The Research Of The Correlation Between Different TCM Syndrome Types And The Level Of Blood Glucose,Blood Lipid And Hs-CRP In NAFLD Patients

Background:With the global epidemic of obesity and Metabolic syndrome NAFLD has become one of the common chronic liver diseases in developed countries such as the United States,some European countries and many Asian countries.The incidence of NAFLD is closely related to region,age,race,gender,diet,exercise,occupation,etc.The pathogenesis of NAFLD is complicated,among which the "Second Strike" doctrine is generally recognized.Insulin resistance is the main cause of "the first strike".Then,oxidative stress,lipid peroxidation damage,chronic inflammation and other factors caused "the second strike" to the liver.After long-term,repeated oxidative damage and chronic inflammation,NAFLD can develop into NASH,liver fibrosis,liver cirrhosis,and even hepatocellular carcinoma.By present,a large number of animal experiments and clinical studies have shown that NAFLD patients' degree of disease was corresponded to the changes of biochemical indicators.Through the application of modern test technology,we can have an objective and better understanding of the pathology.Different TCM syndromes combined with laboratory indicators will be of great value in the evaluation of TCM treatment on NAFLD.Objective:This research was designed to investigate the relationship between biochemical markers,hs-CRP and different TCM syndromes,to evaluate the prognosis of NAFLD and to provide effective suggestions to patients suffering.Methods:We collected 88 patients who were diagnosed with NAFLD(the case group)and 30 healthy volunteers(the health group)between June 2016 and February 2017 from the Health Examination Center of the China-Japan Friendship Hospital.All patients were asked to finish a comprehensive questionnaire.According to clinical guidelines and standards,the patients were divided into four subgroups:Phlegm and blood stasis syndrome group(16 cases);Phlegm-dampness syndrome group(20 cases);Damp-heat syndrome group(44 cases);Spleen-deficiency syndrome group(8 cases).We used ?2 test to analyze the gender,age,the correlation between TCM syndromes and biochemical indexes among the groups.The skew distributional data was analyzed by non-parametric test and the normal distributional data by one-way ANOVA.Results:(1)The case group:There were 54 cases(61.36%)of males and 34 cases(38.64%)of females.The ratio of male to female was 1.59:1.The average age was 42.26±11.29.The health group:There were 19 males(63.33%)and 11 females(36.67%).The ratio of male to female was 1.73:1,with an average age of 41.77 ±10.87.(2)The relationship between different syndromes and blood glucose(GLU):The total exception rate of GLU was 21.8%.Comparison of abnormal rate of GLU among 4 groups:Damp-heat syndrome group>Phlegm and blood stasis syndrome group>Phlegm-dampness syndrome group>Spleen-deficiency syndrome group.(3)The relationship between different syndromes and blood lipid:The total exception rate of CHO was 37.5%,TG was 38.6%,HDL-C was 23%,LDL-C was 20.7%.Comparison of abnormal rate of CHO among 4 groups:Phlegm-dampness syndrome group>Spleen deficiency syndrome group>Damp-heat syndrome group>Phlegm and blood stasis syndrome group,P=0.031.Comparison of abnormal rate of TG among 4 groups:Phlegm-dampness syndrome group>Damp-heat syndrome group>Phlegm and blood stasis syndrome group>Spleen deficiency group,P=0.000.Comparison of abnormal rate of HDL-C among 4 groups:Damp-heat syndrome group>Phlegm and blood stasis syndrome group,Phlegm-dampness syndrome group>Spleen-deficiency group,P=0.029.Comparison of abnormal rate of LDL-C among 4 groups:Phlegm and blood stasis syndrome group>Phlegm-dampness syndrome group>Damp-heat syndrome group>Spleen-deficiency group,P=0.005.The level of TG showed the statistically difference when comparing Phlegm and blood stasis syndrome group,Damp-heat syndrome group and Phlegm-dampness syndrome group with the health group(P=0.001,P=0.000,P=0.000).Damp-heat syndrome group and Damp-heat syndrome group were also statistically different from Spleen-deficiency group(P=0.049,P=0.018).(4)The relationship between different syndromes and hs-CRP:The level of hs-CRP showed the statistically difference when comparing Phlegm and blood stasis syndrome group,Phlegm-dampness syndrome group and Damp-heat syndrome group with the health group(P=0.001,P=0.000).Conclusion:(1)The research showed that Damp-heat syndrome was the major syndrome in patients diagnosed with NAFLD,and the Spleen-deficiency syndrome was the least.(2)There were higher abnormal rates in GLU and blood lipid and chronic inflammation was more prominent in Damp-heat syndrome and Phlegm and blood stasis syndrome in NAFLD.