Objective: To explore Chinese medicine (CM) syndrome distribution of chronic hepatitis B virus (HBV) carriers in immunotolerant phase (ITP). Methods: One hundred and eighty-five chronic HBV carriers in ITP, seen in the Third Affiliated Hospital of Sun Yat-sen University from May 2009 to December 2010, were admitted in an observational study under the guidance of CM. Patients' CM symptoms and signs, demographics, liver biochemistries, and qualitative HBV DNA were recorded in the questionnaires. CM syndromes were then differentiated to 15 detailed types and analyzed by generalization. Lastly, the location, pathogenic factors and nature of the disease were also assessed. Results: When CM syndrome patterns were differentiated to 15 types, there were 27 (15%) no syndrome cases, 94 (50%) single syndrome cases and 64 (35%) compound syndromes cases. The main detailed syndromes included Liver (Gan)-qi depression (LQD), Kidney (Shen)-qi deficiency (KQD), Spleen (Pi)-qi deficiency (SQD) and Kidney-yang deficiency (KYAD). After CM syndromes generalized to five types, their frequency was Spleen-Kidney deficiency (SKD)>LQD>inner dampness-heat retention (IDHR)>Liver-Kidney deficiency (LKD)>blood stasis blocking collateral (BSBC). SKD and LQD occupied 64%. The disease location included Liver, Gallbladder (Dan), Spleen, Stomach (Wei) and Kidney. The pathogenic factors were mainly qi stagnation, qi deficiency, yang deficiency, concurrently dampness-heat and blood stasis. The deficiency syndrome was more than excess syndrome in its nature. Conclusions: 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.

目的:研究天晴甘美注射液对慢性乙型肝炎(慢乙肝)患者外周血单个核细胞(PBMC)细胞周期的影响.方法:采用凯基细胞周期检测法检测天晴甘美对细胞周期的影响.结果:天晴甘美注射液呈剂量依赖性抑制外周血单个核细胞z增殖,使细胞阻滞于G0/G1期,细胞DNA合成减少,但细胞无凋亡.结论:天晴甘美注射液对PBMC具有一定抑制作用,可能使细胞阻滞于G0/G1期,导致细胞DNA合成减少.

Objective To study influence of magnesium isoglycyrrhizinate(MIG) on Toll-like receptor 3pathway in PBMC cells in chronic hepatitis B patients.Methods Inhibitory effect of MIG injection on PBMC proliferation were examined by MTT.Semi-quantitative RT-PCR examined expression of TLR3,TRIF,TNFα and IFNβ1 in PBMC cells post-treated with Poly I: C and MIG.Results MIG injection inhibited proliferation of PBMC cells significantly in dose-dependent manner,except for the comparison between 12.5 and 6.25 μg / ml group.The inhibition rates were 58%,52%,40%,30%,23%,17%,8%,and 6%,repectively in the eight groups,800,400,200,100,50,25,12.5 and 6.25 μg / ml.Expression of interferon(IFN) β1 was significantly higher in 200 μg / ml of MIG group compared with blank control group(14.6 ± 2.43 and 9.79 ± 3.02,respectively),while expression of TNFα was significantly downregulated in 200 μg / ml and 100 μg / ml group compared with blank control group(10.59± 1.67,13.3 ± 2.07 and 15.7 ± 1.59,respectively).Conclusion MIG might play a role in immunoregulation by promoting IFNβ1 and inhibiting TNFα in PBMC cells.

OBJECTIVE To explore the relationship between the syndrome types in traditional Chinese medicine (TCM) and serum HBV DNA load in chronic HBV carriers positive for HBeAg. METHODS According to the TCM syndrome types, 185 chronic HBV carriers with HBeAg positivity were classified into single syndrome group (liver Qi depression, kidney Qi deficiency, spleen Qi deficiency, and kidney Yang deficiency), compound syndrome group, and unidentifiable syndrome group; based on the nature of the condition in TCM terms, the patients were classified into excess syndrome group, deficiency syndrome group and comorbidity syndrome group. The serum HBV DNA levels in these cases were analyzed in relation to the TCM syndrome types and disease nature. RESULTS HBV DNA levels showed no significant difference among the patients with single syndrome, compound syndromes and unidentifiable syndrome (F=0.910, P=0.404), nor among the patients with the 5 different single TCM syndromes (χ²=4.672, P=0.323) or those with different disease nature (F=0.631, P=0.596). CONCLUSION Serum HBV DNA level can not be considered as the evidence for syndrome differentiation in chronic HBV carriers with positive HBeAg.

目的:通过分析慢性乙型重型肝炎(以下简称乙型慢重肝)病程第一周、第三周、第五周、第八周的中医证候分布情况,归纳出乙型慢重肝基本证型和核心证型,并探索其中医证候随病程进展的演变规律,为临床规范治疗提供依据。方法:采用前瞻性、纵向动态性观察方法,运用描述性统计分析,统计乙型慢重肝病程第一、三、五、八周的证候出现频数和频率。结果:乙型慢重肝病程第一、三、五、八周的出现频率大于50%的证候分别是:第一周和第三周:湿热内蕴证、肝胆热毒炽盛证、肝脾血瘀证;第五周在第三周的基础上增加了肝脾气虚证、气滞水停证、肝血虚证;第八周在第五周的基础上增加肾气虚证、痰湿内阻证,减少了气滞水停证。其中,肝胆热毒炽盛证、肝脾血瘀证、湿热内蕴证、肝肾阴虚证出现频率大于90%,可作为核心证候。病程一到八周证候演变规律:肝胆热毒夹湿兼瘀证→瘀毒互结证→瘀热毒水湿互结兼肝脾肾气阴两虚证→正虚痰瘀互结证。结论:乙型慢重肝病情危重,证候繁杂多变,虚实交错,不同起病阶段,证候分布情况不同,故治疗上,可按照疾病所处阶段,分别选用清、下、消、补等不同治法。

OBJECTIVE:To investigate the effects of glycyrrhizin (GL) on the expression of hepatitis B virus e antigen (HBeAg), HBV DNA, Toll-like receptors 2,4 (TLR2,4) and proliferation of cells in HepG2.2.15 cell line. METHODS:Real-time PCR examined HBV DNA, ELISA examined HBsAg, HBeAg and MTT examined the proliferation of cells. FCM examined the positive percent of cells expressing TLR2,4 before and after stimulated with GL, in contrast to the blank group. RESULTS:The expression of HBsAg was low in the cell line, so e antigen was studied. The total HBeAg mean was significantly difference on the second day after stimulated (P<0.01), but only in the group with 400 microg/ml HBeAg decreased significantly in contrast to the blank group (P<0.05), the group with 800 microg/ml increased significantly in contrast to the other groups (P<0.01). The total HBV DNA mean on the third day after stimulated was significant, only the group with 50 microg/ml decreased in contrast to the blank group, but P>0.05, the other four groups increased. The intensity of TLR4 expression in the cells was significantly higher than that of the control group (P<0.05), both of total mean TLR2,4 increased significantly (P<0.01). The four groups except the group with 200 microg/ml increased significantly in no dose-dependent manner (P<0.05). GL in three goups under 200 microg/ml all could make cells proliferate, but only 200 microg/ml group had significant difference compared to the blank group (P<0.05). Both 400 and 800 microg/ml groups inhibited the growth of cells (P<0.01). The proliferation of cells were notably negative correlated with the expression of HBeAg, HBV DNA (P<0.05). CONCLUSION:The study suggestes GL could inhibit or promote HBV DNA replicating and e antigen secreting in mutative HepG2.2.15 cell line, the correlation between the proliferation of cells and the both are negative. GL could upregulate TLR2,4 in no dose-dependent manner. Influencing HBV maybe have no correlation to up regulating TLR2,4 by GL at least in vitro.

AIM:To observe the therapeutic effects of new traditional Chinese medicine (TCM) therapy on coagulation disorder and accompanying intractable jaundice in HBV-related liver cirrhosis patients.METHODS:Using stratified random sampling according to fibrinogen (Fib) levels, 145 liver cirrhosis patients due to hepatitis B complicated by coagulation disorder were treated. Of them, 70 in research group were treated with TCM by "nourishing yin, cooling blood and invigorating blood circulation" and Western medicine, 75 in control group were treated with conventional Western medicine. The indexes of liver function, coagulation function and bleeding events were observed and compared.RESULTS:The prothrombin time (PT) was shorter and the fibrinogen (Fib) level was higher in the research group than in the control group (Fib = 1.6-2.0 g/L, 1.1-1.5 g/L, and < or = 1.0 g/L). The total bilirubin (TBIL) level was significantly lower in the research group than in the control group, except for the subgroup of FIB < or = 1.0 g/L.CONCLUSION:TCM therapy can improve coagulation fuction and decrease TBIL.

目的:观察和探讨通幽汤治疗习惯性便秘的疗效和理论.方法:60例习惯性便秘患者分为二组.治疗组采用通幽汤加味治疗;对照组采用<尊生>润肠丸治疗,观察津血不足型便秘证的疗效.结果:治疗一月治疗组显效率为70%,较对照组40%有非常显著性差异.结论:通幽汤加味治疗习惯性便秘比<尊生>润肠丸疗效为优.

Objective: To evaluate the therapeutic effects for radioactive lung-injured patients by qingzhaojiufei decoction. Methods: Therapy of qingzhaojiufei decoction as test group, and that of hormones and antibiotics as control group. Results and conclusion: The total effective rate had significantly difference between two groups ( P0.01) . Treating radioactive lung-injured patients by qingzhaojiufei decoction was better curative effect than that by hormones and antibiotics.

龙胆泻肝汤出自《医方集解》，由龙胆草、栀子、黄芩、木通、泽泻、生地黄、当归、柴胡、甘草、车前子组成。主治肝胆实火、肝胆湿热证。近代多用治疗急性中耳炎、急性黄疸性肝炎、胆囊炎、带状疱疹等。笔者用治顽固性头痛、乳腺导管内皮样瘤、甲亢等病亦获得满意疗效，现介绍如下。

“肾为欠为嚏”语出《素问*宣明五气》。原文曰：“五气所病：心为噫……肾为欠为嚏……”其意为：五脏之气失调所发生的病变：…肾气虚者易呵欠、喷嚏。《灵枢》对此注解为：“阳者主上，阴者主下，阳引而上，阴引而下。阴阳相引，故数欠…盖少阴之气在下，病则反逆于上，而欲引于下则欠，反逆于上则嚏。盖少阴之络上通于胃也。”它精辟地指出了呵欠、喷嚏是肾气虚的病证之一。