TCM types of syndromes were Gan stagnation with Pi deficiency syndrome 24.1%,damp-heat retention in middle-jiao syndrome 44.4%,Gan-Shen yin deficiency syndrome 8.7%,and blood stasis blocking collateral syndrome 10.0%.By statistical comparison,P＜0.05,were significantly different.Conclusion:The rate of HBeAg seroconversion in the different TCM types of syndromes treated by Lamivudine on chronic hepatitis B patients were Gan stagnation with Pi deficiency syndrome 24.1%, damp-heat retention in middle-jiao syndrome 44.4%,Gan-Shen yin deficiency syndrome 8.7%,and blood stasis blocking collateral syndrome 10.0%.Arranged from high to low order as follows:damp heat retention in middle-jiao syndrome>Gan stagnation with Pi deficiency syndrome >blood stasis blocking collateral syndrome >Gan-Shen yin deficiency syndrome.Clinically,choose lamivudine to resistant hepatitis B virus in the dialectical theory of Chinese medicine based on the rule,to control the development disease.