非酒精性脂肪性肝病患者中医体质和实验室指标研究

Study on traditional chinese medicine constitution and laboratory indicators of non alcoholic fatty liver disease

目的:采用横断面调查研究非酒精性脂肪性肝病(NAFLD)的发病因素,对患者进行中医体质分型,比较不同中医体质患者的血压、血糖、血脂、脂肪化程度等,为辨体论治提供依据。方法:判定195例NAFLD患者的体质类型,记录血压、血糖、血脂、脂肪化程度等,分析中医体质与实验室指标、B超结果之间的关系;采用Logistic回归分析不同中医体质的危险因素。结果:NAFLD患者中痰湿质42.56%、湿热质21.54%、气虚质12.82%、气郁质8.21%、血瘀质5.13%、阴虚质4.62%、阳虚质3.08%、特禀质2.05%。不同体质患者性别、年龄比较,差异无统计学意义(P>0.05)。痰湿质、湿热质、气郁质NAFLD患者血压异常率较大(P<0.05)。气虚质NAFLD患者血脂异常比率较大(P<0.05)。痰湿质、湿热质、气虚质、气郁质NAFLD患者血糖异常比率较大(P<0.05)。痰湿质NAFLD患者中度脂肪化比率较大(P<0.05)。以是否为该体质为因变量(赋值1=是,0=否),将上述单因素分析有意义的指标作为自变量进行Logistic回归分析,显示高血压、高血糖也是痰湿质、湿热质、气郁质NAFLD的危险因素;高血脂、高血糖也是气虚质NAFLD的危险因素。结论:临床应从中医体质角度对NAFLD患者危险因素进行干预,采用健康宣教和生活干预为主,消除危险因素,改善体质,预防NAFLD的发生。

Objective:To study the pathogenic factors of nonalcoholic fatty liver disease(NAFLD)by cross-sectional investigation,to classify the patient′s physique,and to compare the blood pressure,blood sugar,blood lipid,and fatty degree of patients with different TCM physiques,to provide a basis for the differentiation of physique and treatment.Methods:A survey was conducted on 195 patients with NAFLD according to the"Classification and Judgment of Traditional Chinese Medicine Constitution"to determine the type of constitution,record blood pressure,blood sugar,blood lipids,and degree of adiposity,and analyze the relationship between traditional Chinese medicine constitution and laboratory indicators,as well as B-ultrasound results.Then we used logistic regression to analyze the risk factors of different traditional Chinese medicine constitutions.Results:The proportion of NAFLD patients from high to low was 42.56%for phlegm dampness,21.54%for damp heat,12.82%for qi deficiency,8.21%for qi stagnation,5.13%for blood stasis,4.62%for yin deficiency,3.08%for yang deficiency,and 2.05%for intrinsic quality.There was no significant difference in gender and age among patients with different constitutions(P>0.05).The abnormal rate of blood pressure in NAFLD with phlegm dampness,dampness heat,and qi stagnation was relatively high(P<0.05).The ratio of NAFLD Dyslipidemia in qi deficiency syndrome was higher(P<0.05).The ratio of NAFLD dyslipidemia in phlegm dampness syndrome,damp heat syndrome,qi deficiency syndrome,and qi stagnation syndrome was higher(P<0.05).The moderate fatty rate of phlegm dampness NAFLD was relatively high(P<0.05).Taking whether the constitution was the dependent variable(assigned 1=yes,0=no)and using the meaningful indicators in the single factor analysis as independent variables for logistic regression analysis,it was found that hypertension and high blood sugar were also risk factors for phlegm dampness,dampness heat,and qi stagnation in NAFLD.Hyperlipidemia and hyperglycemia were also risk factors for NAFLD due to qi deficiency.Conclusion:Clinical intervention should be conducted on the risk factors of NAFLD patients from the perspective of traditional Chinese medicine constitution,mainly through health education and life intervention,to eliminate risk factors,improve constitution,and prevent the occurrence of NAFLD.