非酒精性脂肪性肝病客观化指标与中医辨证分型关系探讨

目的:探讨非酒精性脂肪性肝病(NAFLD)客观化指标与中医辨证分型的关系。方法:筛选NAFLD患者176例及健康对照组60例,观察记录两组人员中医证侯、肝功能、血脂、B超、CT肝脾比值结果,根据临床证候对`NAFLD患者进行中医辨证分为肝郁脾虚型、湿热内蕴型、痰瘀互结型、肝肾不足型4组,与对照组及各组间相互比较,分析辨证分型与客观化指标之间的关系。结果:NAFLD患者中医辨证分型以肝郁脾虚居多(29.54%)。各临床分型与对照组相比其客观化指标均有不同程度的异常。各组间比较ALT升高多集中在湿热内蕴型和痰瘀互结型,TG升高多为痰瘀互结型,LDL、TC升高多为肝肾不足型,CT肝脾比值降低以湿热内蕴型和痰瘀互结型为甚,B超呈重度改变多发于湿热内蕴型。结论:NAFLD患者客观化指标与中医辨证分型具有一定的内在关系。

Relationship between objective indexes and TCM syndrome differentiation in nonalcoholic fatty liver disease

Objective:To investigate the relationship between objective indexes and TCM syndrome differentiation in nonalcoholic fatty liver disease(NAFLD).Methods:One hundred seventy-six cases of NAFLD patients and 60 cases in healthy control group were brought into this study to observe and record their TCM symptomatic,liver function,blood fat,B ultrasonic,the ratio of hepatic-splenic CT.According to the clinical symptoms of TCM syndrome differentiation,the patients were divided into 4 groups: liver stagnation and spleen deficiency,damp-heat syndrome,phlegm accumulating with blood stasis,liver-kidney deficiency,and then,compared with healthy control group.At the same time,the relationship between TCM syndrome differentiation and objective indexes among each groups were analysed.Results:The group of liver stagnation and spleen deficiency was the majority of TCM syndrome differentiation(29.54%).Compare with healthy control group,the objective indexes of TCM syndrome differentiation had different degrees of abnormalities.Comparisons among each groups:ALT elevation focused on the damp-heat syndrome and phlegm accumulating with blood stasis groups.Phlegm accumulating with blood stasis group has high level of TG,LDL,TC elevations focused on the liver-kidney deficiency group.Lower ratio of hepatic-splenic CT values focused on the damp-heat syndrome and phlegm accumulating with blood stasis groups.Serious NAFLD in B ultrasonic focused on the damp-heat syndrome group.Conclusion:There have same internal relationships between the objective indexes of NAFLD and TCM syndrome differentiation.