【作者】 蔡林宏；

【导师】 谢晶日；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 目的：探讨慢性乙型肝炎(简称：慢乙肝)中医辨证分型与血清γ干扰素(IFN-γ)、HBV-DNA之间的相关性。方法：慢乙肝的中医辨证分型五个标准证型组(肝郁脾虚型、湿热中阻型、瘀血阻络型、肝肾阴虚型、脾肾阳虚型)每组各纳入30例符合诊断标准的慢乙肝患者,共150例进行血清免疫学指标测定,包括应用酶联免疫检测法检测IFN-γ、血清HBV-DNA指标的检测；纳入健康者30例,同时检测IFN-γ。探讨慢性乙型肝炎中医辨证分型与IFN-γ水平及HBV-DNA之间的关系。结果：1.慢乙肝组血清IFN-γ水平较正常对照组低,相比差异有显著性意义(P<0.01)。2.各证型IFN-γ水平变化趋势为：湿热中阻组>肝肾阴虚组>肝郁脾虚组>瘀血阻络组>脾肾阳虚组。肝郁脾虚组、瘀血阻络组之间比较差异无统计学意义(P>0.05),其余各组间比较差异均有统计学意义(P<0.05)。3.HBV-DNA各组血清IFN-γ水平与正常对照组比较,差异有统计学意义(P<0.05), HBV-DNA(+)组IFN-γ水平高于HBV-DNA(-)组IFN-γ水平,但两组间血清IFN-γ水平比较,差异无统计学意义(P>0.05)。4.各证型组HBV-DNA(+)者血清HBV-DNA水平变化趋势为：湿热中阻组>肝肾阴虚组>肝郁脾虚组>瘀血阻络组。湿热中阻组与肝肾阴虚组比较,差异有统计学意义(P<0.05)；湿热中阻组、肝肾阴虚组分别与肝郁脾虚组、瘀血阻络组比较,有显著性差异(P<0.01)；而肝郁脾虚组组与瘀血阻络组比较,差异无统计学意义(P<0.01)。结论：慢乙肝患者中医辨证分型与血清IFN-γ、HBV-DNA之间有一定的相关性。更多还原

【Abstract】 Objective:To study on the relationships among the Traditional Chinese Medicine (TCM) types of Chronic Hepatitis B (CHB), serum interferon-gamma (IFN-γ) levels and HBV-DNA levels.Methods:Five normal TCM types groups are decided according to the standard of TCM syndromes:liver stagnation and spleen deficiency, dampness-heat accumulation, blood-stasis in meridian, liver-kidney yin deficiency, spleen-kidney yang deficiency. Each group has to be collected in thirty CHB clinical patients.To examine those total 150 CHB clinical patients’ serum IFN-y and HBV-DNA levels of course the IFN-y level of thirty healthers in order to find the differences or correlations also directions among them.Results:1. The IFN-γlevel of the whole CHB patients’group is lower than the normal group’s, the differences of them is significant (P<0.01).2. The direction of the IFN-γlevel is dampness-heat accumulation> liver-kidney yin deficiency>liver stagnation and spleen deficiency> blood-stasis in meridian group>spleen-kidney yang deficiency. Dampness-heat accumulation group has the highest IFN-γlevel compared with other four groups. All the comparisons among the five groups are significantly different except the difference between liver stagnation and spleen deficiency group and blood-stasis in meridian group.3.The IFN-y levels of HBV-DNA groups are obvious compared with the normal group’s(P<0.05),but the diference is not significant between themselves(P> 0.05).4.The direction of the HBV-DNA level is dampness-heat accumulation >liver-kidney yin deficiency>liver stagnation and spleen deficiency> blood-stasis in meridian group.Without spleen-kidney yang deficiency group, the HBV-DNA level of dampness-heat accumulation group compared with other three groups’is significant, so as the liver-kidney yin deficiency group, there is on obvious difference between liver stagnation and spleen deficiency group and blood-stasis in meridian group.Conclusion:There are some relationships among the Traditional Chinese Medicine types of Chronic Hepatitis B, serum interferon-gamma (IFN-γ) levels and HBV-DNA levels.更多还原