Study On The Correlation Between TCM Syndromes Of Liver Fibrosis And Clinically Indicators

Objective:Hepatic fibrosis is the common pathological basis of most liver diseases and the only way to cirrhosis.Chinese medicine does not have the term liver fibrosis.It is often classified as "hypochondriac pain","jaundice","ganzhuo" and "Abdominal Masses".The understanding of etiology and pathogenesis of traditional Chinese medicine has not been unified.Multivariate statistical analysis was less applied to the study of TCM syndrome differentiation of liver fibrosis.Fibroscan examination and serological diagnosis model have higher specificity and sensitivity in the diagnosis of liver fibrosis.So we choose the method of multivariate statistical analysis,including principal component analysis method,factor analysis,cluster analysis and Logistic regression,to study the characteristics of TCM syndrome of liver fibrosis,as well as to provide reference for the objectivity and standardization of TCM Syndromes of liver fibrosis specification.We hope to find out the correlation between TCM syndromes and clinical examination indexes of liver fibrosis,so as to provide a basis for optimizing the diagnosis and treatment of liver fibrosis.Methods:232 cases included outpatients and inpatients with liver fibrosis caused by any kind of pathogeny and were all presented between December,2015-December.2016 in Shanxi Hospital of Traditional Chinese Medicine.We designed the clinical questionnaire and collected the four diagnostic information of TCM of patients including 44 information of tongue and pulse,at the same time collected clinical examination index of patients including blood routine examination,liver function,blood coagulation index,four blood lipids,fibrosis,imaging examination and FibroScan examination.And then we calculated the APRI,Fib-4,Frons index in order to analysis the correlation between TCM Syndromes of liver fibrosis and clinical examination by the principal component analysis,factor analysis,cluster analysis and Logistic regression.Single factor analysis of variance and non parametric test named the Kruskal-Wallis H test were used to compare the differences between different syndrome types.Results:1.This study collected 232 cases of outpatients and inpatients with liver disease in Shanxi Province Chinese medicine hospital,106 cases among them were female and 126 were male.The youngest was 18 years old and the oldest was 65 years old in these patients whose average age is 49.29±11.41 years old.According to the etiology,there are 155 cases of chronic hepatitis B(CHB),24 cases of chronic hepatitis C(CHC),15 cases of alcoholic liver disease(ALD),12 cases of nonalcoholic fatty liver disease(NAFLD),14 cases of primary biliary cholangitis(PBC),4 cases of drug-induced liver injury(DiLi),4 cases of unknown causes and 4 cases of alcoholic liver disease combined with hepatitis B.2.The frequency analysis results showed that hepatic fibrosis common diagnostic information contained dry mouth and throat(60.8%),vexation and irritability(50.0%),mental exhaustion(49.1%),white fur(74.14%),thin fur(61.21%),moist fur(50.0%),pale tongue(37.5%);wiry pulse(43.1%)and thready pulse(27.59%).3.The common TCM Syndromes of liver fibrosis contained syndrome of stagnation of liver qi and spleen deficiency(73 case),syndrome of blockade of dampness due to qi stagnation(55 case),syndrome of liver blood stasis obstruction(36 case),syndrome of endogenous heat due to yin deficiency(46 case),syndrome of yang deficiency of spleen and kidney(22 case).4.The TCM syndromes of liver fibrosis were statistically significant with Gender,Age,PLT,PT,IBi L,FibroScan,Fib-4,Frons index,HA(P<0.05).5.Logistic regression analysis found liver-stagnation and spleen-deficiency syndrome was associated with FibroScan,TBi L,Fib-4,Forns index.Qi stagnation and dampness syndrome was connected with PLT,PT and Forns index.syndrome of liver blood stasis obstruction was relate to LSM,PT,HA and Forns,Yin deficiency heat syndrome involed IBiL,FIB-4,Forns index.Spleen and kidney yang deficiency syndrome involed the PLT,HA,FIB-4,Forns index.Conclusion:In this thesis,I deduced the following conclusions by multivariate statistical analysis based on the research of outpatients and inpatients with liver disease in 232 cases in Shanxi Province Chinese medicine hospital,1.The common diagnostic information of hepatic fibrosis include dry mouth and throat,vexation and irritability,mental exhaustion,sallow complexion,belching,and uncomfortable evacuation,pale and moist tongue,thin white fur,wiry and thready pulse.2.The mainly syndromes of hepatic fibrosis containe damp heat,stagnation of the circulation of vital energy,circulation of vital energy in the wrong direction,phlegmatic hygrosis,deficiency of vital energy,insufficiency of the spleen,blood stasis,stagnation of blood,deficiency of yin,deficiency of yang.3.The common TCM Syndromes of liver fibrosis include syndrome of stagnation of liver qi and spleen deficiency,syndrome of blockade of dampness due to qi stagnation,syndrome of liver blood stasis obstruction,syndrome of endogenous heat due to yin deficiency,syndrome of yang deficiency of spleen and kidney.4.The TCM Syndromes of liver fibrosis are correlated with Age,Gender,PLT,PT,IBiL,FibroScan,Fib-4,Frons index and HA.