Study On The Correlation Between TCM Syndromes Of Nonalcoholic Steatohepatitis And Small Intestinal Bacterial Overgrowth

PurposeTo study the correlation and change laws between the various TCM syndromes of NASH patients and SIBO with detecting the SIBO of NASH patients which are under the lactulose hydrogen breath test.Thus,provide relevant basis for the clinical syndrome differentiation and treatment of traditional Chinese medicine of NASH.MethodsSources of cases: From February 2019 to February 2020,there were 120 patients who met the diagnostic criteria and inclusion criteria of this study in health management center and Gastroenterology clinic of our hospital.The relevant information of patients was recorded:name,gender,age,height,weight,BMI,four times of diagnosis data,liver function(ALT,AST and GGT),grading of fatty liver,lactose hydrogen breath test results and other data.Furthermore,the syndrome differentiation of TCM was performed,for which the related database was established,to get the relevant research results of NASH TCM syndromes and SIBO by statistical analysis.Results1.General information:(1)A total of 120 NASH patients as 74 males and 46 females were included in this topic,with a male to female ratio of 1.61:1;(2)With the increase of age,the incidence of NASH gradually increases,moreover,there was a statistically significant difference in type the age and various TCM certificates(P <0.05).The liver stagnation and spleen deficiency group had the youngest age,and the phlegm and blood stasis interaction group had the oldest age.2.BMI:Most patients with NASH have increased BMI.The number of people who are overweight is as high as 48.4%,and the number of people who are obese accounts for 19.2%.The BMI and each TCM syndrome are statistically different(P <0.05).The highest phlegm internal resistance group.3.Fatty liver grading:In NASH patients,for those with mild fatty liver were accounted for 36.67%,for those with moderate fatty liver were accounted for 51.67%,and for those with severe fatty liver were accounted for only 11.66%.At the same time,NASH TCM syndromes have differences in the classification of fatty liver(P<0.05).Most of patients with mild fatty liver had the liver depression and spleen deficiency syndrome,accounting for 74.07%.In addition,the patients with the moderate fatty liver were more common with the phlegm internal obstruction syndrome and damp-heat accumulation syndrome,accounting for 73.53%and 63.16% respectively,while the patients with the moderate fatty liver were common with the intermingled phlegm and blood stasis syndrome,accounting for 42.85%.4.Liver function(ALT、AST、GGT):there was a statistically significant difference in liver function among the groups(P <0.05).There was the most obvious increment in intermingled phlegm and blood stasis group and the lowest increment in the liver depression and spleen deficiency group.At the meanwhile,the abnormal liver function was manifested in ALT and GGT mainly,while the increment of AST was small.5.Relationship between age and SIBO:Comparison between the 18-29 years old group and the 50-65 years old group was suggested that the difference was statistically significant(P<0.05),which was indicated that the positive rate of SIBO was increased with age.6.Relationship between various types of syndromes and SIBO : Chi-square test was shown that the difference between each syndrome type and SIBO was statistically significant(P<0.05).The positive rate of SIBO: the damp-heat accumulation syndrome group,the phlegm internal obstruction group,the liver depression and spleen deficiency group,the intermingled phlegm and blood stasis were counted for 34.2%,67.6%,59.3% and 66.7%respectively.Conclusions1.Among the various TCM syndrome types of NASH,the BMI in the phlegm-turbidity internal resistance group is the highest,followed by the phlegm and blood stasis interaction group and the damp heat accumulation group,while the BMI in the liver stagnation and spleen deficiency group is the lowest one.2.In NASH,In NASH,as the grade of fatty liver progresses from mild to moderate to severe,the traditional Chinese medicine syndrome type changes from the syndrome of liver depression and spleen deficiency to the syndrome of phlegm and turbid internal resistance or the syndrome of dampness and heat accumulation,and the syndrome of phlegm and blood stasis.3.The increase in age of NASH patients is positively correlated with the positive rate of SIBO.Among various TCM syndrome types,the sputum turbid internal resistance group had the highest SIBO positive rate,the phlegm and blood stasis mutual group,and the liver stagnation and spleen deficiency group followed,and the SIBO positive rate was the lowest in the damp heat accumulation group.