Study On The Distribution Of Bile Acid Spectrum In Different TCM Syndrome Types Of Non-alcoholic Fatty Liver Disease

Objective:By studying the distribution characteristics of non-alcoholic fatty liver disease(Non-alcoholic fatty liver disease,NAFLD)different bile acid profiles of different TCM syndrome types,the relationship between various TCM syndrome types of NAFLD and bile acid spectrum is explored to provide a reference for the treatment of NAFLD With an entry point.Methods:Selected NAFLD cases in the outpatient clinic of the Liver Disease Center of Xiamen City Chinese Medicine Hospital from November 2018 to November 2019,106patients with NAFLD were included according to the selection criteria,and the distribution of different TCM syndromes and bile acid spectrum and related indicators of NAFLD patients were analyzed Distribution differences.PSS25.0 was used for data analysis.The measurement data conformed to the normal distribution and were expressed as mean±standard deviation,while the non-normal distribution was expressed as the median(interquartile range).For the measurement data,if the normal distribution and variances are uniform,perform analysis of variance among multiple groups.If there is statistical difference,then further select the LSD-t test for pairwise comparison.And test or Kruskal-Wallis H test for analysis.For the R×C table data of unordered multi-categorical variables,the Pearson?~2 test was used.Result:1.General situation:A total of 106 patients met the inclusion criteria,including 27women and 79 men,accounting for 25.5%and 74.5%,respectively.2.Among the enrolled patients,the proportions of syndrome types are liver stagnation of spleen deficiency syndrome,phlegm internal obstruction syndrome,damp heat syndrome,phlegm and blood stasis syndrome,of which liver stagnation of spleen deficiency syndrome is the most,accounting for 38.6%.3.Comparison of BMI and CAP of various TCM syndrome types:There are statistical differences between the groups of BMI syndrome types(Z=7.815,P=0.005).Among them,the BMI of liver stagnation and spleen deficiency syndrome is the lowest,and the internal phlegm and turbidity syndrome is the highest.There was no statistical difference in the CAP value among the syndrome types(F=1.404,P=0.246).4.Comparison of liver function(ALT,AST,GGT)of various TCM syndrome types:There are statistical differences between the groups of ALT syndrome types(Z=3.470,P=0.019).The ALT level of liver stagnation and spleen deficiency syndrome is higher than other syndrome types.There were statistical differences between the AST syndrome types(Z=2.650,P=0.040).The AST levels of damp heat syndrome and phlegm-stasis syndrome were higher than those of the other two groups.There is no statistical difference between GGT syndrome groups(F=0.657,P=0.580).5.Comparison of blood lipid,fasting blood glucose and uric acid of different TCM syndrome types:TG syndrome groups have statistical differences(F=3.502,P=0.018),and TC syndrome groups(Z=4.476,P=0.007)There are statistical differences between FPG syndrome types(F=3.532,P=0.017);UA syndrome types(F=3.030,P=0.030)have statistical differences,HDL(F=1.404,P=0.246),LDL(F=1.018,P=0.398)There was no statistical difference between the syndrome types.6.Comparison of the bile acid spectrum of each TCM syndrome type with the control group of normal people:the up-regulated bile acids in the liver stagnation and spleen deficiency syndrome group compared with the normal control group include:UDCA,GDCA,TDCA,CA,GCDCA,GUDCA,TCDCA,TUDCA,TCA,down The bile acids include:CDCA,LCA,DCA,HDCA;the up-regulated bile acids in the phlegm internal obstruction syndrome group include:CDCA,UDCA,GCA,TDCA,CA,GCDCA,GUDCA,TUDCA,TCA;The bile acids include:GDCA,DCA,HDCA,TCDCA,LCA;the bile acids up-regulated in the damp heat syndrome syndrome group compared with the normal control group include:UDCA,GCA,CA,GCDCA,TUDCA,TCA,the down-regulated bile acids include:CDCA,GDCA,TDCA,LCA,DCA,HDCA,GUDCA,TCDCA;phlegm and blood stasis syndrome compared with the normal control group up-regulated bile acids include:GDCA,LCA,GCDCA,TUDCA,TCA,down-regulated bile acids include:CDCA,UDCA,GCA,TDCA,CA,DCA,HDCA,GUDCA,TDCCA.7.The bile acids with obvious differences among NAFLD syndrome groups include HDCA,GDCA,and TUDCA.No statistical difference.Result:1.Liver depression and spleen deficiency syndrome are the most common among various TCM syndrome types of NAFLD patients.2.The composition of serum bile acid spectrum of each TCM syndrome type of NAFLD patients is different from that of normal people.There are differences in HDCA,GDCA and TUDCA in serum bile acid spectrum of each TCM syndrome type.It is suggested that the index of serum bile acid spectrum can help to distinguish the TCM syndromes of non-alcoholic fatty liver disease to a certain extent.3.There are differences in BMI,ALT,AST,TG,TC,FPG,UA of various TCM syndrome types in NAFLD patients.Prompt NAFLD patients with different degrees of illness,there are differences in the composition of the bile acid spectrum of each TCM syndrome.