| Objective:To summarize the distribution of constitution of traditional Chinese medicine in different stages of chronic HBV infection,compare the constitution differences of patients with chronic HBV carrier,chronic hepatitis B and hepatitis B cirrhosis in different stages of compensatory period,and explore the relationship between constitution and disease outcome of chronic HBV infection,so as to provide theoretical basis and practical basis for "differentiating body from body and treating disease" and "treating disease before disease" in clinical practice.Methods:Questionnaire evaluation was conducted on subjects who met the inclusion criteria.Record the general situation of patients,including name,sex,age,contact information,residence,disease diagnosis and patient’s HBeAg status.Fill in the "Classification and Judgment Form of TCM Constitution" and determine the TCM constitution type of patients according to the "Classification and Judgment Criteria of TCM Constitution".Enter the database and make statistical analysis by SPSS 20.0 statistical software.Results:(1)Of the 712 patients included,416(58.4%)were males and 296(41.6%)were females;370(52.0%)were aged 18-40 years,342(48.0%)were aged 41-65 years;240 were single,412 were two constitutions and 60 were three constitutions;the most common constitutions of chronic HBV carriers were plain constitution(33.6%)and yang deficiency constitution(30.3%)and chronic constitution.Qi deficiency(53.8%)and damp-heat(37.8%)were the most common types of hepatitis B patients,while blood stasis(62.7%)and yin deficiency(38.1%)were the most common types of compensatory liver cirrhosis.(2)Compared with TCM constitution distribution in di fferent stages of chronic HBV infection,the proportion of calm constitution and yang deficiency constitution in chronic HBV carriers was significantly higher than that in compensatory patients of chronic hepatitis B and hepatitis B cirrhosis,and the proportion of qi deficiency constitution and damp-heat constitution in chronic hepatitis B patients was significantly higher than that in compensatory patients of chronic HBV carriers and hepatitis B cirrhosis,while the proportion of yin deficiency constitution and qi depression constitution was significantly higher.The proportion of blood stasis and yin deficiency in patients with compensatory hepatitis B cirrhosis was significantly higher than that in patients with chronic hepatitis B and chronic hepatitis B.The proportion of Qi deficiency,damp-heat and qi depression in patients with compensatory hepatitis B cirrhosis was also signi f icantly higher than that in patients with chronic hepatitis B(P<0.01).(3)Physical differences were compared among patients with chronic HBV infection of different genders.There were 32(27.1%)cases of phlegm-dampness,12(10.2%)cases of dampness-heat,0(0.0%)cases of blood stasis in males,14(11.7%)cases of phlegm-dampness,0(0.0%)cases of dampness-heat and 12(10.0%)cases of blood stasis in females at the stage of chronic hepatiti s B,wi th si gnificant di f ferences(P<0.01).There were 74 times of damp-heat quality(50.7%),4 times of blood stasis qual ity(2.7%),0 times of calm quality(0.0%),32 times of yin deficiency quality(21.9%),70 times of qi deficiency qual ity(41.9%),16 times of damp-heat quality(17.4%),12 times of blood stasis quality(13.0%),4 times of calm and quality(4.3%),34 times of yin deficiency qual ity(37.0%)58 times of qi deficiency qual ity(63.0%)with statistical significance(P<0.05).In the compensatory phase of hepatitis B cirrhosis,30 cases(19.7%)of phlegm-dampness,40 cases(26.3%)of dampness-heat,0 cases(0.0%)of calmness,36 cases(23.7%)of qi-depression were found in males,4 cases(4.8%)of phlegm-dampness-heat,2.4%of dampness-heat,4 times(4.8%)of calmness and 30 cases(35.7%)of qi-depression in females,with significant differences(P<0.05).(4)There were significant differences in constitution among patients with chronic HBV infection in different age groups.74 times(38.1%)of patients aged 18-40 in chronic HBV carrier stage,34 times(17.5%)of patients with Qi deficiency,74 times(38.1%)of patients aged 41-65 years and 34 times(17.5%)of patients with Qi deficiency,with significant differences(P<0.01);4 times(3.0%)of patients aged 18-40 years in chronic hepatitis B stage.There were 12(11.3%)cases of blood stasis in patients aged 41-65(P<0.05),12(27.3%)cases of phlegm-dampness in patients aged 18-40(27.3%)and 4(9.1%)cases of blood stasis in patients aged 41-65(11.5%)and 144(75.0%)cases of blood stasis in patients aged 41-65(P<0.01).(5)Comparing the constitutional differences among patients with different HBeAg status,there were 70 times(18.7%)of peaceful quality,82 times(21.9%)of Yang deficiency,84 times(22.5%)of Yin deficiency,14 times(3.7%)of dampness and heat in patients with HBeAg(+),18 times(5.3%)of peaceful quality,26 times(7.7%)of Yang deficiency,110 times(32.5%)of yin deficiency and 130 times(38.5%)of dampness and heat in patients with HBeAg(+)(P<0.01).Conclusion:(1)In chronic HBV infection,males are more susceptible to disease and disease progression than females;with the increase of patients’ age,the disease shows a general trend of progress;most patients are characterized by concurrent constitution;the traditional Chinese medicine constitution types of chronic HBV carriers are mainly composed of calm constitution and yang deficiency constitution,while those of chronic hepatitis B are mainly composed of qi deficiency constitution and damp-heat constitution;those of compensatory stage of hepatitis B cirrhosis are mainly composed of blood.Stasis and Yin deficiency are the main types.(2)It is inferred that in patients with chronic HBV carriers,patients with Qi deficiency,damp-heat,Yin deficiency and qi depression may be more likely to progress to chronic hepatitis B,patients with blood stasis,Yin deficiency,Qi deficiency,damp-heat and qi depression may be more likely to progress to compensatory phase of hepatitis B cirrhosis,while patients with both qualities may be less likely to progress to chronic hepatitis B.Compensation period of hepatitis and hepatitis B cirrhosis;in patients with chronic hepatitis B,patients with blood stasis and yin deficiency may be more l ikely to progress to compensatory period of hepatitis B cirrhosis.(3)The constitution of patients with chronic HBV infection is related to gender.Overall,the damp-heat and Phlegm-damp constitution of men is more common than that of women.Women are more likely to have blood stasis and calm constitution than men.In the stage of chronic hepatitis B,women are more likely to have Yin deficiency and Qi deficiency.In the compensatory stage of hepatitis B cirrhosis,women are also more likely to have temperament depression.(4)The constitution of patients with chronic HBV infection is age-related.In the stage of chronic HBV carrier,young patients are more peaceful and elderly patients have more Qi deficiency;in the stage of chronic HBV,older patients have more blood stasis;in the compensatory stage of HBV,young patients are more phlegm-dampness and older patients have more blood-stasis.(5)The constitution of patients with chronic HBV infection is related to the state of HBeAg.The patients with HBeAg(-)are more likely to have mild constitution and yang deficiency constitution,while the patients wi th HBeAg(+)are more likely to have Yin deficiency constitution and damp-heat constitution. |
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