| Objective:Collected the data of CHB patients with or without autoantibody positive,and the differences in general data,serological indexes,pathological diagnosis and so on between the two groups were compared.To explore the distribution and characteristics of syndrome types of CHB patients with or without autoantibody positive,and to provide a more accurate direction for their differentiation and treatment of traditional Chinese medicine(TCM).And further analyze the correlation between autoantibodies and various indexes to find out the independent factors that affect the production of autoantibodies,and use traditional Chinese medicine to regulate immunity as soon as possible to reduce the production of autoantibodies.Methods:From November 2017 to November 2018,354 CHB patients who were hospitalized in the Department of traditional Chinese Medicine infection in Xiamen were selected.Collect the four diagnostic information of the patients respectively,and under the guidance of two deputy directors of traditional Chinese medicine,the syndrome classification of traditional Chinese medicine are carried out.At the same time,the clinical data of the two groups of patients including sex,age,course of disease,serological indexes,pathological diagnosis,etc.,were collected.The database was established and the data were analyzed by using SPSS 22.0 statistical software.The regularity and difference of clinical data and TCM syndrome types of positive patients with CHB were studied.Besides,Logistic regression analysis was used to explore the related indexes affecting the production of autoantibodies in CHB patients.Results:(1)177 CHB patients with autoantibody positive,120 males and 57 females,mean age was 35.65±10.21 years;There were 177 CHB patients with autoantibodies negative,103 males and 74 females,with an average age of 32.66±7.59 years.There was no significant difference in sex distribution between the two groups(P > 0.05).But there was significant difference in age distribution(P < 0.05).(2)Type of damp-heat internal junction was the most in CHB patients with positive autoantibody,accounting for 43.50% of the total,followed by liver depression and spleen deficiency,stasis of blood blocking collaterals,liver-kidney yin deficiency and spleen-kidney yang deficiency,which was less than that of liver-kidney yin-deficiency and spleen-kidneyyang deficiency.The liver stagnation and spleen deficiency type accounted for 57.06% of the total,followed by dampness-heat internal junction type,liver-kidney yin deficiency type,blood stasis type and spleen-kidney yang deficiency type,and the liver-kidney yin deficiency type was less than that of the liver-heat internal junction type,liver-kidney yin deficiency type,blood stasis type and spleen-kidney yang deficiency type.Chi-square test showed that there was a significant difference in the distribution of TCM syndrome types between CHB patients with or without autoantibodies(P < 0.05).(3)Comparison of serological indexes:compared with patients with autoantibody negative,the level of ALT,AST,GGT,ALP,GLB in the group with autoantibody positive was significantly higher,but the level of TBIL,DBIL,ALB,AFP,PT was compared.there was no significant difference between them(P> 0.05).The quantity of HBV-DNA and HBsAg in the group with autoantibody positive were lower than those in the other group(P < 0 05).There was no significant difference in the positive rate of HBeAg between the two groups(P> 0 05).(4)Comparison of pathological diagnosis between the two groups: liver biopsy was performed in all the patients with chronic hepatitis B.There was a significant difference in the distribution of inflammatory grade and fibrosis stage between the two groups in pathological diagnosis(P < 0 05),and there was a significant difference between the two groups in the distribution of inflammatory grade and fibrosis stage(P < 0 05).The degree of inflammation and fibrosis of liver tissue in the group with autoantibody positive was higher than that in the group with negative autoantibody.(5)By using binary Logistic regression analysis,it was found that GLB was an independent factor influencing the production of autoantibodies.Conclusion:(1)The distribution of TCM syndrome types among patients with or without autoantibody positive chronic hepatitis B has certain regularity and difference.(2)There were significant differences in age and ALT,AST,GGT,ALP,GLB,HBV-DNA,HBsAg quantity,between chronic hepatitis B patients with and without autoantibodies.(3)There were significant differences in grade of inflammation and stage of fibrosis in chronic hepatitis B patients with or without autoantibody positive.(4)GLB is an independent factor that affects the production of autoantibodies in patients with chronic hepatitis B. |
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