Study On The Constitution Characteristics And Their Correlationof Chronic Hepatitis B

Objective:Using the constitution theory of traditional Chinese medicine(TCM),the aims of the present study were to discuss the different constitution types of chronic hepatitis B,analyze their distribution characteristics,explore the correlation between constitution of TCM and pathogenesis,so as to establish theoretical basis for constitutional differentiation and treatment,and further provide a new research ideas and methods for the prevention of chronic hepatitis B.Methods:A total of 260 patients with chronic hepatitis B were selected and met the diagnostic criteria of chronic hepatitis B(2015 version)using the randomized-controlled trial.The investigation was carried out according to the classification and determination standard of constitution of TCM issued by the Chinese Society of TCM,and mainly analyzed the types and distribution of constitution of TCM of chronic hepatitis B,and the correlation between constitution type and gender,age,course of disease,liver function,color ultrasound of liver,gallbladder and spleen,HBeAg,HBV DNA quantity and TCM syndrome type.Results:(1)The constitution types of chronic hepatitis B were mainly manifestedQi stagnation constitution,Qi deficiency constitution and damp heat constitution.Qi stagnation constitution accounted for 23.1%,Qi deficiency constitution 20.4%,and damp heat constitution19.6%.The proportion of other four constitution types was as follows:phlegm dampness constitution>Yang deficiency constitution>Yin deficiency constitution>blood stasis constitution.(2)Gender,age and course of disease were related to constitution.Damp heat constitution accounted for 22.2% in men,20.5% in Qi Depression constitution,and 19.2% in Qi deficiency constitution.Qi depression constitution accounted for 28.6% in women,22.6% in Qi deficiency constitution,and14.3% in damp heat constitution.There was statistical difference in constitution typebetween men and women(P<0.05).About 28.6% of the patients less than 40 years old had Qi depression,and 28.3% patients over 40 years old had Qideficiency.As to the course of disease,the number of damp heat constitution in ?5 years group was the highest,the number of Qi deficiency constitution in the 6-10 years group was the highest,and those of Qi deficiency constitutionin the 11-15 yearsand>15 years groups was the highest.The constitution was correlated with gender,age and course of disease,with statistical difference(P<0.05).(3)Among all kinds of constitution types,the change of liver function was most obvious in damp heat constitution,the change rule of enzyme and bilirubin was decreased in turn : damp heat constitution>Qi stagnation constitution>Yin deficiency constitution>Qi deficiency constitution>blood stasis constitution.The proportion of damp heat constitution in HBeAg positive patients was the highest,accounting for 20.9%.The proportion of Qi stagnation constitution in HBeAg negative patients was the highest(29.5%),and there was a correlation between the constitution type and the quantity of HBV DNA,among which Qi stagnation constitution accounted for 27.6%,damp heat constitution for 23.5%,Qi deficiency constitution 14.7%.Damp heat constitution accounted for 24.2% in HBV DNA quantification?1E+5and<1E+7groups,Qi stagnation constitution accounted for 21.0%and Qi deficiency constitution 17.7%.There was a statistical difference between the groups(P<0.05).In patients with the enhancedechogenicity of liver,the constitution of Qi stagnation accounted for 20.8%,the constitution of damp heat for 19.6%.In patients with fatty liver,the constitution of damp heataccounted for 29.1%,the constitution of phlegm dampness for 25.6%.In patients withenlarged spleen,the constitution of Qi Stagnation accounted for 22.9%,the constitution of damp heat followed by 20.8%.In patients withthickened gallbladder wall,the constitution of Qi Stagnation accounted for 27.6%,and the constitution of damp heat19.0%.The proportion of liver echo enhancement and gallbladder wall thickening were Qi depression and Qi deficiency.(4)The syndrome differentiation of TCM was mainly manifested liver and gallbladder damp heat syndrome,accounting for 27.3%,followed by liver stagnation syndrome and spleen deficiency Qi deficiency syndrome(25.8% and22.3%,respectively),which showed that the syndrome types in chronic hepatitis B patients was mainly damp heat accumulation syndrome and liver stagnation Qi stagnation syndrome.Dampness heat constitution accounted for 71.8%,followed by phlegm dampness constitution(24.0%),Qi stagnation constitution(89.6%),Qi deficiency constitution(89.8%),blood stasis constitution(77.8%),Yang deficiency constitution(95.7%),Yin deficiency constitution(95.5%),indicating the type of TCM constitution,were closely related to the differentiation syndrome types of TCM.Conclusion: The constitution of chronic hepatitis B patients was mainly composed of Qi stagnation constitution,Qi deficiency constitution and damp heat constitution.Gender,age and course of disease affected the constitution type.Thechanges of liver function in damp heat constitution were most obviously.The constitution type affected the quantity of HBVDNA,the state of HBe Ag and the color ultrasound of liver,gallbladder and spleen.The constitution type was closely related to the syndrome differentiation type.In summary,it is helpful to prevent the occurrence and development of chronic hepatitis B by regulating the biased constitution.