广西南宁CHB患者HBV基因型及中医证型相关性研究

发布时间：2018-06-21 14:56

本文选题：慢性乙型肝炎 + 中医证型　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:研究广西南宁地区慢性乙型肝炎(CHB)患者乙肝病毒基因型与中医证型之间的相关性。方法:按照中医及西医诊断标准,随机选取110确诊患者分别完善肝功能、乙肝抗原抗体五项、HBV-DNA水平等检查。然后进行HBV基因型检测确定分型以及进行中医辨证分型,主要分为肝胆湿热型、肝郁脾虚型、肝肾阴虚型、瘀血阻络型、脾肾阳虚型5个证型。通过各项实验室检查指标来分析CHB基因型与中医证型之间的相关性。结果:(1)110患者中,HBV基因型以B型为主,有67例,C型43例,中医证型以肝胆湿热型为主,有42例,肝郁脾虚型有27例,脾肾阳虚型有19例,肝肾阴虚型有16例,瘀血阻络型有6例。(2)肝胆湿热型、肝郁脾虚型患者主要以基因型B型为主,肝肾阴虚型、瘀血阻络型、脾肾阳虚型则以C型为主。(3)肝胆湿热型患者ALT、AST、TBIL、GLB最高,其次为瘀血阻络型肝郁脾虚型脾肾阳虚型肝肾阴虚型,基因型C型B型;ALB降低以肝胆湿热型最明显,其次为瘀血阻络型脾肾阳虚型肝肾阴虚型肝郁脾虚型,基因型C型B型;肝炎严重度从高到低依次为瘀血阻络型、肝胆湿热型、脾肾阳虚型、肝肾阴虚型和肝郁脾虚型,基因型C型严重于B型。(4)肝胆湿热型患者Hbe Ag阳性率、HBV-DNA水平高于其他四型,基因型C型高于B型,Hbe Ag阳性率与病毒活跃度成正比关系。结论:(1)慢性乙型病毒性肝炎的基因分型与中医证型有一定相关性。(2)广西南宁地区CHB患者中,中医证型以肝胆湿热型数量居多,基因型以B型数量居多,肝胆湿热型、肝郁脾虚型患者以基因型B型为主,肝肾阴虚型、瘀血阻络型、脾肾阳虚型则以C型为主。(3)实验室指标异常程度以基因型C型较明显,中医证型以肝胆湿热型最明显。
[Abstract]:Objective: to study the relationship between hepatitis B virus genotype and TCM syndromes in patients with chronic hepatitis B (CHB) in Nanning, Guangxi. Methods: according to the diagnostic criteria of traditional Chinese medicine and western medicine, 110 patients were randomly selected to improve liver function and HBV-DNA level. Then the type of HBV genotypes and TCM syndrome differentiation were classified into five types: dampness and heat of liver and gallbladder, liver stagnation and spleen deficiency, liver and kidney yin deficiency, blood stasis and collaterals obstruction, and spleen and kidney yang deficiency. The correlation between CHB genotypes and TCM syndromes was analyzed by laboratory examination. Results the genotype of HBV was mainly type B, and there were 67 cases of type C, 42 cases of syndrome of liver and bile damp-heat, 27 cases of liver stagnation and spleen deficiency, 19 cases of deficiency of spleen and kidney yang, 16 cases of yin deficiency of liver and kidney. There were 6 cases of blood stasis and obstruction of collaterals. The type of dampness and heat of liver and gallbladder, the type B of liver stagnation and spleen deficiency, the type of deficiency of liver and kidney yin, the type of blood stasis and obstruction of collaterals, the type C of spleen and kidney yang deficiency, the highest of TBILGLB of liver and gallbladder dampness heat type. Secondly, the type of liver stagnation and spleen stagnation and deficiency of spleen and kidney yang deficiency type of liver and kidney yin deficiency type, genotype C B type of liver and gallbladder dampness heat type is the most obvious, the second type is liver and kidney yang deficiency type of liver and kidney Yin deficiency type of deficiency of liver and kidney type, genotype C type B; The degree of hepatitis from high to low was blood stasis blocking collaterals type, liver and gallbladder dampness heat type, spleen and kidney yang deficiency type, liver and kidney yin deficiency type and liver stagnation and spleen deficiency type, genotype C being more serious than B type. The positive rate of genotype C was higher than that of type B, and the positive rate of Hbe Ag was proportional to the activity of the virus. Conclusion (1) the genotyping of chronic viral hepatitis B is related to TCM syndrome type. (2) among CHB patients in Nanning area of Guangxi, the number of TCM syndromes is mostly damp-heat type of liver and gallbladder, the number of genotype is type B, the type of dampness and heat of liver and gallbladder is the most. The patients with liver stagnation and spleen deficiency type were mainly genotype B, liver and kidney yin deficiency type, blood stasis blocking collaterals type, spleen and kidney yang deficiency type mainly in C type. The abnormal degree of laboratory indexes was more obvious in genotype C type, and the most obvious in TCM syndrome type was liver and gallbladder dampness heat type.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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