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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**
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