【摘要】 目的探讨中医体质辨识治疗对慢性乙型肝炎患者肝纤维化指标及生活质量的影响。方法选取2007年7月²012年7月我院收治的512例慢性乙型肝炎患者,将其按照随机数字法分为观察组和对照组,每组256例,对照组给予拉米夫定治疗,观察组在对照组基础上给予中医体质辨识治疗,两组均治疗24个月,并于治疗前及治疗后检测两组肝纤维指标[透明质酸（HA）、层粘连蛋白（LN）、Ⅳ型胶原（Ⅳ-C）、Ⅲ型前胶原（P-Ⅲ-P）]及免疫功能指标（T细胞亚群CD₃⁺、CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺）,同时于治疗前及治疗后采用SF-36量表评价患者的生活质量。结果治疗后两组HA、LN、Ⅳ-C、P-Ⅲ-P均较治疗前显著降低（P均<0.05）,但观察组降低更为明显（t=4.453、12.839、21.294、10.554,P均<0.05）。治疗后观察组CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺均较治疗前显著上升,CD₈⁺较治疗前显著降低（P均<0.05）,且观察组治疗后CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺均显著高于对照组治疗后,CD₈⁺显著低对照组治疗后（t=21.144、12.458、17.387、10.819,P均<0.05）。对照组治疗前后免疫功能指标CD₃⁺、CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺无显著性变化（P均>0.05）。治疗后两组SF-36量表各维度PF、RP、BP、GH、VT、SF、RE、MH评分均较治疗前显著上升（P均<0.05）,但观察组上升更为明显（t=6.865、8.620、10.785、18.956、9.605、8.127、16.695、7.452,P均<0.05）。结论中医体质辨识治疗可以降低慢性乙型肝炎的血清肝纤维化指标,提高免疫功能,改善患者的生活质量。更多还原

【Abstract】 Objective To investigate the effect of TCM constitution identification on the indices of liver fibrosis and quality of life in patients with chronic hepatitis B. Methods A total of 512 patients with chronic hepatitis B who were admitted to our hospital from July 2007 to July 2012 were selected and divided into observation group and control group according to random number method, with 256 patients in each group. The control group was given lamivudine for treatment, and the observation group was given TCM constitution identification on the basis of the control group.Both groups were treated for 24 months. Liver fibrosis indices such as hyaluronic acid（HA）, laminin（LN）, type IV collagen（Ⅳ-C）, type Ⅲ procollagen（P-Ⅲ-P） and immunological function indices（T cell subsets CD₃⁺, CD₄⁺, CD₈⁺, CD₄⁺/CD₈⁺） were measured before and after treatment in the two groups. At the same time, SF-36 scale was applied to assess the quality of life of patients before and after treatment. Results The levels of HA, LN, IV-C and P-Ⅲ-P in the two groups after treatment were significantly lower than those before treatment（P all<0.05）, but the decrease was more significant in the observation group（t=4.453, 12.839, 21.594, 10.554, P all<0.05）. After treatment, the levels of CD₃⁺, CD₄⁺,CD₄⁺/CD₈⁺in the observation group were significantly higher than those before treatment. CD₈⁺was significantly lower than that before treatment（P all<0.05）. The levels of CD₃⁺, CD₄⁺, CD₄⁺/CD₈⁺in the observation group after the treatment were significantly higher than those in the control group after treatment. CD₈⁺was significantly lower in the control group after treatment（t=21.144, 12.458, 17.387, 10.819, P all<0.05）. There were no significant changes of CD₃⁺, CD₄⁺,CD₈⁺and CD₄⁺/CD₈⁺in the control group before and after treatment（P all>0.05）. After treatment, the scores of PF, RP,BP, GH, VT, SF, RE and MH in SF-36 scale were significantly higher than those before treatment in both groups（P all<0.05）, but the increase was more significant in the observation group（ t=6.865, 8.620, 10.785, 18.956, 9.605,8.127, 16.695, 7.452, P all<0.05）. Conclusion TCM constitution identification can decrease the serum hepatic fibrosis index of chronic hepatitis B, improve the immune function and improve the quality of life of patients.更多还原