Study On The Distribution Characteristics Of TCM Syndromes In HBV-related Acute-on-chronic Liver Failure Based On Literatur

Objective: To excavate the distribution of TCM symptom types in chronic acute liver failure(ACLF).Methods: CNKI,Wanfang,Weipu,China biomedical literature and Pub Med collected from March 2002 to March 2022 were searched for theoretical discussion and clinical research literature on the differentiation and typology distribution of traditional Chinese medicine in HBV-ACLF from March 2002 to March 2022,screened the literature according to the inclusion and exclusion criteria,and entered it into the Epi Data 3.1 construction database.Excel 2021,SPSS Modeler 18.0,SPSS Statistics 26.0 software for data analysis.Results:(1)Basic literature information: 38 articles were included,including 16 theoretical research literature and 22 clinical research literature.The 22 clinical case studies included 15 retrospective cohort studies,3 clinical observations,1 rand omized controlled trial,and 3 prospective studies.Of the 15 retrospective cohort studies,12 were of high quality and 3 were of moderate quality;Of the five retrospective cohort studies,one was of high quality and four were of moderate quality;Among t he 3 clinical observations,2 were of high quality and 1 was of moderate quality.One RCT was of moderate quality.After the names of the certificate types were standardized,18 TCM certificate types were obtained,and 12 elements were extracted according to the standard of the certificate.(2)Statistics of TCM certificate type: the total frequency of the 18 TCM certificate types was 5872 times,and the frequency exceeded2%,and there were 10 kinds of liver depression and spleen deficiency,humid heat connotation evidence,liver and kidney yin deficiency,spleen and kidney yang deficiency,hot poison blazing evidence,qi deficiency and blood stasis evidence,wet poison and strong evidence,stasis yellow evidence,spleen deficiency and dampness evidence,an d liver yang deficiency evidence,accounting for 91.98% of the total frequency.(3)Factor statistics: A total of 12 standardized TCM certificates were extracted,of which 4 disease factors were the most common of which were spleen(10 times,41.67%),foll owed by liver(5 times,20.83%),kidney(5 times,20.83%),and gallbladder(4 times,16.67%);Among the 8 cases,heat(14 times,20.29%),wet(13 times,18.84%),and poison(13 times,18.84%)were the most common.(4)Association rules: set the support de gree ≥ 70%,the confidence level ≥ 80%,and the improvement degree > 1 to get a total of 6groups of binomial associations,and the moist-hot support degree is the highest,87.50%;The confidence level was also the highest,at92.31%;There were three asso ciations in the two groups,including humid heat-toxicity and humid heat-blood stasis.(5)Factor analysis: theoretical research literature summarized four common factors: liver-gallbladder-qi deficiency,humid heat-spleen,blood stasis-toxicity-yin defici ency-yang deficiency-kidney,and qi stagnation,and the cumulative factor contribution rate was 74.61%;The clinical research literature summarized six common factors,including spleen-qi deficiency-yang deficiency,liver-kidney-yin deficiency,gall-humidity-heat,qi stagnation,toxicity and blood stasis,and the cumulative factor contribution rate was 91.35%.(6)Cluster analysis: the evidence of theoretical research literature can be clustered into four categories: liver-gallbladder-qi deficiency,spleen-kidney-yin deficiency-yang deficiency-humidity-heat,blood stasis-toxicity,and qi stagnation;It can also be divided into 8categories: liver-gallbladder-qi deficiency,spleen-kidney-yang deficiency,yin deficiency,humidity,heat,blood stasis,toxicity,and qi stagnation;The clinical research literature can be aggregated into6 categories: liver-kidney-yin deficiency,yang deficiency-spleen-qi deficiency,qi stagnation,gall-humidity-heat,toxicity,and blood stasis.Conclusion:(1)Traditional Chinese medicine differentiation classification ACLF,the understanding of the disease position can be considered from the liver and gallbladder,spleen,kidney in turn.(2)Traditional Chinese medicine differentiation classification ACLF,multiple liver-gallbladd er,liver-kidney,spleen-kidney disease combination,the pathological factor is nothing more than "humidity,heat,stasis,poison,deficiency" five ends,overall there are four complex combinations of hepatobiliary,spleen and stomach,more humid heat accu mulation,liver and kidney "toxicity,stasis,deficiency",liver and gallbladder deficiency,spleen deficiency and yang deficiency.(3)ACLF syndrome can be generally divided into damp heat medium obstruction evidence,heat toxic stasis certificate,spleen deficiency and dampness evidence,liver depression and spleen deficiency evidence.The cause of damp heat blockage should be considered from the internal and external evil,and the pathogenesis is mostly moist heat blockade medium focus,fumigation of liv er,gallbladder,spleen and stomach;The causes of heat and poisonous stasis include the five ends of "humidity,heat,stasis,poison,and deficiency",and the disease mechanism is mostly humid and hot steaming,and poisonous stasis is knotted;Spleen defi ciency and dampness are evidence,and the pathogenesis is mostly spleen deficiency,spleen and yang deficiency caused by cold and wet endogenous,and for a long time,the spleen and kidney yang deficiency;Liver,liver,depression,and spleen deficiency ar e caused by the disease mechanism and excessive woodiness.