非酒精性脂肪肝中医证型及临床生化指标相关性研究

顾立梅; 曹培让; 顾超; 魏兰福; 田耀洲

非酒精性脂肪肝中医证型及临床生化指标相关性研究

1.
江苏省中西医结合医院消化科，江苏南京 210028
2.
哈佛医学院贝斯女执事医疗中心，马萨诸塞州 02215

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出版历程
- 刊出日期: 2019-11-10

Correlation Between Traditional Chinese Medicine Syndrome and Clinical Biochemical Indexes of Non-Alcoholic Fatty Liver

1.
Department of Gastroenterology, Jiangsu Province Hospital of Integration of Chinese and Western Medicine, Nanjing, 210028, China
2.
Beth Israel Deaconess Medical Center, Harvard Medical School, MA, 02215, USA

摘要

摘要: 目的探讨非酒精性脂肪肝（NAFLD）患者的中医证型分布规律、特征及其临床因素的相关性。方法以249例NAFLD患者为研究对象，将其辨证分为湿浊内停证、肝郁脾虚证、湿热蕴结证、痰瘀互结证、脾肾两虚证共5种证型，探讨各中医证型与年龄、性别、BMI及血清生化指标的相关性。结果 ①证型占比：湿浊内停证30.1%，肝郁脾虚证28.1%、湿热蕴结证25.7%、痰瘀互结证8.8%、脾肾两虚证7.2%;②男女比例约1.39∶1，湿热内蕴、湿浊内停证患者以男性为主（P<0.05）；肝郁脾虚证者则以女性为主（P<0.01）;③湿热内蕴证组ALT升高最为显著，与湿浊内停证、肝郁脾虚证组比较存在统计学差异（P<0.05）。湿浊内停证TC升高最为显著，与肝郁脾虚证、湿热内蕴证、脾肾两虚证组相比，均存在统计学差异（P<0.05）。结论 NAFLD中医证型以湿浊内停证、肝郁脾虚证、湿热内蕴证最为常见；男性发病率高于女性；湿热内蕴证患者更易出现ALT损伤；湿浊内停证更容易出现TC升高。
- 非酒精性脂肪肝 /
- 中医证型 /
- BMI /
- 临床指标
Abstract: OBJECTIVE To explore the distribution law， characteristics and clinical factors of traditional Chinese medicine (TCM) syndrome types in patients with non-alcoholic fatty liver disease (NAFLD). METHODS 249 patients with NAFLD were enrolled in the study， and their syndrome differentiation was divided into five types: damp-turbidity stagnation syndrome， liver depression and spleen deficiency syndrome， accumulation of damp-heat syndrome， obstruction of phlegm and stasis syndrome and spleen-kidney deficiency syndrome. To explore the correlation between TCM syndrome types， age， gender， BMI and blood purification indicators. RESULTS ①Proportion of syndrome types: damp-turbidity stagnation syndrome accounting for 30.1%， 28.1% for liver depression and spleen deficiency syndrome， accumulation of damp-heat syndrome 25.7%， obstruction of phlegm and stasis syndrome 8.8%， spleen-kidney deficiency syndrome 7.2%.②The ratio of male to female was about 1.39∶1. The patients with accumulation of damp-heat syndrome and damp-turbidity stagnation syndrome were mainly male (P<0.05); those with liver depression and spleen deficiency syndrome were mainly female (P<0.01). ③The alanine transaminase (ALT) elevation in the accumulation of damp heat syndrome was the most significant， and there was statistical difference compared with that of patients with damp-turbidity stagnation syndrome and the liver depression and spleen deficiency syndrome group (P<0.05). The total cholesterol (TC) elevation was the most significant in the damp-turbidity stagnation syndrome， and there was a statistical difference compared with the liver depression and spleen deficiency syndrome， accumulation of damp-heat syndrome， and spleen-kidney deficiency syndrome group (P<0.05). CONCLUSION The most common TCM syndrome types of NAFLD are damp-turbidity stagnation syndrome， liver depression and spleen deficiency syndrome and accumulation of damp-heat syndrome. The male incidence rate is higher than that of female; accumulation of damp-heat syndrome is more liable to induce ALT injury; damp-turbidity stagnation syndrome is more likely to cause TC elevation.
- non-alcoholic fatty liver /
- traditional Chinese medicine syndrome /
- BMI /
- clinical index

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