HBeAg阴性慢性乙肝中医证型与系统生物学相关指标研究
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摘要
HBe Ag阴性慢性乙肝其发病机制为前C区基因变异和/或基本核心启动子(BPC)导致HBe Ag表达下降,使乙肝病毒容易逃避免疫清除,而基因变异、病毒逃逸、免疫系统等无不与系统生物学相关,且生物学技术是HBe Ag阴性慢性乙肝相关诊断的重要手段,是生物系统结构的基础核心。相较HBe Ag阳性慢性乙肝来说,HBe Ag的缺失使得HBe Ag阴性慢性乙肝缺少一个有利的免疫应答观察指标,在治疗上增加了难度,且较易发展为肝硬化、肝癌。中医在治疗肝病的研究上有较多经验,辨证论治是中医治疗肝病的优势,中医证型的确定对疾病的预后及治疗十分关键,然而HBe Ag阴性慢性乙肝的中医证型缺乏明确的理化指标,因此将HBe Ag阴性慢性乙肝中医证型与系统生物学相关指标深入研究,并寻找特异性的系统生物学标志,将提高治疗HBe Ag阴性慢性乙肝的临床水平。文章将从系统生物学方面探讨与HBe Ag阴性慢性乙肝中医证型的相关性。
The pathogenesis of Hepatitis B e antigeny( HBe Ag)-negative is the decrease of HBe Ag expression caused by the gene mutation in the former C region and/or the basic core promoter( BPC),which makes chronic hepatitis B virus( HBV) easy to escape immune clearance. Compared with HBe Ag-positive chronic hepatitis B,the absence of HBe Ag makes HBe Ag-negative chronic hepatitis B lack a favorable immune response observation index,which increases the difficulty in treatment and is easy to develop into liver cirrhosis and liver cancer. Traditional Chinese medicine has more experience in the treatment of liver disease research. Syndrome differentiation and treatment is the advantage of TCM treatment of liver disease and the determination of TCM syndrome type is very critical to the prognosis and treatment of disease. However,the traditional Chinese medicine syndrome type of HBe Ag negative chronic hepatitis B lacks clear physical and chemical indicators and so the HBe Ag negative chronic hepatitis B syndrome type and system biology related indicators were made in-depth study and we found out specific system biology. This article discussed the relationship between HBe Ag negative chronic hepatitis B syndrome types from the aspect of system biology.
The pathogenesis of Hepatitis B e antigeny( HBe Ag)-negative is the decrease of HBe Ag expression caused by the gene mutation in the former C region and/or the basic core promoter( BPC),which makes chronic hepatitis B virus( HBV) easy to escape immune clearance. Compared with HBe Ag-positive chronic hepatitis B,the absence of HBe Ag makes HBe Ag-negative chronic hepatitis B lack a favorable immune response observation index,which increases the difficulty in treatment and is easy to develop into liver cirrhosis and liver cancer. Traditional Chinese medicine has more experience in the treatment of liver disease research. Syndrome differentiation and treatment is the advantage of TCM treatment of liver disease and the determination of TCM syndrome type is very critical to the prognosis and treatment of disease. However,the traditional Chinese medicine syndrome type of HBe Ag negative chronic hepatitis B lacks clear physical and chemical indicators and so the HBe Ag negative chronic hepatitis B syndrome type and system biology related indicators were made in-depth study and we found out specific system biology. This article discussed the relationship between HBe Ag negative chronic hepatitis B syndrome types from the aspect of system biology.
引文
[1]唐奇远,何清,艾书玲,等. HBeAg阳性和HBeAg阴性慢性乙型肝炎患者血清学指标及肝组织病理学比较[J].中华实验和临床感染病杂志(电子版),2013,7(1):37-40.
[2]刘顺庆,高月求. HBeAg阴性慢性乙型肝炎研究现状[J].肝脏,2012,17(6):429-432.
[3]中华中医药学会肝胆病分会.病毒性肝炎中医辨证标准(2017年版)[J].中西医结合肝病杂志,2017,27(3):193-194.
[4]吴银亚,谭善忠,沈建军,等.慢性乙型肝炎病毒感染携带者中医证型分布特点[J].中国中医药信杂志,2012,19(5):17-19.
[5]王凤云,刘燕玲,张引强.慢性乙型肝炎患者中医证型特点及分布差异[J].世界华人消化杂志,2008,7(16):716-720.
[6]杨振,施卫兵,余金花,等. HBeAg阴性慢性乙型肝炎不同ALT水平中医证型分布特点及与病毒载量关系的研究[J].中医药临床杂志,2015,27(4):484-486.
[7]陈培琼,张金珍,田广俊,等. HBeAg阴性慢性乙型肝炎中医证型分布及与HBVDNA、肝纤四项关系的研究[J].中国中医药信息杂志,2009,16(11):15-18.
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[9]陈剑. HBeAg阴性慢性乙型肝炎中医证型与HbsAg定量相关性研究[C].福州:福建中医药大学,2014.
[10]李白雪,张技,吴疆,等. MicroRNA在慢性乙型肝炎中医证候研究中的应用前景[J].中华中医药杂志,2014,29(11):3499-3501.
[11]张磊,王健,潘玲,等. microRNA与慢性乙肝中医证候的研究[J].时珍国医国药,2014,25(10):2483-2485.
[12]刘业方,张传涛,黄群,等.基于microRNA调控的HBeAg(-)轻度慢性乙型肝炎脾胃湿热证发生的分子机制研究[J].辽宁中医杂志,2016,43(9):1803-1806.
[13]管艳,苏式兵,毛海琴.基于差异基因表达谱的慢性乙型肝炎病证结合研究[J].广州中医药大学学报,2014,31(5):693-698.
[14]刘友平,刘鹏,汪静,等.慢性乙肝脾肾阳虚证血浆蛋白质组学分析[J].泸州医学院学报,2011,34(5):573-577.
[15]刘友平,郭芳宏,王磊琼,等.慢性乙肝肝郁脾虚证血浆蛋白质组学分析[J].时珍国医国药,2011,22(9):2135-2136.
[16]刘友平,王磊琼,郭芳宏,等.慢性乙型肝炎肝肾阴虚证血浆蛋白质组学[J].世界华人消化杂志,2011,19(7):718-722.
[17]李白雪,张传涛,张莉敏,等.慢性乙型病毒性肝炎中医虚实辨证的分子生物学研究概述[J].环球中医药,2013,6(11):871-874.
[18]罗俊华,曹秋实. HBeAg阴性慢性乙型肝炎中医证型与T淋巴细胞亚群及IL-4、IFN-γ相关性研究[J].云南中医学院学报,2014,37(4):1-3,8.
[19]袁满春,赵锋,刘志伟,等.中医辨证分型与慢性乙型肝炎患者T淋巴细胞亚群及VCS参数的关系[J].中国现代医生,2014,52(30):58-60,63.
[20]孙明珠,党双锁.细胞因子与慢性肝脏疾病的研究进展[J].世界华人消化杂志,2009(21):2121-2126.
[21]刘宁,徐杰,刘金花,等.慢性乙型肝炎、乙肝肝硬化、乙肝肝癌患者Th1/Th2型细胞因子水平变化研究[J].胃肠病学和肝病学杂志,2014,23(2):158-161.
[22]叶立红,王翀奎,刘莲,等. HBeAg阳性和阴性慢性乙型肝炎患者病理与细胞因子对比研究[J].现代中西医结合杂志,2010,19(36):4660-4662.
[23]廖宝林,林思炜,陈伟烈,等. HBV前CC基因启动子区变异与HBeAg阴性CHB患者肝组织病理变化的关系[J].实用医学杂志,2016,32(14):2347-2350.
[24]刘丽丽,张国梁,刘永华,等.慢性乙型肝炎患者中医证型与ALT、HBV DNA及肝组织病理的关系[J].世界中医药,2017,12(3):562-565,569.
[25]李卿. HBeAg阴性慢性乙型肝炎中医证型与肝组织病理改变相关性研究[C].长沙:湖南中医药大学,2008.
[26]李惠敏,刘云华,刘立,等. 278例慢性乙肝病毒携带者中医证型与肝脏组织病理学的关系[J].云南中医学院学报,2016,39(1):77-80,98.
[27]张国良,吴其恺,林巧,等. 260例慢性乙型肝炎中医证型与肝组织病理改变的相关性研究[J].中国中西医结合杂志,2007,27(7):613-615.
[28]张爱民,陈铿,谭行华,等.中医证候预测慢性乙型肝炎干扰素疗效的临床研究[J].中国当代医药,2013,20(7):92-94.
[29]肖倩,梁重峰,谭善忠,等.聚乙二醇干扰素治疗不同中医证型的HBeAg阴性慢性乙型肝炎的疗效分析[J].中医药导报,2015,21(3):11-13.
[30]陈学福,马晓军,罗晓丹,等.聚乙二醇干扰素α-2a治疗不同中医证型慢性乙型肝炎的疗效分析[J].北方药学,2017,14(7):4-5.
[2]刘顺庆,高月求. HBeAg阴性慢性乙型肝炎研究现状[J].肝脏,2012,17(6):429-432.
[3]中华中医药学会肝胆病分会.病毒性肝炎中医辨证标准(2017年版)[J].中西医结合肝病杂志,2017,27(3):193-194.
[4]吴银亚,谭善忠,沈建军,等.慢性乙型肝炎病毒感染携带者中医证型分布特点[J].中国中医药信杂志,2012,19(5):17-19.
[5]王凤云,刘燕玲,张引强.慢性乙型肝炎患者中医证型特点及分布差异[J].世界华人消化杂志,2008,7(16):716-720.
[6]杨振,施卫兵,余金花,等. HBeAg阴性慢性乙型肝炎不同ALT水平中医证型分布特点及与病毒载量关系的研究[J].中医药临床杂志,2015,27(4):484-486.
[7]陈培琼,张金珍,田广俊,等. HBeAg阴性慢性乙型肝炎中医证型分布及与HBVDNA、肝纤四项关系的研究[J].中国中医药信息杂志,2009,16(11):15-18.
[8]Chan HL,Wong VW,Tse AM,et al. Serum hepatitis B surface antigen quantitation can reflect hepatitis B virus in the liver and predict treatment response[J]. Clin Gastroenterol Hepatol,2007,5(12):1462-1468.
[9]陈剑. HBeAg阴性慢性乙型肝炎中医证型与HbsAg定量相关性研究[C].福州:福建中医药大学,2014.
[10]李白雪,张技,吴疆,等. MicroRNA在慢性乙型肝炎中医证候研究中的应用前景[J].中华中医药杂志,2014,29(11):3499-3501.
[11]张磊,王健,潘玲,等. microRNA与慢性乙肝中医证候的研究[J].时珍国医国药,2014,25(10):2483-2485.
[12]刘业方,张传涛,黄群,等.基于microRNA调控的HBeAg(-)轻度慢性乙型肝炎脾胃湿热证发生的分子机制研究[J].辽宁中医杂志,2016,43(9):1803-1806.
[13]管艳,苏式兵,毛海琴.基于差异基因表达谱的慢性乙型肝炎病证结合研究[J].广州中医药大学学报,2014,31(5):693-698.
[14]刘友平,刘鹏,汪静,等.慢性乙肝脾肾阳虚证血浆蛋白质组学分析[J].泸州医学院学报,2011,34(5):573-577.
[15]刘友平,郭芳宏,王磊琼,等.慢性乙肝肝郁脾虚证血浆蛋白质组学分析[J].时珍国医国药,2011,22(9):2135-2136.
[16]刘友平,王磊琼,郭芳宏,等.慢性乙型肝炎肝肾阴虚证血浆蛋白质组学[J].世界华人消化杂志,2011,19(7):718-722.
[17]李白雪,张传涛,张莉敏,等.慢性乙型病毒性肝炎中医虚实辨证的分子生物学研究概述[J].环球中医药,2013,6(11):871-874.
[18]罗俊华,曹秋实. HBeAg阴性慢性乙型肝炎中医证型与T淋巴细胞亚群及IL-4、IFN-γ相关性研究[J].云南中医学院学报,2014,37(4):1-3,8.
[19]袁满春,赵锋,刘志伟,等.中医辨证分型与慢性乙型肝炎患者T淋巴细胞亚群及VCS参数的关系[J].中国现代医生,2014,52(30):58-60,63.
[20]孙明珠,党双锁.细胞因子与慢性肝脏疾病的研究进展[J].世界华人消化杂志,2009(21):2121-2126.
[21]刘宁,徐杰,刘金花,等.慢性乙型肝炎、乙肝肝硬化、乙肝肝癌患者Th1/Th2型细胞因子水平变化研究[J].胃肠病学和肝病学杂志,2014,23(2):158-161.
[22]叶立红,王翀奎,刘莲,等. HBeAg阳性和阴性慢性乙型肝炎患者病理与细胞因子对比研究[J].现代中西医结合杂志,2010,19(36):4660-4662.
[23]廖宝林,林思炜,陈伟烈,等. HBV前CC基因启动子区变异与HBeAg阴性CHB患者肝组织病理变化的关系[J].实用医学杂志,2016,32(14):2347-2350.
[24]刘丽丽,张国梁,刘永华,等.慢性乙型肝炎患者中医证型与ALT、HBV DNA及肝组织病理的关系[J].世界中医药,2017,12(3):562-565,569.
[25]李卿. HBeAg阴性慢性乙型肝炎中医证型与肝组织病理改变相关性研究[C].长沙:湖南中医药大学,2008.
[26]李惠敏,刘云华,刘立,等. 278例慢性乙肝病毒携带者中医证型与肝脏组织病理学的关系[J].云南中医学院学报,2016,39(1):77-80,98.
[27]张国良,吴其恺,林巧,等. 260例慢性乙型肝炎中医证型与肝组织病理改变的相关性研究[J].中国中西医结合杂志,2007,27(7):613-615.
[28]张爱民,陈铿,谭行华,等.中医证候预测慢性乙型肝炎干扰素疗效的临床研究[J].中国当代医药,2013,20(7):92-94.
[29]肖倩,梁重峰,谭善忠,等.聚乙二醇干扰素治疗不同中医证型的HBeAg阴性慢性乙型肝炎的疗效分析[J].中医药导报,2015,21(3):11-13.
[30]陈学福,马晓军,罗晓丹,等.聚乙二醇干扰素α-2a治疗不同中医证型慢性乙型肝炎的疗效分析[J].北方药学,2017,14(7):4-5.