Chinese medicine syndrome distribution of chronic hepatitis b virus carriers in immunotolerant phase

Xie, Hui; Yang, Hongzhi; Wu, Weikang; Guan, Weibing; Ke, Qian-shan; Li, Yongwei; Dai, Min; Xiao, Gemin; Zhang, Jiong-Shan; Li, Yangmei

doi:10.1007/s11655-013-1569-5

Cited by 6 publications

(8 citation statements)

References 16 publications

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“…All TCMS pattern differentiation was checked firstly by an attending doctor and then verified by a chief physician. Some patients had two or more TCMS patterns, both in this study and our previously published study [ 9 ]. In this study, we did not design treating interventions and only considered the relationship between TCM syndromes and HBsAg.…”

Section: Methodssupporting

confidence: 66%

“…Syndrome differentiation is the well-recognized essence of TCM, and as such identification of syndrome patterns is key to preventing and treating a disease by this approach [ 9 , 10 ]. The traditional Chinese medicine syndrome (TCMS) pattern distribution of the active state of CHB has been developed.…”

Section: Introductionmentioning

confidence: 99%

“…The traditional Chinese medicine syndrome (TCMS) pattern distribution of the active state of CHB has been developed. Although, the TCMS pattern of chronic HBV carriers was elucidated in ITP [ 9 , 11 – 13 ], until now no comprehensive study has systematically investigated these consecutive phases and the TCMS patterns during the complete natural history of CHB remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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

Xie

Liu

Zhang

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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The aim of this study is to investigate traditional Chinese medicine syndrome (TCMS) patterns and their association with hepatitis B surface antigen (HBsAg) levels during the natural history of chronic hepatitis B virus infection (CHB). Patients were categorized according to the phase of CHB, as follows: immune tolerance (ITP); immune clearance (ICP); low or nonreplication (LRP); reactivation (RAP); hepatic cirrhosis (HC); and primary liver cancer (PLC). TCMS patterns were classified among the following types: spleen-kidney deficiency (SKD); liver-qi depression (LQD); damp-heat in liver-gallbladder (LGDH); liver-kidney deficiency (LKD); and blood stasis blocking collateral (BSBC). HBsAg levels and other serological indicators were quantified for all patients and their association with TCMS was statistically analyzed and determined. Two hundred and eighty-nine patients with CHB were included. During the natural history of CHB, TCMS patterns were statistically different among the different phases (P < 0.001). The most frequently occurring syndromes among the six progressive phases were SKD, LGDH, LKD, LGDH, BSBC, and LGDH, respectively. The predominant patterns in the inactive stage (ITP + LRP), active stage (ICP + RAP), and late or advanced stage (HC + PLC) were SKD (31%), LGDH (51.8%) and BSBC (34.4%), respectively. Median HBsAg levels were also statistically different among the five patterns of TCMS (P < 0.001). The highest HBsAg levels were observed in SKD (4.48 log10 IU/mL). Medium levels were in LQD (3.91 log10 IU/mL) and LGDH (3.90 log10 IU/mL). The lowest HBsAg levels were in LKD (3.60 log10 IU/mL) and the second lowest levels in BSBC (3.81 log10 IU/mL). In addition, HBsAg levels in LKD and BSBC were significantly lower than those in SKD, LQD, and LGDH (P < 0.05 or 0.001). TCMS was altered during the natural history of CHB and correlated with HBsAg titers. This study could provide further insight into the therapy of CHB.

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Section: Methodssupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Xie

Liu

Zhang

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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“…It suggests that the etiology and pathogenesis of CHB are very complex. The pathogenic factors were mainly dampness, Qi stagnation, heat, and blood stasis, same as the results from the study by Xie et al [ 14 ]. However, with multivariate logistic regression analysis, only the TCM syndrome element of blood stasis was identified to be associated with advanced fibrosis in our study.…”

Section: Resultssupporting

confidence: 85%

The Score Model Containing Chinese Medicine Syndrome Element of Blood Stasis Presented a Better Performance Compared to APRI and FIB‐4 in Diagnosing Advanced Fibrosis in Patients with Chronic Hepatitis B

Chi¹,

Shi²,

Xiao³

et al. 2016

Evidence-Based Complementary and Alternative Medicine

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This study aims to explore a useful noninvasive assessment containing TCM syndrome elements for liver fibrosis in CHB patients. The demographic, clinical, and pathological data were retrospectively collected from 709 CHB patients who had ALT less than 2 times the upper limit of normal from April 2009 to October 2012. Logistical regression and area under receiver-operator curve (AUROC) were used to determine the diagnostic performances of simple tests for advanced fibrosis (Scheuer stage, F ≥ 3). Results showed that the most common TCM syndrome element observed in this CHB population was dampness and Qi stagnation, followed by blood stasis, by heat, and less by Qi deficiency and Yin deficiency. The logistical regression analysis identified AST ≥ 35 IU/L, PLT ≤ 161 × 109/L, and TCM syndrome element of blood stasis as the independent risk factors for advanced fibrosis. Therefore, a score model containing these three factors was established and tested. The score model containing blood stasis resulted in a higher AUC (AUC = 0.936) compared with APRI (AUC = 0.731) and FIB-4 (AUC = 0.709). The study suggested that the score model containing TCM syndrome element of blood stasis could be used as a useful diagnostic tool for advanced fibrosis in CHB patients and presented a better performance compared to APRI and FIB-4.

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“…It describes special phenotype with comprehensive symptoms and signs of patients at a particular stage of disease [10]. e identification of TCM syndrome is the key to guide the specific TCM prescription [11,12].…”

Section: Introductionmentioning

confidence: 99%

Biological Differentiation of Dampness‐Heat Syndromes in Chronic Hepatitis B: From Comparative MicroRNA Microarray Profiling to Biomarker Identification

Jiang

Wan

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Increasing interest is aroused by traditional Chinese medicine (TCM) treatment of chronic hepatitis B (CHB) based on specific TCM syndrome. As the most common CHB syndromes, spleen-stomach dampness-heat (SSDH) syndrome and liver-gallbladder dampness-heat (LGDH) syndrome are still apt to be confused in TCM diagnosis, greatly hindering the stable exertion of TCM effectiveness. It is urgently needed to provide objective and biological evidences for differentiation and identification of the two significant syndromes. In this study, microRNA (miRNA) microarray analyses coupled with bioinformatics were employed for comparative miRNA profiling of SSDH and LGDH patients. It was found that the two syndromes had both the same and different significantly differentially expressed miRNAs (SDE-miRNAs). Commonness and specificity were also both found between their SDE-miRNA-based bioinformatics analyses, including Hierarchical Clustering, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, and miRNA-GO/pathway networks. Furthermore, syndrome-specific SDE-miRNAs were identified as the potential biomarkers, including hsa-miR-1273g-3p and hsa-miR-4419b for SSDH as well as hsa-miR-129-1-3p and hsa-miR-129-2-3p for LGDH. All these laid biological and clinical bases for classification and diagnosis of the two significant CHB dampness-heat syndromes including SSDH and LGDH, providing more opportunities for better application of TCM efficacy and superiority in CHB treatment.

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Chinese medicine syndrome distribution of chronic hepatitis b virus carriers in immunotolerant phase

Abstract: Most of chronic HBV carriers in ITP have their CM syndrome, and the most common types are SKAD, LQD. This study suggests that the natural history may be improved through breaking the state of immune tolerance or shorten the time of ITP by strengthening Spleen-Kidney and reliving Liver qi.

Cited by 6 publications

References 16 publications

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

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

The Score Model Containing Chinese Medicine Syndrome Element of Blood Stasis Presented a Better Performance Compared to APRI and FIB‐4 in Diagnosing Advanced Fibrosis in Patients with Chronic Hepatitis B

Biological Differentiation of Dampness‐Heat Syndromes in Chronic Hepatitis B: From Comparative MicroRNA Microarray Profiling to Biomarker Identification

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