Traditional Chinese medicine syndromes of chronic hepatitis B with precore mutant

Abstract

AIM:This study aims at exploring the distribution of TCM syndromes in CHB patients with HBV pre-core mutation (1896) and the relationship between pre-core mutation and T lymphocytes subgroup, through which to provide objective data on clinical syndrome differentiation of TCM, and further to suggest the therapeutic principle and guide clinical treatment. METHODS:One hundred and forty CHB patients were evenly divided into two study groups, HBV pre-core mutant group and HBV pre-core wild-type group. Besides, 30 healthy blood donors were selected as a healthy control group. HBV-labeled compound, T lymphocytes subgroup, and HBV-DNA pre-core mutant were tested in the study groups.T lymphocytes subgroup were also tested in the control group. All the patients were both diagnosed by syndrome differentiation of TCM and western medicine. RESULTS:The most common syndrome in mutant group was damp-heat combined with blood stasis, and the most common syndrome in the wild-type group was dampheat stasis in the middle-jiao. There were more cases of medium and severe hepatitis in mutant group than that in wild-type group. The content of CD4+ lymphocytes and CD4+/CD8+ ratio were decreased gradually (healthy control group>wild-type group>mutant group). In the wild-type group, severe and medium CHB patients had considerably lower level of them than mild CHB patients. However, in the mutant group, the opposite result appeared. Meanwhile, the content of HBV-DNA in mutant group was higher than that in wild-type group.CONCLUSION: Damp, heat, toxin and blood stasis were the basic pathogens of CHB, whether pre-core mutant or not. CHB with precore mutant may lead to more severe hepatitis. The decreased content of CD4+ lymphocytes and ratio of CD4+/CD8+ may be taken as one of the indices in confirming the deficiency syndrome of CHB patients with pre-core mutation.

Frequency and pattern of Chinese herbal medicine prescriptions for chronic hepatitis in Taiwan

“…In Taiwan, the integration of Western and Chinese medicine has developed since 1950's (Chan, 2005), and the TCM practitioners have learned the Western medicine mostly through continuous education or undergraduate training courses. Therefore, under the impression of chronic hepatitis, TCM physicians still can classify the patients into five types of Chinese syndrome or "Zheng", such as "dampness heat stasis", "liver Qi stagnation and spleen deficiency", "yin deficiency of liver and kidney", "blood stasis into collateral" and "yang deficiency of spleen and kidney" according to the TCM differential syndromes (Liou et al, 2005;Tzeng and Sheen, 2005;Yang et al, 2005).…”

“…However, from the pattern of CHM use, we could distinguish what kinds of formulae were suitable for the different symptomatology classification and typological presentations of patients with chronic hepatitis based on the discriminating theory of ancient Chinese medicine (Bian-zheng-lun-zhi) (Li et al, 2004;Chan, 2005;Yang et al, 2005). Through analyzing the 10 most frequent use of Chinese herbal formulae in this study, we may postulate that the most encountered Zheng of chronic hepatitis in Taiwan was "dampness heat stasis" (5 out of 10), followed by "liver Qi stagnation and spleen deficiency" and "yin deficiency of liver and kidney" (2 out of 10, respectively).…”

Traditional Chinese Medicine Syndrome Patterns and Their Association with Hepatitis B Surface Antigen Levels during the Natural History of Chronic Hepatitis B Virus Infection

“…TCMS of patients were differentiated among five types, with reference to the viral hepatitis diagnostic standards defined in December 1991 by the Internal Medicine Hepatopathy Committee of the Chinese Traditional Medicine Association [ 24 ] and our previous study [ 25 ]; these five types included spleen-kidney deficiency (SKD), liver-qi depression (LQD), inner damp-heat retention (LGDH), liver-kidney deficiency (LKD), and blood stasis blocking collateral (BSBC). All TCMS pattern differentiation was checked firstly by an attending doctor and then verified by a chief physician.…”

Based on HMGB1-PTEN pathway to explore the difference of T lymphocyte function in chronic hepatitis B with representative TCM syndromes

“…LDSDS and SGDHS are the two most representative syndromes [39]. The two syndromes have great differences in pathogenesis, condition, and prognosis, and have different immune functions that affect the progression and outcome of the disease [40][41]. In this study, we can provide syndrome differentiation evidence for the treatment of chronic hepatitis B from the perspective of immunology and HMGB1-PTEN pathway.…”