Dissertation > Medicine, health > Internal Medicine > Infectious disease > Viral infections > Viral Hepatitis > Hepatitis B

Study on relationship between changes of chronic HBV infected liver pathology element and main syndrome elements

Author GuLiLi
Tutor WangXianBo
School Beijing University of Traditional Chinese Medicine
Course Traditional Chinese Medicine
Keywords liver tissue pathology TCM main syndrome factors chronic HBV infection
CLC R512.62
Type Master's thesis
Year 2014
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Chronic hepatitis Bvirus infection can cause liver inflammation and fibrosis, and eventually develop cirrhosis, liver cancer. Early diagnosis of liver fibrosis and cirrhosis in chronic liver disease control progress, prognosis, treatment and curative effect evaluation are important clinical significance. Integrated application of biochemical indicators, clinical indicators, radiological indicators, Chinese traditional medicine (TCM) syndrome selements and syndromes type, to explore the liver pathological changes in patients with HBV infection has become an important topic in the research of HBV chronic infection.[Objective]1. Using prospective studies research the relationship between biochemical indicators, clinical indicators and pathological changes in patients with chronic HBV infection, and identified the key factors that significantly affect liver inflammation and fibrosis.2. Analysis the main syndrome of chronic viral hepatitis B, and research the relation of the liver pathological changes and the main elements of TCM syndromes, use clinical epidemiology and mathematical statistics methods.[Methods]1. Collecting349patients admitted with chronic HBV infection who had liver biopsy at the Capital Medical University, Beijing Ditan Hospital were entered in this study. All patients with available clinical information and baseline laboratory parameters were enrolled from January2012to January2014. By univariate and multivariate logistic regression analysis26observation indexes, such as age, gender, body mass index, to select independent predictors of different study end point (G≥2, S≥2,≥G2S2).2. Finishing and descriptive analysis clinical data, symptoms and signs, tongue picture, pulse condition, to determine their TCM main syndrome elements of324patients with chronic HBV infection. And explore the relationship between chronic HBV of the dampness, heat, blood stasis, deficiency these four major syndrome elements and liver pathology changes, then analysis the distribution of these elements, deficiency in significant liver inflammation and fibrosis.[Results]1. A total of349patients with chronic HBV infection were enrolled, the ratio was1.8:1male to female, including128significantliver inflammation, multivariate analyses results showed that age, WBC, ALT, GGT, HBeAg-positive, PT were the independent predictors.2. There are128significant liver inflammation in349cases of patients with chronic HBV infection including, univariate and multivariate analyses results showed that age, PLT, PT were the significant predictors.3. Analysis of clinical data of278cases of liver tissue pathology<G2S2and71cases patients with chronic HBV infection of liver tissue pathology of G2S2, the results showed that age, PLT, GGT, PT, HBeAg positive, were the independent predictors of significant inflammation and significant fibrosis exist at the same time.4. The results of study of the relation chronic HBV infection liver tissue pathology changes with TCM main syndrome factors showed that patients with dampness or heat syndrome elements their liver pathology in general are not significant liver inflammation (proportion is79.35%,79.35%respectively),these two groups had no statistical significance (P=0.763), similarly these patients don’t have significant significant liver fibrosis (proportion is83.70%,83.70%respectively);Factors of blood stasis and deficiency are different with dampness and heat in the liver inflammation and fibrosis (P<0.05).[Conclusion]1. Age, GGT, PT are the key factors of patients with chronic HBV infection tissue pathology changes;ALT, HBeAg-positive are the risk factors for liver inflammation, and the WBC is the protection factor of liver inflammation; PLT can protect the patients with chronic HBV infection develop into fibrosis.2. If the syndrome factor is given priority to with dampness or heat, the liver tissue pathology of patients with chronic HBV infection should be characterized not significant inflammation or (and) not significant fibrosis;patients with stasis or deficiency elements as the main syndrome their liver pathology will more severe than these whose syndrome factors is wet or heat.

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