Preliminary Research On Patterns Of TCM Of NAFLD Based On Cluster, Factor And Logistic Regression Analysis

Background:Non-alcoholic Fatty Disease(NAFLD),with improvement of people's life standard,has been one of the most common and highest prevalent disease.Currently,there isn't one specific western medicine,meantime, compound Chinese drugs and some Chinese herb has certain effectiveness in the treatment of NAFLD,such as lowering blood fat,promoting liver function recovery,treating hepatic fibrosis,and so on,with few adverse reaction. Therefore,medical doctors has taken more importance in Chinese herbs than before.But there isn't diagnostic standards about patterns of TCM of NAFLD, and standardized research about diagnosis of NAFLD are still in initiative stage with many insufficiencies,it is necessary to consummate the diagnostic standard of Chinese pattern of NAFLD.Objectives:To investigate distribution of patterns of TCM syndromes of NAFLD and to lay the foundation to formulate the objective,applicable and maneuverable standard for clinical diagnosis,through clinical epidemiological investigation of 246 eligible patients from inpatient department and medical examination center of the first affiliated hospital of Guangzhou University of Chinese Medicine,visited between 12/2007 and 3/2008.Methods:adopting combining methods of literature research,clinical epidemiological investigation and mathematical statistics to make information collecting tables including four aspects of physical examination of TCM syndromes for NAFLD and to establish database.Using descriptive analysis, factor analysis,and cluster analysis to make objective standards of TCM syndromes of NAFLD,and to set up maneuverable diagnostic standards of syndromes for clinical initially.Results:(1)35 eligible articles were involved after collecting and classifying,which included 13 different patterns of TCM syndromes.Tan Shi Nei Zhu pattern(22 cases)is the most frequent one,and Qi Zhi Xue Yu pattern (13 cases),Shi Re Nei Yun pattern(13 cases),Gan Yu Qi Zhi pattern(12 cases), Tan Yu Hu Jie pattern(12 cases),Gan Shen Yin Xu pattern(8 cases),Pi Qi Xue pattern(7 cases),Gan Yu Pi Xu pattern(6 cases),Gan Yin Xu pattern(4 cases) were also very frequent,and Gan Dan Shi Re pattern(1 case),Pi Shen Yang Xu pattern(1 case),Shen Yin Xu pattern(1 case),and Gan Wei Bu He pattern was very rare.(2)Assign values into 56 symptoms or physical signs, according" Guideline Of Clinical Research of Chinese Drugs and New Drugs " and make information collecting tables of TCM after statistic analysis of symptoms in literature and standardizing them.(3)There were 246 eligible patients who could be diagnosed NAFLD.13 public factors,which reflected basic pathogenesis,according to diagnostic criteria of TCM syndromes were obtained after factor analysis.Then,five types were classified through frequency analysis,then names of the types were confirmed through professional discussion,and finally,five patterns could be established.There were shown in order as following:Gan Yu Pi Xu pattern(53 cases),Tan Shi Nei Zu pattern (59 cases),Pi sflen yang xu,tan shi nei zu pattern(45 cases),Pi Shen Yang Xu,Tan Shi Nei Zu pattern(45 cases),Shi Re Nei Yun pattern(54 cases),Qi Zhi Xue Yu pattern(35 cases).The distribution regulation,with one accord to the results of factor analysis,had generally embodied basic pathogenesis of NAFLD.(4)Determine the models of binary logistic regression of each patterns.Conclusions:The effective combination between theories of TCM and modern scientific and research method was embodied and objective reference evidence was provided for clinical diagnosis and treatment through discussing the diagnostic criteria of TCM syndromes of NAFLD using mathematical statistical methods.