Study On The Correlation Between Syndrome Classification Of Fatty Liver Disease And The Color Doppler Ultrasonic Feature Or Blood Biochemical Indexes

Objective:This study is due to investigate the relationship between fatty liver "syndromes" of TCM and the color Doppler ultrasonic feature,blood biochemical indexes,approach the internal relations between fatty liver "syndromes" of TCM and modern medical objective indexes,and in order to guide the clinical application of color Doppler ultrasound examination,to make a earlier diagnosis and Prognosis in happening liver cirrhosis for different TCM syndrome in patients with fatty liver.Methods:seventy cases of fatty liver disease with different TCM syndromes and thirty cases of normal subjects as the contral group were included in the study,these cases from our hospital out-patient and in-patient.The diagnostic standard of patients with fatty liver disease referred to the standard that was formulated by Liver Gallbladder Disease of TCM,Boxiang Wang editor,including three syndromes,stagnation of hepatic Qi,Phlegm-stasis Blocking Collateral Type and in the Phlegm-Dampness Type.All of the above patients,including seventy cases of fatty liver disease with different TCM syndromes and thirty cases of normal subjects as the contral group,whose ultrasound examination of the indicators,including the performance of two-dimensional ultrasonographic and color doppler ultrasound,the largest occipitomental diameter of right hepatic lobe,echo of liver parenchyma,far-field echoes diaphragm and clarity of hepatic vascular image,doppler maximum blood flow velocity signal derived from Right hepatic vein(RHV),Middle hepatic vein(MHV),left hepatic vein(LHV),the diameter of the main portal vein,and the average blood flow velocity(TAMX), were tested by color doppler sonarography.Lab-measuing indexes included serum TC,TG and ALT.The above parameters were compared with healthy control group,Analysising and investigating the relationship between different TCM syndrome in patients with fatty liver's evidence of hemodynamic change and the severity of fatty liver disease so that explore the clinical significance.The quantitated indexes were analyzed with one-factor analysis of statistical software of SPSS13.0 edition.Results:1.To study the diameter of main portal vein and the average velocity of blood flow of portal vein in fatty liver patients with different TCM syndromes showed and the healthy control group:Among them,stagnation of hepatic Qi in patients with fatty liver disease shows no clear differences.However,the diameter of main portal vein was widened,the average blood flow velocity of the portal vein was decreases in the Phlegm-stasis Blocking Collateral Type and in the Phlegm-Dampness Type(P＜0.01),which difference was a significant.Furthermore, their respective comparison between three different TCM syndrome in patients with fatty liver,there was a significant difference,the diameter of main portal vein was significantly widened,the average blood flow velocity of the portal vein was significantly decreases in the Phlegm-stasis Blocking Collateral Type(P＜0.01).2.To study the blood flow spectra of Middle hepatic vein(MHV)and Right hepatic vein(RHV) in fatty liver patients with different TCM syndromes showed and healthy control group:Peak systolic velocity(PSV) of Middle hepatic vein(MHV) and Right hepatic vein(RHV) were decreased in the Phlegm-Dampness Type and in the Phlegm-stasis Blocking Collateral Type than that in the stagnation of hepatic Qi,the differences was statically significant(P＜0.001).Moreover,along with the worsening of fat liver,Peak systolic velocity(PSV) decreased gradually.3.To study lab-measuing indexes included TC and TG,ALT in fatty liver patients with different TCM syndromes showed and healthy control group:TC and TG,ALT in different TCM syndromes fatty liver patients were significantly higher than those in healthy control subjects,and the difference had statistical significance(P＜0.01). And their respective comparison between three different TCM syndrome in patients with fatty liver,TC and TG,ALT in stagnation of hepatic Qi was higher than healthy people,However,but the difference was not significant compared to Phlegm-stasis Blocking Collateral Type and in the Phlegm-Dampness Type.(P＞0.05).Blood levels of ALT and TC Concentration increasing in Phlegm-Dampness Type of fatty liver patients,but this difference was not significant compared to stagnation of hepatic Qi and Phlegm-stasis Blocking Collateral Type(P＞0.05). Blood levels of ALT and TG Concentration enrichment in Phlegm-stasis Blocking Collateral Type,and the difference had statistical significance(P＜0.01).Conclusion:The ultrasound sonogram feature of liver and lab-measuing indexes included TC and TG,ALT had an important guid sense to the different TCM syndrome in patients with fatty liver.The types of syndrome in fatty liver disease.Patients were different,as well as the degree of liver lesion was inequality, doppler maximum blood flow velocity signal derived from Right hepatic vein(RHV),Middle hepatic vein(MHV),the diameter of the main portal vein,and the average blood flow velocity(TAMX) changed correspondingly.And those changes were coincident to the changes of syndromes in fatty liver disease.The patients with stagnation of hepatic Qi were mainly in light grade fatty liver, however the patients for Phlegm-Dampness Type were mainly in moderate grade fatty liver,and the patients for Phlegm-stasis Blocking Collateral Type were mainly in high grade fatty liver.Color Doppler ultrasound examination methods and blood biochemical indexes included alanine aminotransferase(ALT),total cholesterol(TC) and triglyceride(TG) is valuable in judging the different TCM syndrome types of fatty liver.These examination Methods will provide reliable reference of understanding of the evolvement of fatty liver disease and Prognosis.Forecasting fatty liver disease develop early stag of liver cirrhosis.