Exploring The Related Factors Of Mild Hepatic Encephalopathy Based On TCM Syndrome Differentiation Of Liver Cirrhosi

Objective:To screen patients with minimal hepatic encephalopathy(MHE)of cirrhosis,analyze the correlation between MHE prevalence and objective indicators,and explore the differences and correlation of MHE prevalence based on TCM syndrome differentiation influencing factors,with a view to providing a reference for the diagnosis and treatment of traditional Chinese medicine for mild hepatic encephalopathy in patients with liver cirrhosis.Methods:1.The study included 1574 outpatients and inpatients with cirrhosis who met the enrollment criteria.The abnormality of the Number Connection Test A(NCT-A)and/or Digital Symbol Test(DST)was used as MHE Diagnosis is based on the NCT-A and DST normal control ranges established in the previous period,and MHE patients with liver cirrhosis are selected.Logistic regression is used to analyze the correlation between MHE disease and objective indicators.2.1574 patients with liver cirrhosis were divided into 6 groups according to TCM syndrome differentiation:liver qi stagnation syndrome group,water-damp internal syndrome syndrome group,damp-heat accumulation syndrome syndrome group,liver and kidney yin deficiency syndrome group,spleen and kidney yang deficiency syndrome group,blood stasis obstruct Syndrome group;compare the prevalence of MHE in each syndrome group,and use statistical methods to analyze the related influencing factors of mild hepatic encephalopathy in each syndrome group.Results:1.Of the 1574 patients with cirrhosis,NCT-A and/or DST abnormalities were the basis for diagnosis of MHE.A total of 294 patients with MHE were screened out,accounting for 18.67%(294/1574).Logistic regression suggested that blood ammonia(P=0.015,B=0.02)level was positively correlated with MHE prevalence in patients with liver cirrhosis,and red blood cell count(P=0.004,B=0.005)level was negatively correlated with MHE prevalence in patients with liver cirrhosis.2.Among the 1574 patients with liver cirrhosis,the liver-qi stagnation syndrome group was the most,with a total of 408 cases,accounting for 25.92%,followed by the blood stasis-blocking syndrome group,with a total of 294 cases,accounting for 18.68%,and the damp-heat accumulation syndrome group with 265 cases,accounting for 16.84%,229 cases of liver and kidney yin deficiency syndrome group,accounting for 14.55%,117 cases of water dampness internal syndrome syndrome group,accounting for 7.43%,spleen and kidney yang deficiency syndrome group was the smallest,a total of 53 cases,accounting for 5.53%.Among the syndrome types,the prevalence of MHE in the liver-qi stagnation syndrome group was 18.38%(75/408),the prevalence of MHE in the water-humidity internal resistance syndrome group was 21.37%(25/117),and the MHE prevalence in the damp heat syndrome syndrome group The rate was 21.13%(56/265).The prevalence of MHE in the group of deficiency of liver,kidney and yin was 22.27%(51/229).The prevalence of MHE in the group of deficiency of spleen,kidney and yang was 32.18%(28/87).The prevalence of MHE in the collateral syndrome group was 8.50%(25/294).The chi-square test showed that P=0.000,indicating that there was a significant difference in the prevalence of MHE among the groups.3.Logistic regression analysis found that ascites(P=0.026,B=0.957)was positively correlated with MHE prevalence in patients with liver cirrhosis and liver qi stagnation syndrome;no related influencing factors were found in MHE prevalence in patients with internal dampness syndrome;Pulse string(P=0.008,B=-1.592)was negatively correlated with MHE prevalence in patients with cirrhosis of damp heat syndrome;Age(P=0.046,B=0.036),dry eyes(P=0.006,B=0.435)and constipation(P=0.011,B=0.55)were positively correlated with MHE prevalence in patients with liver cirrhosis,liver and kidney yin deficiency syndrome;Abdominal distension(P=0.029,B=0.609)is positively correlated with MHE prevalence in patients with liver cirrhosis and spleen and kidney Yang deficiency,and hemoglobin level(P=0.007,B=-0.058)is negatively correlated with MHE prevalence in patients with cirrhosis and spleen and kidney Yang deficiency;blood stasis No related influencing factors were found in patients with obstruction syndrome.Conclusion:1.Patients with cirrhosis have a higher proportion of MHE prevalence.Higher blood ammonia levels and lower red blood cell count levels are associated with MHE prevalence.2.TCM syndrome differentiation of liver cirrhosis patients is more common with liver qi stagnation syndrome and blood stasis obstruction syndrome,followed by damp heat syndrome,liver and kidney yin deficiency syndrome and water dampness internal syndrome syndrome,and spleen and kidney yang deficiency syndrome is the least.The prevalence of MHE in patients with spleen and kidney yang deficiency syndrome is relatively more common,and the prevalence of MHE in blood stasis syndrome is the lowest.3.Cirrhosis and liver-qi stagnation syndrome patients with ascites are more susceptible to MHE,patients with damp heat syndrome are relatively less susceptible to disease,elderly patients with liver and kidney yin deficiency syndrome are more susceptible to MHE,and the disease is caused by dry eyes and constipation.Symptoms are closely related.Patients with spleen and kidney yang deficiency have abdominal distension such as bulging and low hemoglobin levels are prone to NHE.