Study On The Correlation Between TCM Syndrome Type Of Liver Fibrosis And The Results Of Liver Instantaneous Elasticity Detection

Objective:Detection of liver stiffness(LSM)in patients with hepatic fibrosis by transient elasticity scanner(Fibroscan),to explore the relationship between the 3 kinds of main TCM Syndromes of liver fibrosis--Liver and gallbladder damp heat syndrome,liver stagnation and spleen deficiency syndrome,liver kidney yin deficiency syndrome and liver stiffness values(LSM).To determine the value of Fibroscan in the diagnosis of liver fibrosis and to provide a reliable basis for the objective study of TCM syndrome and the clinical syndrome differentiation and treatment.Methods:Collected 106 cases of liver fibrosis who were diagnosed in the inpatient department and outpatient department of Hubei Provincial Traditional Chinese Medical Hospital liver disease research institute from April 2016 to July 2017,including 48 cases of Liver and gallbladder damp heat syndrome,34 cases of liver depression and spleen deficiency syndrome,24 cases of liver kidney yin deficiency syndrome.Collected the basic patient information and clinical information in detail,and performed clinical syndrome differentiation of traditional Chinese medicine according to the "guide for diagnosis and treatment of the combination of Chinese and Western medicine for liver fibrosis" formulated by the Chinese Association for the integration of Chinese and Western medicine in 2010.Collected the result of liver function,four items of liver fiber,LSM value of the enrolled patients to explore the correlation between TCM Syndrome of Liver Fibrosis and LSM and four items of liver fiber,and the correlation between LSM and four items of liver fiber.Software SPSS 20.0 wil be used for collecting the data.If P <0.05,the research had statistical significance.Results:1.The distribution of TCM syndromes in 106 patients enrolled was:liver kidney yin deficiency syndrome<liver stagnation and spleen deficiency syndrome<Liver and gallbladder damp heat syndrome.The LSM values of the three TCM syndromes were compared in two pairs and the differences were statistically significant(P<0.05).The level of LSM value in each type of TCM syndrome type group:Liver and gallbladder damp heat syndrome>liver stagnation and spleen deficiency syndrome>liver kidney yin deficiency syndrome.2.Comparison of test results of various types of HA:Liver and gallbladder damp heat syndrome>liver stagnation and spleen deficiency syndrome>liver kidney yin deficiency syndrome,there are significant differences between groups(P<0.01).Comparison of test results of various types of LN:Liver and gallbladder damp heat syndrome>liver stagnation and spleen deficiency syndrome>liver kidney yin deficiency syndrome,there are significant differences between groups(P<0.01).Comparison of test results of various types of PC?:Liver and gallbladder damp heat syndrome>liver stagnation and spleen deficiency syndrome>liver kidney yin deficiency syndrome,there are significant differences between groups(P<0.01).Comparison of test results of various types of C-?:Liver and gallbladder damp heat syndrome>liver stagnation and spleen deficiency syndrome>liver kidney yin deficiency syndrome.The difference was not statistically significant when compared the liver stagnation and spleen deficiency syndrome and liver kidney yin deficiency syndrome(P>0.05),but there were significant differences when compared between other groups(P<0.01).Comparison of test results of various types of liver function:ALT?AST?TBIL was the highest in Liver and gallbladder damp heat syndrome,followed by liver stagnation and spleen deficiency syndrome and liver kidney yin deficiency syndrome.There was no statistical difference between the ALB values of each TCM syndrome type group(P>0.05).There were significant differences when compared the three TCM syndrome type groups' result of ALT,AST and TBIL.There was no statistical difference when compared the group of liver stagnation and spleen deficiency syndrome and liver kidney yin deficiency syndrome in TBIL(P>0.05),but There were significant differences in ALT and AST(P<0.05).3.The LSM values were positively correlated with HA,LN,Collagen III,and Collagen IV among various syndromes.Conclusion:1.There was a good correlation between the LSM values of the TCM syndrome types of liver fibrosis,and the LSM value could be used as an objective and standardized reference index for TCM differentiation of the disease.2.The transient elasticity imaging technology(Fibroscan)had high accuracy in the evaluation of clinical liver fibrosis,and could reflect the liver stiffness of patients with different syndromes of liver fibrosis,which was helpful to assist clinical guidance and had high clinical application value.