Objective] To explore the correlation between the TCM syndromes distribution of mild chronic hepatitis B(CHB) and liver tissue pathology . [Methods] 494 CHB patients(among whom 407 patients are mild CHB) are chosen as objects in the retrospective survey ,mainly studying their liver pathology grading,staging and TCM syndrome.In accordance with TCM syndrome,patients are divided into five groups,including syndrome of liver-qi stagnation and spleen-qi deficiency,syndrome of damp-heat stagnation,syndrome of static blood blocking collaterals,syndrome of yin deficiency of liver and kidney and syndrome of yang deficiency of spleen and kidney.It also analyzes the features of TCM syndrome distribution in mild CHB patients and skin and histopathology with the statistical method of testing.[Results] It turns out that among the 494 CHB patients,the TCM syndrome distribution is syndrome of liver-qi stagnation and spleen-qi deficiency﹥syndrome of damp-heat stagnation﹥syndrome of static blood blocking collaterals﹥syndrome of yin deficiency of liver and kidney﹥syndrome of yang deficiency of spleen and kidney,and the distribution of the 407 cases with mild chronic hepatitis B inflammation and fibrosis from light to heavy is as follows:syndrome of liver-qi stagnation and spleen-qi deficiency,syndrome of damp-heat stagnation,syndrome of static blood blocking collaterals,syndrome of yin deficiency of liver and kidney,syndrome of yang deficiency of spleen and kidney.There are significant statistical differences between the inflammation and fibrosis of the five syndromes;According to inflammation: syndromes of liver-qi stagnation and spleen-qi deficiency are significantly different compared with syndromes of static blood blocking collaterals ,syndrome of yin deficiency of liver and kidney and syndrome of yang deficiency of spleen and kidney respectively(χ2=11.310,P<0.005;χ2=16.565,P<0.001;χ2=16.013,P<0.001); According to inflammation and fibrosis: syndrome of liver-qi stagnation and spleen-qi deficiency are significantly different compared with syndrome of static blood blocking collaterals,syndrome of yin deficiency of liver and kidney and syndrome of yang deficiency of spleen and kidney respectively(χ2=18.798,P<0.001;χ2=18.313,P<0.001;χ2=23.076,P<0.001); syndrome of damp-heat stagnation also has remarkable statistical differences from syndrome of static blood blocking collaterals,syndrome of yin deficiency of liver and kidney and syndrome of yang deficiency of spleen and kidney(χ2=18.798,P<0.001;χ2=18.313,P<0.001;χ2=23.076,P<0.001);However,there is no statistical difference between syndrome of liver-qi stagnation and spleen-qi deficiency and syndrome of damp-heat stagnation.The TCM syndrome in patients with mild chronic hepatitis B is highly correlated with the degree of liver histopathological inflammation and fibrosis ,mainly syndrome of liver-qi stagnation and spleen-qi deficiency and syndrome of damp-heat stagnation,which belongs to the early pathological changes,but there is still a quarter of patients who need to receive antiretroviral therapy.Syndrome of static blood blocking collaterals,syndrome of yin deficiency of liver and kidney and syndrome of yang deficiency of spleen and kidney belong to the late or advanced stage pathological changes.These patients also need antiviral treatment. [Conclusion] The TCM syndrome in patients with mild chronic hepatitis B provides scientific basis for the anti-hepatitis B therapy.The patients who can’t accept the liver biopsy could choose a reasonable antiviral treatment according to the TCM syndrome.%[目的]探索轻型慢性乙型肝炎(Chronic hepatitis B,CHB)患者中医证型的分布规律及其与肝组织病理改变的相关性。[方法]回顾性调查494例CHB患者（其中轻型CHB407例）的肝组织病理分级、分期及中医证型。依照中医证型将患者分为肝郁脾虚证、湿热中阻证、瘀血阻络证、肝肾阴虚证、脾肾阳虚证5组，分析轻型CHB患者中医证型分布规律、活体肝组织病理学特点及两者之间的相关性。[结果]494例慢乙肝中医证型分布为：肝郁脾虚证＞湿热中阻证＞瘀血阻络证＞肝肾阴虚证＞脾肾阳虚证，其中以肝郁脾虚证、湿热中阻证为主；407例轻型CHB患者炎症及纤维化程度由轻及重依次为：肝郁脾虚证、湿热中阻证、瘀血阻络证、肝肾阴虚证、脾肾阳虚证；5种证型炎症程度两两比较，肝郁脾虚证分别与瘀血阻络证、肝肾阴虚证、脾肾阳虚证3组对比有显著统计学意义（χ2=11．310、P<0．005；χ2=16．565、P<0．001；χ2=16．013、P<0．001）；5种证型纤维化程度两两比较，肝郁脾虚证分别与瘀血阻络证、肝肾阴虚证、脾肾阳虚证3组对比有显著统计学意义（χ2=18．798、P<0．001；χ2=18．313、P<0．001；χ2=23．076、P<0．001）；湿热中阻证分别与瘀血阻络证、肝肾阴虚证、脾肾阳虚证3组对比有显著统计学意义（χ2=15．480、P<0．001；χ2=15．232、P<0．001；χ2=19．684、P<0．001）；轻型CHB患者中医证型与肝组织病理学炎症程度及纤维化密切相关，以肝郁脾虚证与湿热中阻证为主，属病理学改变早期，但仍有约1/4患者需接受抗病毒治疗；瘀血阻络证、肝肾阴虚证、脾肾阳虚证患者属于肝组织病变中晚期，需积极抗病毒治疗。[结论]轻型CHB患者中医辨证分型可为临床抗病毒治疗提供依据，不能行肝穿刺活检的患者可以根据中医辨证分型及临床相关检测手段综合分析，合理选择抗病毒治疗。
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