TCM constitution distribution and clinical features of patients with hepatitis B cirrhosis and dysplastic nodules

Mengbing FANG; Cheng LIU; Yu ZHANG; Jiayi ZENG; Zhiheng CHEN; Sheng LI; Xiaoling CHI; Huanming XIAO

doi:10.12449/JCH240515

Volume 40 Issue 5

May 2024

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2024 > 40(5): 961-967

PDF( 775 KB)

TCM constitution distribution and clinical features of patients with hepatitis B cirrhosis and dysplastic nodules

DOI: 10.12449/JCH240515

Mengbing FANG¹,
Cheng LIU¹,
Yu ZHANG¹,
Jiayi ZENG¹,
Zhiheng CHEN¹,
Sheng LI^{2, 3},
Xiaoling CHI^{2, 3},
Huanming XIAO^{2, 3
,
,
,}

1.
The Second Clinical Medical College of Guangzhou University of Chinese Medicine，Guangzhou 510006，China
2.
Department of Hepatology，Guangdong Provincial Hospital of Traditional Chinese Medicine，Guangzhou 510006，China
3.
Department of Hepatology，The Second Affiliated Hospital of Guangzhou University of Chinese Medicine，Guangzhou 510006，China

Research funding:

The Thirteenth Five-Year Plan for Major and Special Programs of the National Science and Technologyof China (2018ZX10725506-003);

The Thirteenth Five-Year Plan for Major and Special Programs of the National Science and Technologyof China (2018ZX10725505-004);

the Clinical Research Projects of Guangdong Provincial Hospital of Chinese Medicine (YN10101903);

the Clinical Research Projects of Guangdong Provincial Hospital of Chinese Medicine (YN2016XP03);

the Clinical Research Projects of Guangdong Provincial Hospital of Chinese Medicine (YN2022DB04);

Open Project of State Key Laboratory of Dampness Syndrome of Chinese Medicine (SZ2022KF02);

Advantage Disease Project of Guangdong Provincial Hospital of Traditional Chinese Medicine (［2020］ No.37);

Chi Xiaoling of Project of Inheritance Workshop of Famous Old Chinese Medicine Experts of State Administration of Traditional Chinese Medicine (Guozhong Pharmaceutical Human Education Letter ［2022］ No.‍75);

The Fifth Batch of National Research and Training Programs for Clinical Talents of Traditional Chinese Medicine (Guozhong Pharmaceutical Human Education Letter ［2022］ No.1)

More Information

Corresponding author: XIAO Huanming， xiaohuanming@163.com （ORCID： 0000-0002-8739-0720）
Received Date: 2023-08-20
Accepted Date: 2023-09-25
Published Date: 2024-05-25

Abstract

Abstract

Objective To investigate the characteristics of TCM constitution distribution in hepatitis B cirrhosis patients with dysplastic nodules （DN）， and to provide a basis for the prevention and treatment of precancerous lesions of liver cancer. Methods This study was conducted among 113 hepatitis B cirrhosis patients with DN， 105 hepatitis B cirrhosis patients with regenerative nodules （RN）， and 70 hepatitis B cirrhosis patients with small hepatocellular carcinoma （sHCC） who were hospitalized in Guangdong Provincial Hospital of Traditional Chinese Medicine from May 2015 to March 2023. Related data were collected， including age， sex， liver function Child-Pugh class， TCM constitution type， and laboratory markers. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups； the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups； the chi-square test was used for comparison of categorical data between groups， and the Bonferroni correction method was used for further comparison between two groups. Results The main TCM constitution types of hepatitis B cirrhosis patients with DN were Qi-deficiency constitution （27 patients， 23.89%）， blood-stasis constitution （26 patients， 23.01%）， and phlegm-dampness constitution （23 patients， 20.35%）. There were significant differences between the three groups in the proportion of patients with phlegm-dampness constitution or damp-heat constitution （χ²=6.822 and 6.383， both P<0.05）； the hepatitis B cirrhosis patients with RN had the highest proportion of patients with phlegm-dampness constitution （30.48%）， followed by those with DN （20.35%） and those with sHCC （14.29%）， while the hepatitis B cirrhosis patients with sHCC had the highest proportion of patients with damp-heat constitution （27.14%）， followed by those with DN （16.81%） and those with RN （12.38%）. There were significant differences between the hepatitis B cirrhosis DN patients with different TCM constitution types in sex， age， Child-Pugh class， prealbumin， albumin （Alb）， aspartate aminotransferase， total bilirubin （TBil）， total bile acid， and alpha-fetoprotein （all P<0.05）. Compared with the male hepatitis B cirrhosis DN patients， female patients showed a significantly higher proportion of patients with Qi-deficiency constitution （χ²=4.895， P=0.027）. Among the patients with Qi-deficiency constitution， the patients with Child-Pugh class A liver function accounted for a significantly lower proportion than those with Child-Pugh class B liver function （χ²=6.380， P=0.012）， while among the patients with phlegm-dampness constitution， the patients with Child-Pugh class A liver function accounted for a significantly higher proportion than those with Child-Pugh class B liver function （χ²=8.515， P=0.004）. The patients with phlegm-dampness constitution had significantly higher levels of prealbumin and Alb than those with the other four constitutions （all P<0.05）， as well as significantly lower levels of TBil and total bile acid than those with damp-heat constitution （P<0.05）； the patients with Yin-deficiency constitution had a significantly lower level of Alb than those with qi-deficiency constitution， blood-stasis constitution， or phlegm-dampness constitution （all P<0.05）； the patients with Yin-deficiency constitution had a significantly lower proportion of patients with abnormal alpha-fetoprotein than those with non-Yin-deficiency constitutions （χ²=4.448， P=0.035）. Conclusion Hepatitis B cirrhosis patients with DN mainly have the TCM constitution types of Qi deficiency， blood stasis， and phlegm dampness. The patients with phlegm-dampness constitution seem to have a low probability of carcinogenesis， while those with damp-heat constitution and Yin-deficiency constitution have a relatively high risk of carcinogenesis.
- Liver Cirrhosis,
- Dysplasia Nodules,
- Constitutional Type （TCM）

FullText(HTML)

References(19)

References

[1]	General Office of National Health Commission. Standard for diagnosis and treatment of primary liver cancer(2022 edition)[J]. J Clin Hepatol, 2022, 38( 2): 288- 303. DOI: 10.3969/j.issn.1001-5256.2022.02.009. 国家卫生健康委办公厅. 原发性肝癌诊疗指南(2022年版)[J]. 临床肝胆病杂志, 2022, 38( 2): 288- 303. DOI: 10.3969/j.issn.1001-5256.2022.02.009.
[2]	Chinese Journal of Hepatology; Liver Cancer Study Group, Chinese Society of Hepatology, Chinese Medical Association. Expert consensus on multidisciplinary diagnosis and treatment of precancerous lesions of hepatocellular carcinoma(2020 edition)[J]. J Clin Hepatol, 2020, 36( 3): 514- 518. DOI: 10.3969/j.issn.1001-5256.2020.003.007. 《中华肝脏病杂志》编辑委员会, 中华医学会肝病学分会肝癌学组. 肝细胞癌癌前病变的诊断和治疗多学科专家共识(2020版)[J]. 临床肝胆病杂志, 2020, 36( 3): 514- 518. DOI: 10.3969/j.issn.1001-5256.2020.003.007.
[3]	Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B(version 2022)[J]. Chin J Infect Dis, 2023, 41( 1): 3- 28. DOI: 10.3760/cma.j.cn311365-20230220-00050. 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(2022年版)[J]. 中华传染病杂志, 2023, 41( 1): 3- 28. DOI: 10.3760/cma.j.cn311365-20230220-00050.
[4]	SONG B, YAN FH. Chinese imaging medicine-hepatobiliary pancreatic spleen volume[M]. 3rd ed. Beijing: People’s Medical Publishing House, 2019: 78- 80. 宋彬, 严福华. 中华影像医学·肝胆胰脾卷[M]. 3版. 北京: 人民卫生出版社, 2019: 78- 80.
[5]	FAN XL, LING Q, FANG Z, et al. Clinical value of MRI in the diagnosis of small hepatocellular carcinoma with disodium gadolinium sephate in the context of liver cirrhosis[J]. Imag Sci Photochem, 2020, 38( 6): 1038- 1042. DOI: 10.7517/issn.1674-0475.200410. 范晓黎, 凌茜, 方正, 等. MRI在肝硬化背景下诊断小肝癌中联用钆塞酸二钠的临床价值分析[J]. 影像科学与光化学, 2020, 38( 6): 1038- 1042. DOI: 10.7517/issn.1674-0475.200410.
[6]	WANG Q, SHENG ZX. Constitution theory of traditional Chinese medicine[M]. Nanjing: Phoenix Science Press, 1982: 15. 王琦, 盛增秀. 中医体质学说[M]. 南京: 江苏科学技术出版社, 1982: 15.
[7]	TENG X, JIN T, LIU Y, et al. Research progress in the relationship between genetic mechanisms of vestibular migraine and constitution of traditional Chinese medicine[J]. J Changchun Univ Chin Med, 2023, 39( 1): 108- 112. DOI: 10.13463/j.cnki.cczyy.2023.01.024. 滕鑫, 荆涛, 刘寅, 等. 前庭性偏头痛遗传学机制与中医体质关系的研究进展[J]. 长春中医药大学学报, 2023, 39( 1): 108- 112. DOI: 10.13463/j.cnki.cczyy.2023.01.024.
[8]	YAO XX, HAO YK, XIAO Z, et al. Distribution of traditional Chinese medicine syndrome types and elements in liver cirrhosis patients with dysplastic nodules: An analysis of 138 cases[J]. J Clin Hepatol, 2023, 39( 2): 352- 358. DOI: 10.3969/j.issn.1001-5256.2023.02.015. 姚肖肖, 郝尧坤, 肖准, 等. 138例肝硬化不典型增生结节患者中医证型证素分布分析[J]. 临床肝胆病杂志, 2023, 39( 2): 352- 358. DOI: 10.3969/j.issn.1001-5256.2023.02.015.
[9]	HUANG Q, LI JT, ZHANG HB, et al. Li Jingtao’s experience in diagnosis and treatment of precancerous lesions of liver cancer[J]. Chin J Integr Tradit West Med Liver Dis, 2020, 30( 3): 246- 248. DOI: 10.3969/j.issn.1005-0264.2020.03.018. 黄倩, 李京涛, 张海博, 等. 李京涛诊治肝癌癌前病变经验探析[J]. 中西医结合肝病杂志, 2020, 30( 3): 246- 248. DOI: 10.3969/j.issn.1005-0264.2020.03.018.
[10]	HUANG JJ, CHEN SL, PAN Z, et al. Treatment of precancerous lesions of liver cancer with toxic turbidity and blood stasis[J]. Chin J Integr Tradit West Med Liver Dis, 2014, 24( 1): 59- 60. DOI: 10.3969/j.issn.1005-0264.2013.06.018. 黄晶晶, 陈松林, 潘哲, 等. 毒浊瘀论治肝癌癌前病变[J]. 中西医结合肝病杂志, 2014, 24( 1): 59- 60. DOI: 10.3969/j.issn.1005-0264.2013.06.018.
[11]	GONG PQ, CHI XL, JIANG YY. Chi xiaoling’s experience on diagnosis and treatment of liver cirrhosis[J]. Chin Arch Tradit Chin Med, 2018, 36( 12): 2996- 2999. DOI: 10.13193/j.issn.1673-7717.2018.12.046. 公培强, 池晓玲, 蒋元烨. 池晓玲教授对肝硬化的证治经验[J]. 中华中医药学刊, 2018, 36( 12): 2996- 2999. DOI: 10.13193/j.issn.1673-7717.2018.12.046.
[12]	XIAO HM, LI S, XIE YB, et al. Discussion on the theory and application of soothing liver and strengthening spleen in the treatment of chronic liver disease[J]. Chin J Integr Tradit West Med Liver Dis, 2021, 31( 7): 651- 653. DOI: 10.3969/j.issn.1005-0264.2021.07.020. 萧焕明, 黎胜, 谢玉宝, 等. 疏肝健脾法治疗慢性肝病的理论与应用探讨[J]. 中西医结合肝病杂志, 2021, 31( 7): 651- 653. DOI: 10.3969/j.issn.1005-0264.2021.07.020.
[13]	ZHOU L. Physical analysis of patients with family history of hepatitis B cirrhosis[D]. Shenyang: Liaoning University of Traditional Chinese Medicine, 2013. 周浪. 具有乙肝肝硬化家族史的患者的体质分析[D]. 沈阳: 辽宁中医药大学, 2013.
[14]	NG CH, CHAN SW, LEE WK, et al. Hepatocarcinogenesis of regenerative and dysplastic nodules in Chinese patients[J]. Hong Kong Med J, 2011, 17( 1): 11- 19.
[15]	CHO HJ, KIM B, LEE JD, et al. Development of risk prediction model for hepatocellular carcinoma progression of indeterminate nodules in hepatitis B virus-related cirrhotic liver[J]. Am J Gastroenterol, 2017, 112( 3): 460- 470. DOI: 10.1038/ajg.2016.480.
[16]	PAPATHEODORIDIS G, DALEKOS G, SYPSA V, et al. PAGE-B predicts the risk of developing hepatocellular carcinoma in Caucasians with chronic hepatitis B on 5-year antiviral therapy[J]. J Hepatol, 2016, 64( 4): 800- 806. DOI: 10.1016/j.jhep.2015.11.035.
[17]	YU JH, SUH YJ, JIN YJ, et al. Prediction model for hepatocellular carcinoma risk in treatment-naive chronic hepatitis B patients receiving entecavir/tenofovir[J]. Eur J Gastroenterol Hepatol, 2019, 31( 7): 865- 872. DOI: 10.1097/MEG.0000000000001357.
[18]	WANG Y, ZHOU YT, CHEN RX, et al. The prognostic value of total bile acid for patients with hepatocellular carcinoma[J]. Chin J Clin Med, 2019, 26( 4): 594- 597. DOI: 10.12025/j.issn.1008-6358.2019.20190519. 王妍, 周颖婷, 陈荣新, 等. 血清总胆汁酸水平对肝细胞肝癌患者预后的影响[J]. 中国临床医学, 2019, 26( 4): 594- 597. DOI: 10.12025/j.issn.1008-6358.2019.20190519.
[19]	CHIANG HH, LEE CM, HU TH, et al. A combination of the on-treatment FIB-4 and alpha-foetoprotein predicts clinical outcomes in cirrhotic patients receiving entecavir[J]. Liver Int, 2018, 38( 11): 1997- 2005. DOI: 10.1111/liv.13889.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(1) / Tables(5)

Get Citation

PDF

XML

Article Metrics

Article views (268) PDF downloads(37)

TCM constitution distribution and clinical features of patients with hepatitis B cirrhosis and dysplastic nodules

DOI: 10.12449/JCH240515

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content