Khảo sát đặc điểm thiệt chẩn trên người bệnh viêm gan siêu vi B mạn tính theo chỉ số ALT và tải lượng HBV DNA

Chronic Hepatitis B poses a significant global health burden, leading to severe liver complications like cirrhosis and hepatocellular carcinoma. In Vietnam, it represents a critical public health challenge, affecting millions and causing substantial mortality annually. Traditional Chinese Medicine (TCM) offers unique diagnostic approaches, notably tongue diagnosis (thiệt chẩn), which provides valuable insights into systemic health, organ function, and physiological balance. While the importance of tongue diagnosis is widely recognized in various medical conditions, there is a notable scarcity of localized research in Vietnam investigating the specific characteristics of tongue diagnosis in chronic Hepatitis B patients, particularly in relation to conventional biochemical markers such as ALT levels and HBV DNA load. This study aims to address this gap by surveying these tongue characteristics to provide crucial reference data for standardizing TCM diagnoses in this patient group.

Medical researchers, clinicians specializing in gastroenterology and Traditional Chinese Medicine, public health professionals, and students interested in chronic Hepatitis B diagnosis and integrated medical approaches.

This study aimed to investigate the relationship between tongue diagnosis characteristics and clinical markers, specifically ALT levels and HBV DNA load, in patients with chronic Hepatitis B. The objective was to provide essential reference data that could aid in standardizing Traditional Chinese Medicine (TCM) diagnostic practices for this patient population. A cross-sectional descriptive study was conducted from March to June 2024, involving 395 chronic Hepatitis B patients at Le Van Thinh Hospital. Data collected included ALT and HBV DNA levels, alongside tongue images analyzed using the ZMT-1A Tongue Analysis System.

Key findings revealed significant correlations. For male patients, a statistically significant association was observed between dental impressions on the tongue and changes in ALT levels (p < 0.05), with the highest percentage (47.5%) of patients having no dental impressions and ALT levels below 30 IU/L. Among female patients, a similar correlation existed between dental impressions, central tongue cracks, and ALT levels (p < 0.05), where 47.69% and 38.97% exhibited no dental impressions or central cracks, respectively, with ALT levels ranging from 19 to less than 38 IU/L. Across all 395 patients, irrespective of gender, a significant correlation was found between tongue characteristics such as thickness, slenderness, and the presence of tongue papillae (p < 0.05) and HBV DNA levels. Specifically, 44.81% of patients showed no tongue papillae, and 41.77% had a normal-sized tongue, both associated with HBV DNA levels below 7 IU/ml. The study concluded that the absence of dental impressions is a common finding in chronic Hepatitis B patients with mildly elevated ALT levels in both genders. Furthermore, variations in tongue papillae and the tongue's thickness/slenderness are directly correlated with HBV DNA quantification. These insights highlight the potential for integrating objective tongue assessments into the comprehensive management and diagnosis of chronic Hepatitis B, offering a bridge between traditional and modern diagnostic approaches and contributing to more holistic patient care.