TCM Syndrome Distribution And Characteristics Of Fatty Liver Disease

Background:Fatty liver disease (FLD) is caused by many reasons not including specific liver-injury factors except for alcohol intake, and is regarded as a comprehensive clinicopeathological disease with large vacuoles of triglyceride fat accumulated in liver cells. To date, the cause and the pathology of FLD are poorly understood. TCM syndrome differentiation has not reached to a unique standard yet, and the adoption of different evaluation criteria restricts the efficiency of TCM application in FLD therapy. Establishment of a standard for TCM syndrome differentiation and investigation of syndrome distribution can play an important role in TCM diagnosis and therapy of FLD.Objective:This clinical study was designed to analyze the patients with FLD by investigation of their current status, understand the distribution of FLD based on TCM syndrome differentiation, statistically analyze the association of various syndromes with general information and biochemical indexes, as well as provide a basis for standardization of TCM diagnosis in FLD.Methods:A questionnaire survey was conducted within 129 patients who met FLD-inclusive criteria and received treatments from November 2009 to April 2011 in the clinic of Gastroenterology, the clinic of health for senior cadres, and at the Department of Cardiology, the Department of Diabetes, the Department of Nephrology, the Department of Endocrinology, and the Department of Gastroenterology in China-Japan Friendship Hospital. Distribution of FLD patients was determined based on a well-established syndrome standard. The age and gender distribution for each syndrome pattern was investigated using descriptive statistical analysis. The relation of TCM syndrome with drinking and exercise habit was analyzed using Chi-square test. Furthermore, the relation of TCM syndrome with body mass index (BMI) and biochemical indexes was also investigated with variance analysis.Results:1). General information. The average age of 129 patients was 46.91±14.87, with a distribution focus of 67.4% between 30 and 60. The male to female ratio was 1.63:1 including 80 men and 49 women subjects.2). TCM syndrome differentiation 129 subjects were statistically differentiated as dampness-heat of spleen and stomach (51.9%), stagnation of liver-energy and asthenia of spleen (22.5%), atypical syndrome (13.2%), Yin deficiency of liver and kidney (7.0%), and blood stasis obstruction (5.4%).3). The relation of TCM syndrome with general information. Dampness-heat of spleen and stomach was shown as the most frequent syndrome in each age group. More women were found than men with Yin deficiency of liver and kidney. By contrast, more men were found with the other syndromes. Of 129 subjects,83 lacked of exercise, while 34 subjects had a confirmed drinking habit. Of 129 subjects,60 subjects were overweight and 47 were obese. The mean of BGI was highest in subjects with dampness-heat of spleen and stomach.4). The relation of TCM syndrome with biochemical indexes. Hepatic dysfunction took up 38% of the total subjects. ALT and GGT were remarkably increased in subjects with blood stasis obstruction. Dyslipidemia took up 32.6% of the total FLD subjects. TG was increased in every syndrome pattern, and subjects with blood stasis obstruction were shown to have the highest mean of TG. Increase of CHO was only observed in subjects with dampness-heat of spleen and stomach. Subjects with blood stasis obstruction were shown to have the lowest HDL-C. Abnormal LDH-C was observed in subjects with dampness-heat of spleen and stomach and in subjects with Yin deficiency of liver and kidney. Abnormal fasting glucose took up 44.2% of the total subjects. Higher levels of fasting glucose were observed in subjects'with Yin deficiency of liver and kidney, followed by dampness-heat of spleen and stomach and Yin deficiency of liver and kidney.Conclusion:1). The sequence of TCM syndrome patterns sorted by the number of subjects are dampness-heat of spleen and stomach, stagnation of liver-energy and asthenia of spleen, atypical syndrome, Yin deficiency of liver and kidney, and blood stasis obstruction.2). High incidence of FLD is commonly found in individuals at an age ranging from 30 to 60. Men have been shown to have higher incidence of FLD than in women. Most patients with FLD are overweight or obese, and lacking in exercise.3). The syndromes are associated with several biochemical indexes. Remarkable GGT increase is associated with blood stasis obstruction. Furthermore, the lowest HDH-C is observed with blood stasis obstruction. Finally, increase of fasting glucose is associated with blood stasis obstruction.