| Objective: To explore the distribution characteristics of TCM disease location and syndrome elements in patients with chronic hepatitis B complicated with non-alcoholic fatty liver by collecting the information of TCM four diagnosis,and to provide reference for syndrome differentiation and classification of patients with chronic hepatitis B complicated with non-alcoholic fatty liver.Methods: A prospective study was carried out to compile the Collection Table of Four Diagnosis Information in patients with CHB complicated with NAFLD.The basic information and four diagnosis information of patients were collected.At the same time,the weight of syndrome elements corresponding to each syndrome was recorded by referring to Zhu Wenfeng’s Syndrome Elements Differentiation,and the weighted sum was performed for TCM syndrome elements judgment.Using Microsoft Excel data management,data import SPSS 25.0statistical analysis software,measurement data with mean + /-standard deviation(x ± s)said.Count data are expressed in frequency,frequency,and component ratio.The relationship between variables was analyzed by Logistic regression.Bilateral test was used,and p<0.05 was considered statistically significant.Results: 1.General information: A total of 120 patients with CHB and NAFLD were included in this study.94 cases were male,accounting for78.3%;26 cases were female,accounting for 21.7%;The male to female ratio is 3.62 to 1.The age range was 23-65,with a mean age of41.53 ±8.91.41 patients with normal body weight(34.2%);66 were overweight,accounting for 55%;13 were obese,accounting for 10.8%;Average BMI: 24.72 ±2.76 kg/m2.Hypertension in 7 cases,accounting for 5.8%;Diabetes mellitus 9 cases,accounting for 7.5%;Hyperlipidemia was found in 14 cases,accounting for 11.7%.2.Distribution of TCM syndrome elements: the distribution of disease location syndrome elements was liver(75.0%)> spleen(48.3%)>stomach(19.2%)> gallbladder(10.8%)> kidney(3.3%).The combination of disease sites and syndrome elements were mainly single disease sites and double disease sites,of which 57 cases were single disease sites,accounting for 47.5%.There were 59 cases with double disease,accounting for 49.2%;Three disease sites were 3 cases,accounting for 2.5%;There was one case with four diseases,accounting for 0.08%.Liver(37.5%)was the main disease site,liver + spleen(20.0%),spleen + stomach(14.2%),liver + bile(9.2%)was the main disease site.The disease distribution was as follows: Qi stagnation(64.2%)> dampness(63.3%)> Qi deficiency(42.5%)> heat(39.2%)>phlegm(24.2%)> Yin deficiency(24.2%)> Yang deficiency(16.7%)>blood stasis(7.5%).The combination of diseases was as follows:bidisease(31.7%)> three-disease(30.8%)> four-disease(21.7%)>single disease(10.0%)> five-disease(5.8%).Among them,the single disease was mainly Qi-stagnation(10%),the double disease was Qi-stagnation + Qi-deficiency(13.3%),dampness + heat(7.5%),Qi-stagnation + blood stasis(5.0%),and the three diseases were mainly Qi-deficiency + dampness + phlegm(7.5%),Qi-stagnation + heat + Yin deficiency(5.0%),and dampness + heat + Yin deficiency(5.0%).The four diseases were mainly Qi stagnation + dampness + heat + Yin deficiency(7.5%),qi deficiency + dampness + phlegm + Yang deficiency(5.0%),Qi stagnation + Qi deficiency + dampness + Yang deficiency(5.0%),and the five diseases were mainly Qi stagnation +dampness + phlegm + heat + Yin deficiency(5.0%).3.Correlation between general data and TCM syndrome elements: with the change of gender,the possibility of establishing the diagnosis of each syndrome element did not change significantly(p ≥ 0.05).Age:The probability of diagnosis of kidney syndrome,stomach syndrome,qi deficiency syndrome,blood stasis syndrome and Yang deficiency syndrome increased by 1.236,1.059,1.095,1.141,1.062 times for each unit increase of age(p<0.05,OR >1).The probability of diagnosis of liver syndrome,bile syndrome,heat syndrome and Yin deficiency syndrome decreased by 7.6%,11.1%,8.3% and 6.1%,respectively(p<0.05,OR <1).There was no significant correlation between age and spleen syndrome,qi stagnation syndrome,dampness syndrome and phlegm syndrome(p ≥ 0.05).BMI: The probability of diagnosis of spleen syndrome,stomach syndrome,dampness syndrome,phlegm syndrome and Yang deficiency syndrome increased by 1.857,2.757,2.595,14.942,3.023 times for each unit increase of BMI(p<0.05,OR >1).The probability of hepatic syndrome and qi stagnation syndrome were decreased by 72.4% and 67.5%,respectively(p<0.05,OR <1).There was no significant correlation between the changes of BMI and kidney syndrome,bile syndrome,qi deficiency syndrome,blood stasis syndrome,heat syndrome and Yin deficiency syndrome(p≥ 0.05).Conclusion: 1.CHB associated with NAFLD is more likely to occur in young and middle-aged men,and the BMI is mainly overweight.2.The location syndrome elements in patients with CHB complicated with NAFLD involve liver,spleen,stomach,gallbladder,and kidney,mainly liver.The combination of disease sites and syndrome elements was dominated by single disease site and double disease site,the single disease site was dominated by liver,and the five double disease sites were dominated by liver + spleen,spleen + stomach,liver + bile.3.Pathogenic syndrome elements include qi stagnation,dampness,qi deficiency,heat,phlegm,Yin deficiency,Yang deficiency and blood stasis,mainly Qi stagnation,dampness,qi deficiency and heat.The combination of pathogenic syndromes mainly consists of two diseases and three diseases.The two diseases mainly consist of Qi stagnation +Qi deficiency,dampness + heat,qi stagnation + blood stasis,and the three diseases mainly consist of qi deficiency + dampness + phlegm,qi stagnation + heat + Yin deficiency,and dampness + heat + Yin deficiency.4.There was no significant correlation between gender and the establishment of syndrome elements.Age was positively correlated with the diagnosis of kidney syndrome,stomach syndrome,qi deficiency syndrome,blood stasis syndrome and Yang deficiency syndrome,and negatively correlated with the diagnosis of liver syndrome,bile syndrome,heat syndrome and Yin deficiency syndrome.BMI was positively correlated with spleen syndrome,stomach syndrome,dampness syndrome,phlegm syndrome and Yang deficiency syndrome,and negatively correlated with kidney syndrome,bile syndrome,qi deficiency syndrome,blood stasis syndrome,heat syndrome and Yin deficiency syndrome. |
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