Distributional Characteristics Of Syndrome Elements Of Syndrome Drift In Syndrome Of Liver Depression And Spleen Deficiency In Chronic Hepatitis B Complicated By Non-alcoholic Fatty Liver Disease

Objective:To observe the distribution and characteristics and to study biochemical,virological and histological features of syndrome drift in syndrome of liver depression and spleen deficiency in CHB complicated with NAFLD.Aiming at optimizing syndrome differentiation of traditional Chinese medicine and treatment.Methods:95 cases of syndrome of liver depression and spleen deficiency in CHB complicated with NAFLD patients in Xiamen Hospital of Traditional Chinese Medicine from September 2018 to November 2019 were enrolled in this study.Follow-up would be ended when the syndrome drift occurs and up to three months.TCM diagnostic information was recorded every 2 weeks and the laboratory indexes were recorded every month.Syndrome drift was defined as that with the development of disease,new symptoms or signs were emerging,but the symptoms or signs cannot lead to another pattern of syndrome due to the new symptoms or signs were inadequate neither in amount nor in severity.TCM diagnostic information were assessed by the Traditional Chinese Medicine Health Identification System software(developed by Fujian University of Traditional Chinese Medicine Syndrome Study Base).The data were analyzed by SPSS 22.0 software package.Results:1.The syndrome drift occurred in 49(51.6%,95% CI:41.6%,61.6%)of the 95 patients in this study.2.Baseline Data:There was significant statistical difference in the distribution of BMI(t=-2.338,P=0.022),LDL-c(Z=3.098,P=0.002),CAP(t=-2.300,P=0.024).There was no significant statistical difference in the distribution of quantitative HBsAg,HBeAg,HBV DNA loading,ALT,AST,ALP,GGT,TBil,TC,TG,FPG,LSM,age,gender,hepatic tissue inflammatory grade G,hepatic tissue fibrosis stage S in the two groups(P>0.05).3.The statistics analysis of syndrome elements which the score ?70 in the syndrome drift group:disease location syndrome elements were existed between pre-and post-syndrome drift include liver,gallbladder and stomach.The emerging disease location syndrome elements were kidney,heart-spitrit,uterus.Disease nature syndrome elements were existed between pre-and post-syndrome drift include phlegm,dampness,yin deficiency,yang deficiency,qi stagnation,qi deficiency,blood deficiency.The emerging disease nature syndrome elements were heat,cold,blood stasis,blood-cold,essence deficiency.4.The statistics analysis of the syndrome elements which the score>0(no matter ?70 or not)in the syndrome drift group:the disease location syndrome elements score of liver,kidney,heart,tendon and bone was significant statistical difference between syndrome drift and non-syndrome drift group(P<0.05).The disease location syndrome elements were existed between pre-and post-syndrome drift include liver.The emerging disease location syndrome elements were kidney,heart,tendon and bone.The disease nature syndrome elements score of water retention,yin deficiency,yang hyperactivity,qi stagnation,qi without Fixating,blood deficiency,essence deficiency was significant statistical difference between syndrome drift and non-syndrome drift group(P<0.05).The disease nature syndrome elements were existed between pre-and post-syndrome drift include yin deficiency,qi stagnation,qi without Fixating,blood deficiency,essence deficiency.The emerging disease nature syndrome elements were water retention,yang hyperactivity.Conclusion:1.Syndrome drift was found frequently in syndrome of liver depression and spleen deficiency in CHB complicated by NAFLD.During the follow-up period,49(51.6%,95%CI:41.6%,61.6%)cases of the 95 patients emerged syndrome drift,and patients with high BMI,or LDL-c,or CAP were more liable to emerge syndrome drift.2.In syndrome of liver depression and spleen deficiency in CHB complicated by NAFLD,the disease location syndrome elements liver and the disease nature syndrome elements yin deficiency,qi stagnation,qi without Fixating,blood deficiency,essence deficiency were throughout.The emerging disease location syndrome elements were kidney,heart,tendon and bone and the emerging disease nature syndrome elements were water retention,yang hyperactivity.