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Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (5): 525-531.doi: 10.3736/jcim20120507

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

Investigation on traditional Chinese medicine syndrome distribution of 4 618 hepatitis B virus infection subjects in Qidong of Jiangsu Province, China

Qing-bo Lang1, Dong-xia Zhai1, Feng Huang1, Jian-guo Chen2, Yong-hui Zhang2, Qun Liu1, Xiao-feng Zhai1, Bai Li1, Chang-quan Ling1   

  1. 1. Department of Traditional Chinese Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
    2. Qidong Liver Cancer Prevention Research, Qidong 226200, Jiangsu Province, China
  • Received:2011-12-26 Accepted:2012-01-18 Online:2012-05-20 Published:2018-06-15

Objective: To study the traditional Chinese medicine (TCM) syndrome distribution in patients with hepatitis B virus (HBV) infection in Qidong region of Jiangsu Province, China.

Methods: A cross-sectional survey was performed. Subjects from Qidong of Jiangsu Province of China were screened among the locally enrolled residents by detecting hepatitis B surface antigen (HBsAg) from May 2007 to May 2011 and were assigned to HBsAg-negative cohort or HBsAg-positive cohort. Then, the subjects were diagnosed according to alanine aminotransferase, alpha-fetoprotein and B ultrasound. The syndrome of the subjects was determined using a TCM questionnaire consisting of signs and symptoms.

Results: A total of 5 908 subjects were enrolled in this survey, among whom, 4 718 were diagnosed with HbsAg infection (positive result of HbsAg detection) and 1 147 were negative. 143 subjects were excluded for not receiving the blood examination. The final diagnoses of the subjects were non-HBV infection (n=1 128), HBV carrier (n=4 019), chronic hepatitis B (n=225), posthepatitic cirrhosis (n=263) or liver cancer (n=111). The TCM syndrome differentiation results showed that there were differences in syndrome distribution between HBV-infected and non-HBV-infected patients. The main syndromes of the HBV-infected patients were qi deficiency, qi stagnation, blood stasis and dampness heat, related to the Zang of liver and spleen. The distribution principles of TCM syndrome among patients of HBV carrier, chronic hepatitis B and cirrhosis were similar. Moreover, with the progression of the patients’ condition, the scores of syndromes increased, and the number of accompanying syndromes increased as well. The main syndromes of patients with liver cancer were blood stasis and excess heat, which was slightly different from that of the other HBV-infected patients.

Conclusion: The TCM syndrome distribution in patients of HBV infection in Qidong region of Jiangsu Province shows regularity. The disorder is mainly due to qi stagnation and blood stasis and is also related to deficiency of healthy qi, especially deficiency of spleen qi

Key words: hepatitis B virus, hepatitis B, chronic, hepatitis B surface antigens, liver cirrhosis, liver neoplasms, syndrome complex, cross-sectional studies, cohort studies

Table 1

Basic condition of the cohort"

Group n Gender (n) Age
(x±s,
years)
Drinking history (n) Family tumor history (n)
Male Female Yes No Unknown Yes No Unknown
HBsAg-positive 4 618 2 590 2 028 52.18±8.67 1 277 1 512 1 829 1 470 1 387 1 761
HBsAg-negative 1 147 1 100 47 59.29±7.22 523 421 203 307 635 206

Table 2

Distribution of composite syndromes of the subjects (n, %)"

Group n Distribution of composite syndrome
Liver-gallbladder
dampness-heat
Damp pathogen
obstructing the spleen
Stagnation qi due
to liver depression
Liver depression
and spleen deficiency
Non-HBV infected 1 128 151 (13.4%) 84 (7.4%) 380 (33.7%) 306 (27.1%)
HBV carrier 4 019 622 (15.5%) 427 (10.6%) 1 665 (41.4%) 1 486 (37.0%)
Chronic hepatitis B 225 45 (20.0%) 41 (18.2%) 114 (50.7%) 106 (47.1%)
Posthepatitic cirrhosis 263 60 (22.8%) 31 (11.8%) 164 (62.4%) 137 (52.1%)
Liver cancer 111 29 (26.1%) 11 (9.9%) 49 (44.1%) 46 (41.4%)
Group n Distribution of composite syndrome
Liver depression
and blood stasis
Liver-kidney
yin deficiency
Spleen-kidney
yang deficiency
Differentiation of
syndrome unavailable
Non-HBV infected 1 128 309 (27.4%) 147 (13.0%) 88 (7.8%) 397 (35.2%)
HBV carrier 4 019 1 405 (35.0%) 668 (16.6%) 553 (13.8%) 1 141 (28.4%)
Chronic hepatitis B 225 87 (38.7%) 40 (17.8%) 36 (16.0%) 50 (22.2%)
Posthepatitic cirrhosis 263 83 (30.4%) 64 (23.6%) 40 (15.2%) 46 (17.5%)
Liver cancer 111 50 (42.3%) 22 (18.9%) 13 (10.8%) 22 (19.8%)

Table 3

Distribution of the accompanying basic syndromes of the subjects (n, %)"

Group n Distribution of different number of accompanying syndromes
0 1 2 3
Non-HBV infected 1 128 397 (35.2%) 332 (29.4%) 199 (17.6%) 108 (9.6%)
HBV carrier 4 019 1 141 (28.4%) 1 050 (26.1%) 676 (16.8%) 554 (13.8%)
Chronic hepatitis b 225 50 (22.2%) 43 (19.1%) 42 (18.7%) 43 (19.1%)
Posthepatitic cirrhosis 263 46 (17.5%) 50 (19.0%) 52 (19.8%) 64 (24.3%)
Liver cancer 111 22 (19.8%) 38 (34.2%) 14 (12.6%) 10 (9.0%)
Total 1 656 (28.8%) 1 513 (26.3%) 983 (17.1%) 779 (13.6%)
Group n Distribution of different number of accompanying syndromes
4 5 6 7
Non-HBV infected 1 128 56 (5.0%) 30 (2.7%) 5 (0.4%) 1 (0.1%)
HBV carrier 4 019 325 (8.1%) 196 (4.9%) 57 (1.4%) 20 (0.5%)
Chronic hepatitis b 225 27 (12.0%) 15 (6.7%) 5 (2.2%) 0 (0%)
Posthepatitic cirrhosis 263 36 (13.7%) 9 (3.4%) 3 (1.1%) 3 (1.1%)
Liver cancer 111 17 (15.3%) 9 (8.1%) 1 (0.9%) 0 (0.0%)
Total 461 (8.0%) 259 (4.5%) 71 (1.2%) 24 (0.4%)

Table 4

Scores of basic syndrome of the subjects (x±s)"

Group n Score of different basic syndrome
Qi stagnation Blood stasis Excess heat Dampness
Non-HBV infected 1 128 8.71±7.74 14.40±10.05 3.21±4.47 5.95±5.47
HBV carrier 4 019 10.88±9.22** 15.93±11.22** 4.86±5.57** 6.30±5.87**
Chronic hepatitis B 225 13.31±9.69**△△ 15.86±10.77* 6.05±5.95**△△ 7.01±6.71*
Posthepatitic cirrhosis 263 15.50±10.34**△△▲ 15.16±11.76 6.39±6.44**△△ 7.89±7.84**△△
Liver cancer 111 13.45±10.90**△□ 17.22±10.86* 6.80±6.35**△△ 7.57±8.03
Group n Score of different basic syndrome
Qi deficiency Blood deficiency Yin deficiency Yang deficiency
Non-HBV infected 1 128 11.97±10.45 9.71±9.20 3.78±6.40 7.33±11.36
HBV carrier 4 019 14.06±11.60** 14.64±11.61** 4.94±7.80** 13.17±15.69**
Chronic hepatitis B 225 16.60±12.74**△△ 13.19±10.72** 4.75±6.85* 13.38±16.62**
Posthepatitic cirrhosis 263 18.35±14.26**△△ 12.83±10.03** 6.29±7.96**△△▲ 13.91±16.24**
Liver cancer 111 14.82±12.93*□ 10.57±9.60△△▲□ 4.85±6.94* 11.85±14.55**
[1] Zhuang H . Hepatitis B virus infection in China and the challenges[J]. Zhonghua Chuan Ran Bing Za Zhi, 2005,23(S):2-6.
庄辉 . 我国乙型肝炎病毒感染与挑战[J]. 中华传染病杂志, 2005,23(增刊):2-6
[2] EASL. EASL Clinical Practice Guidelines: management of chronic hepatitis B[J]. J Hepatol, 2009,50(2):227-242
doi: 10.1016/j.jhep.2008.10.001
[3] Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association . The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J]. Zhonghua Liu Xing Bing Xue Za Zhi, 2010,32(4):405-415.
doi: 10.3760/cma.j.issn.0578-1426.2011.02.027
中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2010年版)[J]. 中华流行病学杂志, 2010,32(4):405-415
doi: 10.3760/cma.j.issn.0578-1426.2011.02.027
[4] Wang JY, Wang LT . The study and consideration of TCM syndrome of chronic hepatitis B patients[J]. Guang Ming Zhong Yi, 2010,(9):1743-1744.
doi: 10.3969/j.issn.1003-8914.2010.09.138
王见义, 王灵台 . 慢性乙型肝炎中医证型的研究与思考[J]. 光明中医, 2010,( 9):1743-1744
doi: 10.3969/j.issn.1003-8914.2010.09.138
[5] Li DT, Ling CQ, Zhu DZ, Yu CQ, Chen Z, Zhai XF, Shen J, Zhang BH, Zhang JF, Lang QB . Study on the quantitative evaluation on the degree of TCM basic syndromes often encountered in patients with primary liver cancer[J]. Zhongguo Zhong Xi Yi Jie He Za Zhi, 2007,27(7):602-605.
李东涛, 凌昌全, 朱德增, 俞超芹, 陈喆, 翟笑枫, 沈婕, 张百红, 张金峰, 郎庆波 . 原发性肝癌中医常见基本证候轻重程度量化评价研究[J]. 中国中西医结合杂志, 2007,27(7):602-605
[6] Li DT, Ling CQ, Lang QB, Zhu DZ, Yu CQ, Chen Z, Zhai XF, Shen J, Zhang JF, Zhang BH . Construction of a therapeutic effect evaluation system for patients with primary liver cancer based on syndrome differentiation in traditional Chinese medicine[J]. J Chin Integr Med, 2007,5(1):15-22.
李东涛, 凌昌全, 郎庆波, 朱德增, 俞超芹, 陈喆, 翟笑枫, 沈婕, 张金峰, 张百红 . 以证候为内容的原发性肝癌中医疗效评价体系研究[J]. 中西医结合学报, 2007,5(1):15-22
[7] Zheng XY. Clinical guideline for new drugs of traditional Chinese medicine(trial implementation)[M]. Beijing: China Medical Science Press,2002: 143-151.
郑筱萸 . 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社,2002: 143-151
[8] Chinese Society of Liver Cancer, Chinese Anti-Cancer Association . Criteria for diagnosing and staging of primary liver cancer[J]. Zhonghua Gan Zang Bing Za Zhi, 2001,9(6):324.
中国抗癌协会肝癌专业委员会. 原发性肝癌的临床诊断与分期标准[J]. 中华肝脏病杂志, 2001,9(6):324
[9] Zhang XD, Du Y, Nie HM, Chen JJ . Thought of TCM syndrome of chronic hepatitis B patients[J]. Zhong Yi Za Zhi, 2009,( 2):173-175.
doi: 10.3321/j.issn:1001-1668.2009.02.034
张晓东, 杜赟, 聂红明, 陈建杰 . 慢性乙型肝炎中医证候研究思路探析[J]. 中医杂志, 2009,( 2):173-175
doi: 10.3321/j.issn:1001-1668.2009.02.034
[10] Qian Y . Syndrome differentiation of hepatitis patients[J]. Zhongguo Zhong Yi Yao Xian Dai Yuan Cheng Jiao Yu, 2004,2(1):13-15.
钱英 . 病毒性肝炎中医辨证分型[J]. 中国中医药现代远程教育, 2004,2(1):13-15
[11] Liu SN, Tao XP, Wang RB, Xu RP, Liu Z, Zhou B, Bai YN, Xu DJ, Fu JP, Liu JM, Sun FX . Study on the evolution law of TCM syndrome of patients with chronic hepatitis B[J]. Zhongguo Zhong Yi Yao Ke Ji, 2008,( 3):161-163.
doi: 10.3969/j.issn.1005-7072.2008.03.001
刘绍能, 陶夏平, 王融冰, 徐瑞平, 刘震, 周斌, 白宇宁, 许德军, 付菊萍, 刘军民, 孙凤霞 . 慢性乙型肝炎中医证候演变规律研究[J]. 中国中医药科技, 2008,( 3):161-163
doi: 10.3969/j.issn.1005-7072.2008.03.001
[12] Zhang Q, Liu P, Zhang HW, Wang L, Du GL, Chen HF, Chen L, Wang JR, Wang XB . Study on the patterns of TCM syndrome differentiation of 900 patients with posthepatitic cirrhosis[J]. Zhongguo Zhong Xi Yi Jie He Za Zhi, 2006,26(8):694-697.
张琴, 刘平, 章浩伟, 王磊, 都光礼, 陈慧芬, 陈良, 王江容, 王宪波 . 900例肝炎后肝硬化中医证候判别模式的研究[J]. 中国中西医结合杂志, 2006,26(8):694-697
[13] Zhang Q, Liu P, Chen HF, Chen L, Cao SH, Liu Y, Wei JJ, Fang ZH, Wu DZ . Clinical investigation on characteristics of traditional Chinese medical syndrome of hepatocirrhosis[J]. J Chin Integr Med, 2003,1(2):108-112.
张琴, 刘平, 陈慧芬, 陈良, 曹素华, 刘莺, 魏建军, 方志红, 吴定中 . 肝炎后肝硬化中医证候特点的临床调查研究[J]. 中西医结合学报, 2003,1(2):108-112
[14] Yuan JL, Zhang H, Wang L, Lin Y, Hu XC, Zhang Q, Liu P . Biochemical characteristics of traditional Chinese medicine syndromes and their elements in patients with hepatitis B cirrhosis[J]. J Chin Integr Med, 2011,9(4):374-381.
袁继丽, 张华, 王磊, 林彦, 胡鑫才, 张琴, 刘平 . 乙型肝炎后肝硬化患者中医证候要素的生物化学特征[J]. 中西医结合学报, 2011,9(4):374-381
[15] Guo JC, Gou YH, Duan CR, Li CQ, Xiao LN, Shi ZW, Shi JP, Yu JH, Wang YF, Yu XL, Wu XY . Study on the TCM syndromes of chronic severe hepatitis B[J]. Zhonghua Zhong Yi Yao Xue Kan, 2011,29(5):969-971.
过建春, 苟运浩, 段传荣, 李春青, 肖丽娜, 石伟珍, 施军平, 喻剑华, 王宇芳, 俞秀丽, 吴晓瑛 . 慢性乙型重型肝炎中医证候规律研究[J]. 中华中医药学刊, 2011,29(5):969-971
[16] Deng HL, Wang TF, Zhao Y, Xue XL, Wu XY, Wang GQ . Common traditional Chinese medicine syndrome elements of chronic hepatitis B: a questionnaire survey of experts[J]. Shi Jie Hua Ren Xiao Hua Za Zhi, 2011,19(8):845-849.
邓华亮, 王天芳, 赵燕, 薛晓琳, 吴秀艳, 王庆国 . 慢性乙型肝炎常见的中医证候要素[J]. 世界华人消化杂志, 2011,19(8):845-849
[17] Yuan H, Cao TZ, Liu H, Li XL, Wang D, Wu QK, Deng X, Wen B, Nie G . Study on the TCM syndromes of 302 patients with hepatitis B cirrhosis[J]. Zhongguo Zhong Xi Yi Jie He Gan Bing Za Zhi, 2009,19(6):346-349.
doi: 10.3969/j.issn.1005-0264.2009.06.010
袁虹, 曹廷智, 刘红, 李晓良, 王东, 吴其恺, 邓欣, 文彬, 聂广 . 302例乙型肝炎肝硬化患者中医证候学探讨[J]. 中西医结合肝病杂志, 2009,19(6):346-349
doi: 10.3969/j.issn.1005-0264.2009.06.010
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