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  本文選題：慢性乙型肝炎 + 中醫(yī)證型��； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:研究廣西南寧地區(qū)慢性乙型肝炎(CHB)患者乙肝病毒基因型與中醫(yī)證型之間的相關(guān)性。方法:按照中醫(yī)及西醫(yī)診斷標(biāo)準(zhǔn),隨機選取110確診患者分別完善肝功能、乙肝抗原抗體五項、HBV-DNA水平等檢查。然后進行HBV基因型檢測確定分型以及進行中醫(yī)辨證分型,主要分為肝膽濕熱型、肝郁脾虛型、肝腎陰虛型、瘀血阻絡(luò)型、脾腎陽虛型5個證型。通過各項實驗室檢查指標(biāo)來分析CHB基因型與中醫(yī)證型之間的相關(guān)性。結(jié)果:(1)110患者中,HBV基因型以B型為主,有67例,C型43例,中醫(yī)證型以肝膽濕熱型為主,有42例,肝郁脾虛型有27例,脾腎陽虛型有19例,肝腎陰虛型有16例,瘀血阻絡(luò)型有6例。(2)肝膽濕熱型、肝郁脾虛型患者主要以基因型B型為主,肝腎陰虛型、瘀血阻絡(luò)型、脾腎陽虛型則以C型為主。(3)肝膽濕熱型患者ALT、AST、TBIL、GLB最高,其次為瘀血阻絡(luò)型肝郁脾虛型脾腎陽虛型肝腎陰虛型,基因型C型B型;ALB降低以肝膽濕熱型最明顯,其次為瘀血阻絡(luò)型脾腎陽虛型肝腎陰虛型肝郁脾虛型,基因型C型B型;肝炎嚴(yán)重度從高到低依次為瘀血阻絡(luò)型、肝膽濕熱型、脾腎陽虛型、肝腎陰虛型和肝郁脾虛型,基因型C型嚴(yán)重于B型。(4)肝膽濕熱型患者Hbe Ag陽性率、HBV-DNA水平高于其他四型,基因型C型高于B型,Hbe Ag陽性率與病毒活躍度成正比關(guān)系。結(jié)論:(1)慢性乙型病毒性肝炎的基因分型與中醫(yī)證型有一定相關(guān)性。(2)廣西南寧地區(qū)CHB患者中,中醫(yī)證型以肝膽濕熱型數(shù)量居多,基因型以B型數(shù)量居多,肝膽濕熱型、肝郁脾虛型患者以基因型B型為主,肝腎陰虛型、瘀血阻絡(luò)型、脾腎陽虛型則以C型為主。(3)實驗室指標(biāo)異常程度以基因型C型較明顯,中醫(yī)證型以肝膽濕熱型最明顯。
[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.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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本文編號：2049137