Relationship Between Nonalcoholic Fatty Liver Disease TCM Syndrome And Objective Indicators

Background:Now, with the change of life style and eating habits, The incidence of NAFLD is rising,NAFLD has become a common cause of abnormal transaminase in developed regions; NAFLD is a clinical syndrome which the main characteristics is hepatocyte steatosis.It’s pathogenesis is not fully clearly.At present,the mechanism generally accepted is "two-hit";The main treatments are lipid-lowering, reduce IR, protecting liver and other symptomatic treatment。 The traditional Chinese medicine holds that the main pathogenesis is the dysfunction of liver and spleen and kidney, and wet phlegm and blood stasis stay in the liver。 Currently, a lots Of clinical studies have confirmed that Traditional Chinese medicine has obvious advantages in the treatment of NAFLD.Objectives:At present about the syndrome differentiation type of NAFLD had a disadvantage of lack of objectivity and repeatability. Based on146cases of patients with nonalcoholic fatty liver disease four diagnostic data collection, the purpose is to preliminary discussion the correlations between TCM syndrome type and objective indexes. Analysing the clinical distribution characteristics of objective indicators, Provided objective reference for the TCM differentiation types.Methods:Based on146cases of patients with nonalcoholic fatty liver disease questionnaire investigation, collectting the related data of the patients, The main objective indicators collected include:age, sex, profession, duration, height, weight, ALT, AST, GGT, TC, TG, FBG, type-B ultrasonography, metabolic syndrome components. TCM differentiation types based on the consensus that Chinese and Western medicine diagnosis and treatment of NAFLD which enacted on the2011.Through the statistical methods to analyze related index, Calculating the correlation between TCM syndrome type and objective index, Mainly includes the distribution characteristics of TCM syndrome types, The correlation between TCM syndrome type and age, gender; The relationship between TCM syndrome type and course, BMI; The relationship of the TCM syndrome type and liver function, blood lipid, fasting blood sugar, and the relationship between TCM syndrome type and metabolic syndrome components.Results:1. This study collected146cases of patients, The most common TCM syndrome type is phlegm stagnation type (30.14%).2. The peak incidence among males is the40-60years of age, The peak incidence among females is the50-70years of age. when they age both less than50,Male prevalencet rate was significantly higher than females, when they age both more than50,female prevalence rate is higher than males. As the growth of the age, NAFLD’s incidence both females and males present a tendency of increasing.3. The distribution of TCM syndrome types and age have obvious correlation (P<0.05):The elder people has damp-heat type and phlegm stagnation type more common than liver depression and qi stagnation type.4. The distribution of gender and TCM syndrome types have no obvious correlation (P>0.05).5. Mental worker accounted for73.3%, manual worker accounted for26.7%.6. The distribution of TCM syndrome types and course of disease have obvious correlation (P<0.05):Patients with long duration have damp-heat type and phlegm stagnation type more common than liver depression and qi stagnation type、 liver depression and spleen weak type.7. The distribution of TCM syndrome types and BMI have obvious correlation (P<0.05):The people who belongs to phlegm stagnation type, BMI increased most obviously.8. The distribution of TCM syndrome types and ALT, GGT have obvious correlation (P<0.05), The distribution of AST and TCM syndrome types have no obvious correlation (P>0.05):The people who belongs to damp-heat type and turbid phlegm and blood stasis type,ALT increased most obviously. The people who belongs to turbid phlegm and blood stasis type,GGT increased most obviously;9. The distribution of TCM syndrome types and FBG, TC have obvious correlation (P<0.05), there is no correlation between TCM syndrome types and TG, the people who is turbid phlegm and blood stasis type blood sugar elevates obviously, The people who belongs to phlegm stagnation type,TC increased most obviously.10. Results of the146patients,there are47patients with Hypertension,18patients with Type2diabetes,103patients with Dyslipidemia, and38patients with Metabolic syndrome. Its proportion respectively32.2%,12.3%,70.5%,26%.Conclusions:1.Among the TCM differentiation types, phlegm stagnation type is the most common.2. The peak incidence of NAFLD is the40-70years of age, The most common course of NAFLD is about3to5years, The prevalence rate of mental workers was significantly higher than manual workers, With the increase of BMI, the prevalence rate is also rising.3. TCM syndrome type and age distribution, course of disease, BMI, ALT, GGT, TC, FBG was statistically significant.Mainly reflects in the following points:High age of patients with phlegm and blood stasis mutual junction is the most common; Phlegmy wet type intrinsic, mutual junction of phlegm and blood stasis in found in patients who with long duration;BMI increased most obviously in the patients of phlegmy wet resistance type; ALT increased more obviously with the patients who has hot and humid embodiment and phlegm and blood stasis;GGT and FBG in phlegm stasis mutual junction increases the most obviously;TC in phlegm wet type resistance increases significantly;4.NAFLD patients combined dyslipidemia account for the highest proportion.