非酒精性脂肪性肝病中医证型与临床指标的相关性

目的:探讨非酒精性脂肪性肝病(NAFLD)中医证型与体质量指数(BMI)、血压、血清生化指标的关系。方法:对249例诊断为NAFLD进行中医辨证分型,分析湿浊内停、肝郁脾虚、湿热蕴结、痰瘀互结4组间BMI、血压、肝功能、血脂及空腹血糖等方面的差异,探讨NAFLD中医证型与各因素的关系。结果:湿浊内停型、肝郁脾虚型ALT、湿热蕴结型、痰瘀互结型BMI逐渐增高。4组中谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)值最低者均为湿浊内停组,谷丙转氨酶(ALT)、谷草转氨酶(AST)最高者为痰瘀互结组,湿浊内停组的ALT、AST与其他三组比较均有统计学差异;血糖方面,湿热蕴结组的空腹血糖(FBG)与其他三组比较有统计学差异;血脂上,湿浊内停组的胆固醇(TC)与肝郁脾虚组、湿热蕴结组及痰瘀互结组比较均有差异;4组间甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)无显著性差异。结论:NAFLD患者BMI指数、血压、血生化指标对其中医辨证有一定参考意义,可作为中医辨证分型的辅助指标。

Correlation Between TCM Syndromes and Clinical Indicators of Nonalcoholic Fatty Liver Disease

Objective:To investigate the correlation between TCM syndromes of nonalcoholic fatty liver disease(NAFLD) and body mass index (BMI),blood pressure and blood biochemical indices.Methods:Totally 249 patients diagnosed with NAFLD were conducted TCM syndrome differentiation.The differences of BMI,blood pressure,liver function,blood lipid and fast bloodglucose(FBG) between damp turbidity retention group,liver depression and spleen deficiency group,damp-heat accumulation group and intermingling of phlegm and blood stasis group were analyzed.The relations between the TCM syndromes of NAFLD and various factors were discussed.Resuhs:The BMI increased gradually in damp-heat accumulation group and intermingling of phlegm and blood stasis group.The ALT increased gradually in damp turbidity retention group and liver depression and spleen deficiency group.The lowest levels of ALT,AST and GGT were in damp turbidity retention group.The highest levels of ALT and AST were in intermingling of phlegm and blood stasis group.There were statistical difference of the levels of ALT and AST between damp turbidity retention group and the other three groups.As for blood sugar,there was statistical difference of the level of FBG between damp-heat accumulation group and the other three groups.As for blood lipid,there was difference of the level of TC between damp turbidity retention group and the other three groups.There were no significant difference of the levels of TG,HDL-C and LDL-C between the four groups.Conclusion:The BMI,blood pressure and blood biochemical indices are of referential significance and can be the auxiliary index for the TCM syndrome differentiation of NAFLD.