非酒精性脂肪肝中医病-体-证横断面调查

Cross-sectional study of Chinese medicine disease, constitution and syndrome of nonalcoholic fatty liver disease

目的:调查非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)中医病-体-证特点.方法:采用横断面流行病学方法,选取中国中医科学院望京医院脾胃病科、针灸科、骨科等住院患者,对NAFLD患者中医病症、体质、证候等方面进行调查.结果:共有98例NAFLD患者的调查结果进入统计分析,总体而言,大部分NAFLD患者肝功、血脂、生化、血常规等中医微观病证信息大致未见显著异常;体质为痰湿质占34.7%,湿热质占16.3%,血瘀质占16.3%,气郁质占10.2%,阳虚质占6.1%,平和质占6.1%,气虚质、湿热质+血瘀质各占3.1%;辨证属于痰湿内阻证占31.6%,湿热蕴结证占23.5%,痰瘀互结证占20.4%,湿浊内停证占13.3%,肝郁气滞证占8.2%,肝郁脾虚证占3.1%.结论:NAFLD以湿、热、痰、瘀四大证素为主,具体表现在痰湿质、湿热质、血瘀质三种体质及其兼夹体质以及痰湿内阻证、湿热蕴结证、痰瘀互结证、湿浊内停证四类证型,尚无特异性指标针对NAFLD患者进行充分评价.

AIM：To study the feature of Chinese medicine disease,constitution and syndrome of nonalcoholic fatty liver disease（NAFLD）.METHODS：The investigation was based on a cross-sectional epidemiological method.NAFLD subjects treated at Department of Gastroenterology,Acupuncture and Moxibustion,or Orthopaedics,Wangjing Hospital,China Academy of Chinese Medical Sciences were used to assess the Chinese medicine disease,constitution and syndrome of NAFLD.RESULTS：A total of 98 NAFLD subjects were included for statistical analysis.Overall,microcosmic Chinese medicine information including the liver function,blood fat,biochemistry,and blood routine examinations showed no significant abnormality in most of the subjects.Phlegmatic hygrosis was found in34.7% of all NAFLD subjects,damp heat was found in 16.3%,blood stasis in 16.3%,depressed vital energy in 10.2%,yang asthenia in 6.1%,equilibration in 6.1%,vital energy deficiency in 3.1%,and damp heat with blood stasis in 3.1%.Syndrome differentiation showed retention of phlegmatic dampness in 31.6% of all NAFLD subjects,stagnation of damp heat in 23.5%,phlegm accumulation with stagnant blood in 20.4%,turbi damp obstruction in viscus in 13.3%,stagnation of vital energy due to depression of the liver in 8.2%,and stagnation of liver vital energy with deficiency of the spleen syndrome in 3.1%.CONCLUSION：Syndrome elements of NAFLD mainly include dampness,heat,phlegm,and blood stasis.Phlegmatic hygrosis,damp heat,blood stasis and their combinations are the manifestations of NAFLD syndrome elements.Retention of phlegmatic dampness,stagnation of damp heat,phlegm accumulation with stagnant blood,and turbi damp obstruction in viscus are the main syndromes of NAFLD.There is no specific index for sufficient NAFLD evaluation.