非酒精性脂肪性肝病相关危险因素与中医分型的关系

Relationship between correlated risk factor of non-alcoholic fatty liver disease and its traditional Chinese medicine syndrome differentiation type

目的通过流行病学调查,分析非酒精性脂肪性肝病(NAFLD)的相关危险因素与中医辨证分型的关系,为中西医结合防治NAFLD提供理论依据。方法 NAFLD组所有患者按中医辨证分型标准分为肝郁脾虚证、湿热内蕴证、痰瘀互结证、肝肾亏虚证4型,分析年龄、性别、体质量指数(BMI)、血压、血脂、血糖等NAFLD相关危险因素与中医分型的关系。结果肝郁脾虚证以轻度脂肪肝最多见;湿热内蕴证以中度脂肪肝最多见;痰瘀互结证以中度脂肪肝最多见,次为重度脂肪肝;肝肾亏虚证以重度脂肪肝最多见。肝郁脾虚证三酰甘油(TG)、空腹血糖(FBG)、谷丙转氨酶(ALT)正常或轻度升高;湿热内蕴证ALT、TG、FBG轻度升高;痰瘀互结证ALT、TG、FBG明显升高,BMI以痰瘀互结证最高;肝肾亏虚证ALT正常或轻度升高,但其SBP、DBP、TG、FBG明显升高。结论 NAFLD患者脂肪肝B超分度、TG、BMI、FBG、血压等与NAFLD的中医辨证分型密切相关。

Objective It is to analyze the relationship between the correlated risk factors of non-alcoholic fatty liver disease（NAFLD） and the typing results of traditional chinese medicine（TCM）syndrome differentiation based on epidemiological investigations,thus to provide theoretical reference for the control of NAFLD through combining traditional chinese and western medicine.Methods Within the NAFLD Group,according to the syndrome differentiation typing theory of TCM,the subjects were sub-grouped as Liver Stasis and Spleen Deficiency Syndrome,Damp-hot Internal Holding Syndrome,Sputum Stagnation Syndrome,and Liver-Kidney Deficiency Syndrome.The connections between TCM typing and NAFLD risk factors such as age,sex,BMI,blood pressure,blood-lipid,blood sugar were studied.Results Liver Stasis and Spleen Deficiency Syndrome,with normal or slightly increased TG,FBG and ALT,was the major syndrome of mild type NAFLD.Damp-hot Internal Holding Syndrome,with slightly increased ALT,TG and FBG,and Sputum Stagnation Syndrome,with significantly increased ALT,TG and FBG and highest BMI,were two major types of moderate NAFLD.Liver-Kidney Deficiency Syndrome,with normal or slightly increased ALT and significantly increased SBP,DBP,TG and FBG,together with Sputum Stagnation Syndrome were major syndromes of severe NAFLD.Conclusion The sufferers＇ conditions of fat liver,TG,BMI,FBG and blood pressure are closely related with the Traditional Chinese Medicine syndrome differentiation typing.