Study On The Relationship Between TCM Syndrome Types Of HBeAg Positive Chronic Hepatitis B And Liver Stiffness Measurement

Objective:This study aimed to explore the relationship between TCM syndrome types of HBeAg positive chronic hepatitis B patients and liver stiffness measurement,and to analyze the diagnostic value of TE to evaluate liver fibrosis,so as to provide a reference for the treatment of chronic hepatitis B and the prevention of liver fibrosis progress by integrated Chinese and Mordern medicine.Methods:A total of 185 HBeAg positive chronic hepatitis B patients were enrolled in this study.They were divided into different groups ccording to 2017 edition of the Standards of TCM TCM Syndrome Differentiation for Viral Hepatitis.The clinical data were collected and analyzed.And the relationship between TCM syndromes types of HBeAg positive chronic hepatitis B patients and liver stiffness measurement was analyzed.Results:(1)The LSM of different TCM syndromes from high to low were as follows: blood-stasis obstruction syndrome > liver-kidney yin deficiency syndrome > spleen-kidney yang deficiency syndrome>dampness-heat syndrome>liver depression and spleen deficiency syndrome,and the difference was statistically significant.The LSM of liver depression and spleen deficiency syndrome was significantly different than that of other 4 types.There was a statistically significant difference between dampness-heat syndrome and blood-stasis obstruction syndrome in terms of LSM.There was a statistically significant difference between spleen-kidney yang deficiency syndrome and blood-stasis obstruction syndrome intermsofLSM.(2)LSM was negatively correlated with PLT(r =-0.210,P<0.001),LSM was positively correlated with APRI index(r = 0.512,P<0.001).(3)There was a significant difference in the distribution of LSM in hepatic inflammation grade and fibrosis stage(P<0.001).There was a positive correlation between LSM and hepatic inflammation grade andfibrosisstage(0.803,0.793,P<0.001).(4)The ROC curve was drawed by using the liver biopsy as the "gold standard".And the difference between LSM and APRI index in the diagnosis of obvious liver fibrosis in patients with chronic hepatitis B was compared.The results showed LSM and APRI have good diagnostic value for liver fibrosis whether they were used alone or in combination.(5)The relationship between different TCM syndromes and PLT and APRI index and liver biopsy: level of PLT(P<0.001),APRI index(P<0.001),liver tissue inflammation grade(P<0.001),fibrosis stage(P<0.001)were statistically significant.Conclusions:(1)LSM of HBeAg positive chronic hepatitis B patients differed among different TCM syndromes.The LSM of blood stasis obstruction syndrome was the highest.In general,the LSM increased with the severity of liver fibrosis.(2)LSM had a good correlation with the degree of liver fibrosis.And LSM combined with APRI index was of higher diagnostic value in evaluating liver fibrosis.(3)TCM syndrome types of HBeAg positive chronic hepatitis B patients had a certain relationship with PLT,APRI index and liver biopsy.