Study On Diet Intervention In Non-alcoholic Fatty Liver Disease With Phlegm Turbid Internal Resistance Syndrome

Object:Non-alcoholic fatty liver disease(NAFLD)is closely related to abnormal liver function and dyslipidemia,as well as type 2 diabetes,and metabolic syndrome.It may develop into cancer if not treated in time.So it is important for the early treatment of NAFLD.There are many types of TCM syndromes in clinical practice,and the phlegm stasis syndrome is more common.Many studies have shown that it is feasible of diet intervention to treat NAFLD and delay its progress.But,a standardized dietary intervention plan has not yet been formed at this stage.The chinese medicine has outstanding advantages in dietary treatment of diseases.Based on this,in this study,the phlegm stasis syndrome of the main syndromes with NAFLD was selected to explore the dietary risk factors,and formulate the diet intervention plan of homology of medicine and food.The clinical efficacy after treatment in improving TCM syndrome scores,controlled attenuation parameters,liver function,blood lipids,blood glucose and uric acid,were compared between the intervention group and control group.The results were expect to guide the treatment of the patients with the phlegm stasis syndrome of NAFLD.Method:1.Developing and completing dietary questionnaires to investigate and clear the diets of patients with phlegm stasis syndrome of NAFLD to provide a basis for the formulation of dietary intervention program.2.It were searched and sorted of literature experience from 2009 to 2018 and medicated recipes in books for the treatment of NAFLD with phlegm stasis syndrome.And then using the Traditional Chinese Medicine Inheritance Platform to get combination of the chinese medicine.Finally,the diet plan were determined with phlegm stasis syndrome of NAFLD by expert.3.A total of 60 participants are recruited from the Gastroenterology clinic to conduct randomized controlled study,who have participated in treatments for NAFLD with phlegm stasis syndrome during May 2019 to October 2019 at the Dongzhimen Hospital and Dongfang Hospital of Beijing University of Traditional Chinese Medicine.The control group received health education;On the basis of health education,the observation group was treated with diet intervention program for NAFLD of phlegm stasis syndrome.The intervention period was 3 months.After the end of the study,the changes of two groups were measured for TCM syndrome scores,controlled attenuation parameters(CAP),blood lipids[triglycerides(TG),cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL)],liver function[Changes of amino acid aminotransferase(ALT),aspartate aminotransferase(AST),y-glutamyl transpeptidase(GGT)],blood glucose(GLu)and uric acid(UA)to comprehensively evaluate the clinical efficacy of the dietary intervention program.Results:1.Results of the correlation between phlegm stasis syndrome of NAFLD and diet:Eating fast accounted for 10.1%of the dietary habits of all patients with the phlegm stasis syndrome.And more than 57%patients have the habits of fast eating.In addition,the dietary preferences of patients with phlegm stasis syndrome were mainly meat(7.4%)and sweets(7.1%).2.Fomoulation of diet intervention plan:raw hawthorn 10g,lotus leaf 10g,tangerine peel 10g,alisma 15g.3.Results of the clinical research:(1)Statistical analysis of TCM syndrome scores:After treatment in the two groups,the main symptoms of the patients were alleviated,including discomfort or bloating in the right flank,drowsiness and sticky stools.Moreover,the symptom scores also improved.The total effective rate was 88.9%in the intervention group and 56.7%in the control group.There was a statistically significant difference in the comprehensive clinical efficacy between the two groups(P<0.05),which suggested that the comprehensive clinical efficacy of the diet intervention plan group was better than that of the control group.(2)Statistical analysis of CAP:There was a significant statistical difference in CAP between the observation group and the control group(P<0.05).(3)Statistical analysis of biochemical indexes:Except for blood glucose,other indicators of the two groups slightly decreased after treatment,and there was a degree of increase in HDL.But there was not significantly different between the observation group and control group in biochemical indexes(P>0.05).Conclusion:1.Eating meat and sweets are the main dietary preference of patients with phlegm stasis syndrome of NAFLD,and fast eating may be closely related to the occurrence of NAFLD with phlegm stasis syndrome.Therefore,the correct dietary structure should be popularized in clinical practice.2.Diet intervention plan can significantly improve clinical symptoms,signs and the degree of liver steatosis in patients with phlegm stasis syndrome of NAFLD,and which has good clinical application value.