非酒精性脂肪肝中医证型及相关因素临床分析

Clinical Analysis of the Characteristics of NAFLD TCM Syndrome Type and Related Factors

目的：探讨非酒精性脂肪肝（NAFLD）中医证型和相关因素的关系。方法：将212例NAFLD患者进行中医辨证分型,归纳常见证型、症状以及舌脉,将8种中医证型与年龄、性别、BMI以及生化指标等因素进行相关性比较。结果：NAFLD患者最常见症状包括：乏力、右胁痛、便溏、胸闷气短;最常见舌质为淡红舌、紫舌,舌苔为白腻苔、薄白舌;最常见脉象为弦脉、滑脉、沉脉;NAFLD患者共归纳为8种证型,以痰湿内阻以及痰瘀互结型最为多见;8种证型中,只有肝肾阴虚型女性发病率高于男性;77.4%患者BMI指数超标,其中痰湿内阻以及痰瘀互结两证型尤其明显;30岁以下患者以痰湿内阻型为主,31~60岁患者以痰湿内阻和痰瘀互结证为主,61~90岁患者以肝肾阴虚型为主;在理化指标方面,瘀血阻络型患者多伴有谷氨酰转肽酶升高;肝郁脾虚型和湿热蕴结型患者多伴有甘油三酯升高;湿热蕴结型患者多伴有总胆固醇升高;空腹血糖、血尿酸与证型分布无明显差异。结论：NAFLD中医证型与年龄、性别、BMI以及生化指标等因素呈一定相关性。

Objective：To explore the relationship betweennon-alcoholic fatty liver syndrome type of traditional Chinese medicine and related factors. Methods：212 cases of NAFLD patients by syndrome differentiation of TCM,compared the 8 kinds of TCM syndrome type and age,gender,BMI and biochemistrial indexs. Results：The most common symptoms of NAFLD patientsinclude：fatigue,pain in the right hypochondrium,loose stool,chest tightness,shortness of breath.The most commontongue is pink tongue,purple tongue,the most common tongue moss is white greasy,Bao Baishe;the mostcommon pulse include string pulse,slippery pulse,deep pulse.The NAFLD patients with phlegm dampness and phlegm and blood stasis were the most. Among the 8 types,only the pathogenesis of yin deficiency of liver and kidney was higher than that of male female ratio.77.4% patients with BMI index exceed the standard,the stagnation of phlegm dampness and phlegm and blood stasis syndromes especially two. Patients below 30 years old with phlegm dampness type;31-60 years old patients with phlegm dampness and turbid phlegm and blood stasis;61~90 years old patients with liver kidney yin deficiency type mainly.In the physicochemical indexes,blood stasis type patients with higher GGT;The liver stagnation and spleen deficiency type and damp heat accumulation type patients with abnormal triglyceride index;patients with damp heat accumulation type with higher total cholesterol,blood sugar and blood uric acid has nothing to do with type distribution. Conclusion：There is certain correlation between TCM syndrome type of NAFLD and age,sex,BMI and etc.