Study On Pathological Features Of Chronic Hepatitis B And Liver Cirrhosis After Hepatitis B And Their Relation With The Indexes Of Hepatic Fibrosis

Objective:Through the collection of the clinical cases,to analyze the distribution characteristics of syndrome element and TCM body constitution of the patients,to observe the relations between their distribution of TCM body constitution,serum fibrosis index:HA,PIIIP N—P,?-C,LN and LSM,to provide some new ideas and approaches for the prevention and cure of chronic and hepatitis B and cirrhosis caused by hepatitis B in the ways of TCM.Methods:There are 262 suitable clinical cases were divided into two groups:Group CHB(131 cases)and Group Hepatitis B Cirrhosis(131 cases)from Mengchao Hepatobiliary Hospital of Fujian Medical University.Analysis disease characteristics of patients with chronic hepatitis b,hepatitis B cirrhosis patients by using the dialectical method.By using the questionnaire from classification and determination of constitution in TCM answered by chronic hepatitis B patients and hepatitis B cirrhosis patients to classify the patients' body constitution,combined with their biochemical indicator,hepatic fibrosis indexes,LSM and some other data collected from their clinical cases as research subjects to establish the relevant database and input all the data,analyzed the data by statistical software SPSS 20.0.Results:?Disease of chronic hepatitis b syndrome factor mainly include liver,kidney,spleen(account for 80.92%,51.14%and 80.92%respectively),disease syndrome factor are hot,wet,Yang deficiency,qi deficiency and qi stagnation,(account for 69.47%,54.96%and 69.47%respectively,41.98%,40.46%);After hepatitis b cirrhosis of the liver disease of syndrome factor mainly include liver,spleen,kidney(account for 92.37%,74.81%and 92.37%respectively),sexual disease syndrome factor mainly qi deficiency,blood stasis,and qi,Yang deficiency(account for 91.67%,74.81%,72.52%and 74.81%,respectively).By disease syndrome factor comparison,find two sets of liver,spleen syndrome factor score difference(P<0.05),and through the disease syndrome factor comparison,found that two groups of qi deficiency,Yang deficiency,blood stasis,qi and evidence points difference(P<0.05).? In Group CHB,there are 35 Damp-heat constitution cases accounted for 26.7,32 Gentleness constitution cases,24.4%;15 Yin-deficiency constitution cases,11.5%;15 Yang-deficiency constitution cases,11.5%;12 Qi-depression constitution cases,9.2%;10 Qi-deficiency constitution cases,7.6%;6 Phlegm-wetness constitution cases,4.6%;3 Special-intrinsic constitution cases,2.3%;3 Blood-stasis constitution cases,2.3%.In Group Hepatitis B Cirrhosis,25 Blood-stasis constitution cases,19.1%;23 Yang-deficiency constitution cases,17.6%;22 Qi-depression constitution cases,16.8%;19 Qi-deficiency constitution cases,14.5%;17 Yin-deficiency constitution cases,13%;15 Damp-heat constitution cases,11.5%;10 Phlegm-wetness constitution cases,7.6%.? The comparison between two groups'HA,?—C,LN data and LSM appeared some differences,and all have significant difference(P<0.05),while their P?P N—P data has no significant difference(P=0.074>0.05).LSM values and was positively related to the level of liver qi deficiency,blood stasis,HA and liver,qi deficiency,Yang deficiency,and qi stagnation were positively correlated;?C was positively related with Yang deficiency.? As for the comparison of those data in all kinds of TCM body constitution within each group:Group CHB has no significant difference(P>0.05),Group Hepatitis B Cirrhosis has significant difference(P<0.05).The details are as follows.LN:Qi-deficiency constitution>Blood-stasis constitution>Yin-deficiency constitution>Yang-deficiency constitution>Qi-depression constitution>Damp-heat constitution>Phlegm-wetness constitution.The comparisons between Qi-deficiency constitution and Qi-depression constitution,Damp-heat constitution,Phlegm-wetness constitution,Blood-stasis constitution or Yang-deficiency constitution have significant difference(P<0.05);The comparison between Blood-stasis constitution and Damp-heat constitution has significant difference(P<0.05);The comparison between Phlegm-wetness constitution and Blood-stasis constitution has significant difference(P<0.05).?—C:Yin-deficiency constitution>Blood-stasis constitution>Yang-deficiency constitution>Qi-deficiency constitution>Qi-depression constitution>Damp-heat constitution>Phlegm-wetness constitution.The comparisons between Phlegm-wetness constitution and Qi-deficiency constitution,Blood-stasis constitution,Yang-deficiency constitution or Yin-deficiency constitution have significant difference(P<0.05).P ?P N—P:Yin-deficiency constitution>Qi-depression constitution>Blood-stasis constitution>Damp-heat constitution>Yang-deficiency constitution>Qi-deficiency constitution>Phlegm-wetness constitution.The comparisons between Qi-deficiency constitution and Qi-depression constitution or Yin-deficiency constitution have significant difference(P<0.05).HA:Yang-deficiency constitution>Blood-stasis constitution>Phlegm-wetness constitution>Qi-depression constitution>Yin-deficiency constitution>Qi-deficiency constitution>Damp-heat constitution.The comparisons between Yang-deficiency constitution and Qi-deficiency constitution or Damp-heat constitution have significant difference(P<0.05);The comparison between Damp-heat constitution and Blood-stasis constitution has significant difference(P<0.05).LSM:Blood-stasis constitution>Yin-deficiency constitution>Damp-heat constitution>Yang-deficiency constitution>Qi-deficiency constitution>Phlegm-wetness constitution>Qi-depression constitution.When compared with Qi-deficiency constitution,Yang-deficiency constitution or Phlegm-wetness constitution,there are four types of TCM body constitution' comparisons have significant difference(P<0.05):Blood-stasis constitution,Yin-deficiency constitution,Damp-heat constitution and Qi-depression constitution.Conclusion:Patients with cirrhosis after hepatitis b and chronic hepatitis b patients with evidence of element distribution characteristics,in the development of cirrhosis of the liver,disease syndrome factor change.In Group CHB Gentleness constitution and Damp-heat constitution took the larger proportion,while in Group Hepatitis B Cirrhosis were Blood-stasis constitution,Yang-deficiency constitution and Qi-depression constitution.HA,LN,?—C,LSM value element characteristic and justification of patients with liver cirrhosis after hepatitis b constitution types have certain relations.The LSM of Hepatitis B cirrhosis patients in Blood-stasis constitution and Yin-deficiency constitution is higher than patients in other TCM body constitution.Hepatitis B cirrhosis is risk for people who in Blood-stasis constitution and Yin-deficiency constitution.