Clinical Study On The Distribution Rules Of Syndrome Elements In Patients Of Alcoholic Liver Disease With Damp-Heat Constitution And Related Indicators

Objective:To analyze the distribution rules of syndrome elements and to explore the relationship between syndrome elements and the general condition,levels of laboratory indicators(ALB,TB,ALT,AST,?-GT,PT,etc.)and liver biopsy pathological changes in patients of Alcoholic liver disease with damp-heat constitution,in order to provide an objective reference value for the physical identification and standardization of pattern discrimination of Alcoholic liver disease,diagnosis and treatment of TCM and clinical application of related indicators.Methods:(1)According to "the collection form of four diagnostic information",the four diagnostic information and the level of relevant indicators of 140 patients of ALD with damp-heat constitution were collected.The score and the distribution rules of syndrome elements is obtained by inputing the basic information in the syndrome diffrentiation system.(2)To establish the database and to analyze the data with SPSS 24.0,therefore the relationship between common disease location,disease nature and related indicators in patients was summarized.Results:1.The general condition(1)Alcoholic hepatitis accounted for the largest proportion of patients with damp-heat Alcoholic liver disease,most of them were middle-aged,and their BMI status was normal.(2)The incidence of AFL was the highest in adolescents,but of AH and AC was the highest in middle-aged,then,it suggests that the degree of lesion may be different in patients of age groups.(3)The condition of patients gradually progressed with the increase of drinking years.2.The distribution rules of syndrome elements(1)The distribution of syndrome elements:The distribution of syndrome elements in common disease location was spleen>liver>stomach>gall bladder,spleen and liver were the most common,the distribution of syndrome elements in common disease nature was dampness>heat>phlegm>qi stagnation>Yin deficiency,dampness,heat and phlegm,qi stagnation and Yin deficiency were the most common.(2)The score of syndrome elements:the score of Spleen was the highest in syndrome elements of common disease location,while of wet was the highest in syndrome elements of common disease nature.There was statistical significance in comparison with other syndrome elements respectively(P<0.001).(3)The groups of syndrome elements:Spleen syndrome elements were mostly in grade II,liver,stomach and biliary syndrome elements were mostly in grade I;dampness syndrome elements were mostly in grade III,heat and qi stagnation syndrome elements were mostly in grade II,and phlegm and yin deficiency syndrome elements were the highest in grade I.There were statistical differences between the frequency distribution of each syndrome element classification(P<0.001).(4)The combination of syndrome elements:The combination of syndrome elements of disease location is mostly three disease location and above,the combination of syndrome elements of disease nature is mostly three disease nature and above,and the combination of deficiency and excess syndrome elements is mostly intermingled deficiency and excess.3.The relation between the distribution of syndrome elements and general condition(1)AFL is more common in the liver than AH and AC in the spleen;AFL and AH are more common in the wet,while AC is more common in the fever.The frequency distribution of the stages of disease in patients with syndrome elements is different(P<0.001).(2)Adolescents,middle-aged and old age are mostly located in the spleen;adolescents are mostly affected by heat,followed by dampness;middle-aged by dampness,followed by fever;old age are mostly affected by dampness and fever;The frequency distribution of age groups in patients with syndrome elements is different(P<0.001).(3)BMI status was overweight or above with spleen syndrome element;BMI status was lean and obese with damp syndrome element,and overweight with heat and phlegm syndrome element;The frequency distribution of BMI status in patients with syndrome elements is different(P<0.001).4.The relationship between syndrome elements and drinking quantity,drinking years,levels of laboratory indicators(ALB,TB,ALT,AST,?-GT,PT,etc.)and liver biopsy pathological changes(1)Drinking quantity can be used as one of the reference indicators of phlegm syndrome.(2)The decrease of ALB is related to the pathological changes of gallbladder.(3)There is a positive correlation between ALT and phlegm syndrome.(4)The increase of ?-GT is more obvious in damp,heat and gas stagnation.(5)Prolonged PT is related to pathological changes of spleen.(6)Among the common syndromes,the degree of inflammation in liver tissue of ALD with damp-heat syndrome is more than G2(89.5%),Among them,the location of disease is mainly liver and spleen,the frequency distribution of spleen syndrome element and liver and gall bladder in liver inflammation grading was significantly different(P<0.001).Conclusions:1.Distribution of syndrome elements in Alcoholic liver disease with damp-heat constitution:Spleen,liver,stomach and gallbladder are common syndrome elements of disease locations,of which spleen and liver are the main ones;dampness,heat,phlegm,qi stagnation and yin deficiency are common syndrome elements of disease nature,of which dampness and heat are important pathological factors;The patients of ALD with damp-heat constitution mostly presents pathological features of multiple disease locations and disease nature,and both deficiency and excess are basic pathogenesis characteristics.2.Various factors,such as different stages of pathological changes,age groups and BMI status,have certain effects on the distribution of syndrome elements in patients of ALD with damp-heat constitution,Therefore,invigorating Spleen,clearing heat,eliminating dampness and resolving phlegm properly can improve the BMI status of patients.3.The distribution of syndrome elements in ALD with damp-heat constitution are correlated with drinking quantity,laboratory indicators and liver biopsy pathological changes:With the increase of alcohol consumption,the formation of phlegm syndrome is more obvious,so attention should be paid to resolving phlegm in treatment;The decrease of ALB is related to the pathological changes of gallbladder;There is a positive correlation between ALT and phlegm syndrome;Patients with elevated ?-GT have more obvious dampness,heat and qi stagnation;prolonged PT is related to pathological changes of spleen,Therefore,when the value of ALB,ALT,?-GT and PT is abnormal,we can make further progress in resolving phlegm,clearing away heat and dampness,soothing liver and gallbladder,strengthening spleen and guarding against pathogenic factors and diseases according to evidence in clinical practice.4.Most of Alcoholic liver disease with damp-heat constitution showed obvious inflammation,Among them,the location of disease is mainly liver and spleen.Therefore,we should treat it from the liver and spleen and pay attention to invigorating the spleen,regulating the liver to prevent and cure the progress and deterioration of the disease.