Traditional Chinese Medicine Syndrome Element， Evolutionary Patterns of Patients with Hepatitis B Virus-Related Acute on Chronic Liver Failure at Different Stages： A Multi-Center Clinical Study
10.13288/j.11-2166/r.2024.12.012
- VernacularTitle:乙型肝炎病毒相关慢加急性肝衰竭不同分期患者中医证素、证型演变规律的多中心临床研究
- Author:
Simiao YU
1
;
Kewei SUN
2
;
Zhengang ZHANG
3
;
Hanmin LI
4
;
Xiuhui LI
5
;
Hongzhi YANG
6
;
Qin LI
7
;
Lin WANG
8
;
Xiaozhou ZHOU
9
;
Dewen MAO
10
;
Jianchun GUO
11
;
Yunhui ZHUO
12
;
Xianbo WANG
13
;
Xin DENG
14
;
Jiefei WANG
15
;
Wukui CAO
16
;
Shuqin ZHANG
17
;
Mingxiang ZHANG
18
;
Jun LI
1
;
Man GONG
1
;
Chao ZHOU
1
Author Information
1. Fifth Medical Center， Chinese PLA General Hospital， 100039， Beijing
2. The First Affiliated Hospital of Hunan University of Chinese Medicine
3. Tongji Hospital， Huazhong University of Science and Technology
4. Hubei Provincial Hospital of Traditional Chinese Medicine
5. Beijing You'an Hospital， Capital Medical University
6. The Third Affiliated Hospital， Sun Yat-sen University
7. Mengchao Hepatobiliary Hospital of Fujian Medical University
8. Public Health Clinical Medical Center of Chengdu
9. Shenzhen Traditional Chinese Medicine Hospital
10. The First Affiliated Hospital of Guangxi University of Chinese Medicine
11. West Lake Hospital， Hangzhou
12. Shuguang Hospital， Affiliated to Shanghai University of Traditional Chinese Medicine
13. Beijing Ditan Hospital， Capital Medical University
14. The Third People's Hospital of Shenzhen
15. Shanghai Public Health Clinical Center
16. Tianjin Second People's Hospital
17. Jilin Province Hepatobiliary Hospital
18. The Sixth People's Hospital of Shenyang
- Publication Type:Journal Article
- Keywords:
acute on chronic liver failure;
hepatitis B virus;
syndrome;
syndrome elements;
cross-sectional study
- From:
Journal of Traditional Chinese Medicine
2024;65(12):1262-1268
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.
