The Clinical Research Of The TCM Constitution Distribution Rules And Relevant Indexes Of Chronic Hepatitis B Patients With Nonalcoholic Fatty Liver Disease

Objective:This study is to explore the relationship between TCM constitution distribution and relevant indexes of chronic hepatitis B(CHB)patients with nonalcoholic fatty liver disease(NAFLD)by observing their TCM constitution distribution rules,biochemical indexes,and liver histopathology;regulate the constitution of CHB patients with NAFLD,and slow down the disease deterioration of patients by starting from the adjustability of the TCM constitution.Method:Investigated the TCM constitution of 160 CHB patients with NAFLD that met the diagnostic criteria,collected the general and clinical data of the patients,analyzed and discussed the TCM constitution distribution characteristics and their relationship with relevant indexes(such as measurement of liver functions,liver cirrhosis,etc.)of CHB patients with NAFLD.Result 1.TCM constitution distribution characteristics: Among the 160 patients in this study,the major TCM constitution types were phlegm-dampness(28.12%)and dampness-heat(25.03%),followed by moderateness(18.12%),qi deficiency(9.37%),yang deficiency(8.12%),qi depression(6.87%)and blood stasis(4.37%).No yin deficiency or special constitution was collected,and the biased constitution was dominant.2.General data: Among the 160 different TCM constitution of CHB patients with NAFLD,the proportion of women in the patients with qi depression constitution is higher.The proportions of men in patients with damp-heat,moderateness and phlegm-dampness constitution are higher.3.Different TCM constitution types and clinical indexes:(1)The difference of HBV DNA load distribution between different constitution types of CHB patients with NAFLD was statistically significant,and the HBV DNA load of the dampness-heat constitution was significantly higher than that of the yang deficiency constitution.(2)The TBIL,ALT and AST levels of the dampness-heat constitution were statistically higher,indicating the statistically significant difference.The GGT level of the dampness-heat constitution was statistically higher than that of the moderateness constitution.The ALP levels of phlegm-dampness and the dampness-heat constitution were significantly higher than that of the moderateness constitution.(3)The triglyceride levels of dampness-heat and the phlegm-dampness constitution were statistically higher.TC levels of phlegm-dampness,yang deficiency,dampness-heat,and blood stasis constitution were statistically higher.(4)The mean arterial pressure levels of dampness-heat,phlegm-dampness,and qi depression constitution were statistically higher.The BMI levels of phlegm-dampness,dampness-heat,and qi depression constitution were statistically higher.(5)The fibrosis degree of hepatic tissues of most patients with 89.7%moderateness,81.8%qi depression,97.5%dampness-heat,and 100% blood stasis was G2-4,while that of most patients with 86.2%moderateness,93.3%qi deficiency,and92.3%yang deficiency was S0-1.The inflammation level of hepatic tissues of the dampness-heat constitution was statistically higher.The fibrosis degree of hepatic tissues of qi depression and blood stasis constitution was statistically higher.The steatosis level of hepatocytes of the phlegm-dampness constitution was statistically higher.(6)The LSM value of the qi depression constitution was significantly higher than that of the moderatenessconstitution.4.Through disordered and multi-classification logistic regression analysis and with moderateness constitution as the reference,it was found that age,ALT and GGT are the risk factors for qi depression constitution.The OR(95%CI)value is 2.112(1.265~3.528)?1.135(1.024 ~ 1.259)? 1.102(1.002 ~ 1.211).Age and LSM value are the risk factors for damp-heat constitution.The OR(95% CI)value is 1.426(1.033 ~ 1.969)? 4.905(1.489 ~16.156).BMI,age,fatty change of liver cells,triglyceride and LSM value are the risk factors for phlegm-dampness constitution.The OR(95%CI)value is 3.822(1.452 ~ 10.059)?1.431(1.029~1.992)?1.204(1.026~1.413)?9.412(1.012~87.537)?4.546(1.326~15.578).Conclusion:There were certain rules in the TCM constitution distribution:higher incidence of phlegm-dampness and dampness-heat,and less distribution of moderateness,qi deficiency,yang deficiency,qi depression and blood stasis for CHB patients with NAFLD.The different TCM constitution types of patients could be combined for diagnosis and treatment.2.There was certain relationship between the TCM constitution types of CHB patients with NAFLD and their gender,HBV DNA,TBIL,ALT,AST,GGT,ALP,TC,TG,MAP,BMI,CAP value,inflammation of hepatic tissues(G),fibrosis degree of hepatic tissues(S),steatosis of hepatocytes and LSM value.It has reference value for the prevention and treatment of CHB patients with NAFLD to analyze the relationship between the distributive regularity of TCM constitutions and physicochemical indexes of CHB patients with NAFLD,and use different treatments for patients with different TCM constitutions.