| ObjectiveSummed up the law of TCM symptoms distribution about MHE in HBV-liver Cirrhosis,to explore the internal correlation between the TCM symptoms distribution and the physicochemical indexes in this part of the patient,to provide a scientific and reasonable theoretical basis for further understanding of the TCM treatment of this disease.MethodsThe studies is divided into two parts.The first portion which select 50 healthy people,refer to their results of NCT-A(number connection test A)and DST(digit symbol test),to judge the natural reference range.On the other hand,a cross-sectional study was conducted to collect basic data,clinical symptoms,liver function,coagulation function,blood ammonia(NH3),HBV-DNA,NCT-A and DST results and other laboratory-related indicators of patients with HBV-liver Cirrhosis in the inpatient department of Guangdong Provincial Hospital from October 2016 to February 2019.The observation indexes were entered into the database,which to analyze the distribution characteristic of TCM symptoms and the correlation between MHE and physicochemical indexes.Resu!ts1.Basic conditions:300 cases of HBV-liver Cirrhosis patients were included in this study,including 150 cases of compensatory liver cirrhosis and 150 cases of decompensative hepatic cirrhosis,31.3%(94/300)of those patients were dignosed with MHE through NCT-A and DST.The incidence of MHE in decompensative hepatic cirrhosis 1s significantly higher than compensatory liver cirrhosis(P<0.001),the concrete conditions were as follow:19.3%(29/150)of patients were MHE in compensatory liver cirrhosis patients;those patients were more common in male(79.3%),their average age was 46.55±10.83 years;43.3%(65/150)of the decompensative hepatic cirrhosis patients were diagnosed with MHE which were more common in male(69.2%)as well,average age was 51.66+9.61 years2.Distribution of TCM Syndromes of MHE in HBV-liver Cirrhosis:Among the 94 cases of MHE in HBV-liver Cirrhosis,the liver stagnation and spleen deficiency compound symptoms were primary,account for 81.92%(77/94).The TCM Syndromes of MHE in compensatory liver cirrhosis patients manifested as liver stagnation and spleen deficiency compound symptoms,while the TCM Syndromes of MHE in the decompensative hepatic cirrhosis patients manifested as liver stagnation and spleen deficiency compound symptoms and liver-kidney yin deficiency compound symptoms.The TCM Syndromes of MHE in compensatory liver cirrhosis patients were as follow:There were 23 cases(79.31%)of liver stagnation,spleen deficiency and wet sputum;6 cases(20.69%)of liver stagnation,spleen deficiency,dampness and heat syndrome;The TCM Syndromes of MHE iri decompensative hepatic cirrhosis patients were more common in liver stagnation and spleen deficiency compound symptoms,the concrete conditions were as follow:There were 34 cases(52.31%)of liver stagnation,spleen deficiency and wet sputum;14 cases(21.54%)of liver stagnation,spleen deficiency,dampness and heat syndrome;8 cases(12.31%)of liver-kidney yin deficiency,dampness and heat stasis;9 cases(13.84%)of liver-kidney yin deficiency,dampness and turbid stasis.3.The internal correlation between the MHE patients with HBV-liver Cirrhosis and the physicochemical indexes(1)The internal correlation between the MHE patients with HBV-liver Cirrhosis and liver functionThe serum levels of AST and TBIL were significantly higher in MHE patients with HBV-liver Cirrhosis compared with those in non-MHE patients,the concrete comparison were(35.50U/L vs 30.00U/L,P=0.013)and(23.30 p mol/L vs 16.90 pmol/L,P<0.001),MHE patients' levels of ALB was significantly decreased in the non-MHE patients(35.20g/L vs 41.05g/L,P<0.001),but their were no difference between the levels of ALT amongst the two groups(28.50U/L vs 26.50U/L,P?0.558)(2)The internal correlation between the MHE patients with HBV-liver Cirrhosis and HBVDNA?PT and blood ammoniaIn virology aspects,their were no difference between the levels of HBVDNA amongst MHE or non-MHE patients(3.271og10IU/ml vs 3.271og10IU/ml,P?0.969);However,the levels of PT and NH3 were significantly higher in MHE patients with HBV-liver Cirrhosis compared with those in non-MHE patients,the concrete comparison were(14.60±3.15s vs 12.96±2.02s,P<0.001)and(40.50 pmol/L vs 33.50 p mol/L,P?0.047)?(3)The internal correlation between the MHE patients with HBV-liver Cirrhosis and positive rate of ascitesThe positive rate of ascites on MHE patients was significantly higher than non-MHE patients(40.4%vs 16.5%,P<0.01)(4)The internal correlation between the MHE patients with HBV-liver Cirrhosis and child-Pugh classificationThe sum of grade A of child-pugh classification in MHE patients with HBV-liver Cirrhosis(47.9%)is than non-MHE patients(85%)obviously(P<0.001),but the former's grade B and C of child-pugh classification in MHE patients more than the latter(33.0%vs 14.6%and 19.1%vs 0.5%,P<0.001).4.An analysis of risk factors in MHE patients with HBV-liver CirrhosisWe can find there had relevance between the MHE patients with HBV-liver Cirrhosis and the levels of AST?TBIL?ALB?PT?NH3 and child-pugh classificationthrough the relationship mentioned before,but ALT and HBVDNA were not.AFurther analysis of Logistics regression found that child-pugh classification was the independent risk factors for MHE;the serious of the child-pugh classification,the higher risk of MHE,the OR values of MHE in grade C of child-pugh classification was 70.000(95%Cl 9.101,538.421).Conclusion1.The Incidence of MHE in decompensative hepatic cirrhosis patients is more than compensatory liver cirrhosis patients.2.The TCM Syndromes of MHE patients with HBV-liver Cirrhosis manifested as liver stagnation and spleen deficiency compound symptoms and liver-kidney yin deficiency compound symptoms.3.There had relevance between the MHE patients with HBV-liver Cirrhosis and the levels of AST?TBIL?ALB?PT?NH3 and child-pugh classification through the relationship mentioned before,but ALT and HBVDNA were not.4.Child-pugh classification was the independent risk factors for MHE;the serious of the child-pugh classification,the higher risk of MHE. |
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