Clinical Study On Relationship Between Serum Tumor Necrosis Factor-α Levels Of Non-alcoholic Fatty Liver Disease And TCM Syndrome

Objective:To study the correlation between non-alcoholic fatty liver disease in patients with tumor necrosis factor-a level and TCM syndrome, provide an objective basis for TCM syndrome Differentiation-Type of NAFLD, and provide new ideas and methods in the future research for NAFLD prevention and treatment of combination of Chinese and Western medicine.Methods:1. Selected100persons with criteria of the healthy. Selected200patients with criteria of NAFLD.2With reference to "non-alcoholic fatty liver disease Integrative treatment program (pilot program2008)", we categorised the200patients with NAFLD into TCM syndrome of stagnation of liver qi syndrome, liver stagnation and spleen deficiency syndrome, phlegm-dampness syndrome, internal accumulation of damp-heat syndrome, the interaction of phlegm and stasis syndrome, and classified no typical clinical symptoms in patients to no clinical symptom syndrome.3.Applied enzyme-linked immunosorbent assay (ELISA) to quantitative determination of serum TNF-a concentration of selected patients and healthy persons. The determined data were statistically analyzed.Results:1. The serum level of TNF-a concentration (12.11±2.47) in the NAFLD patients group was higher than in that the healthy control group (7.03±0.57), and they were statistically significant difference (P=0.000<0.01).2. The serum level of TNF-a concentration in each TCM syndrome group of NAFLD patients was higher than in that the healthy control group, and they were statistically significant differences (between the liver qi syndrome group and the healthy control group P=0.002<0.01,I,P=0.000<0.01).3. Comparison in the serum level of TNF-a concentration in the each TCM syndrome:the interaction of phlegm and stasis syndrome group (13.75±2.05) and internal accumulation of damp-heat syndrome group (13.40±1.79)> phlegm-dampness syndrome group (11.33±1.87) and no clinical symptom syndrome group (11.89±1.67)>liver stagnation and spleen deficiency syndrome group(10.24±1.10)> stagnation of liver qi syndrome group(8.55±1.59). Liver stagnation and spleen deficiency syndrome group was significantly higher than stagnation of liver qi syndrome group (P=0.003<0.01). Phlegm-dampness syndrome group was significantly higher than liver stagnation and spleen deficiency syndrome group and stagnation of liver qi syndrome group (all P=0.000<0.01).No clinical symptom syndrome group was significantly higher than liver stagnation and spleen deficiency syndrome group and stagnation of liver qi syndrome group (all P=0.000<0.01). There was no statistical difference between the serum level of TNF-a concentration of phlegm-dampness syndrome. group and no clinical symptom syndrome group (P=0.237>0.05). Internal accumulation of damp-heat syndrome group was significantly higher than phlegm-dampness syndrome group, no clinical symptom syndrome group, liver stagnation and spleen deficiency syndrome group and stagnation of liver qi syndrome group (all P=0.000<0.01). The interaction of phlegm and stasis syndrome group was significantly higher than phlegm-dampness syndrome group, no clinical symptom syndrome group, liver stagnation and spleen deficiency syndrome group and stagnation of liver qi syndrome group (all P=0.000<0.01). There was no statistical difference between the serum level of TNF-a concentration of the interaction of phlegm and stasis syndrome group and Internal accumulation of damp-heat syndrome group (P=0.337>0.05)Conclusion:1. The serum level of TNF-a concentration of the group of NAFLD patients with was higher than the healthy control group. NAFLD patients with elevated serum TNF-a and the close relationship between NAFLD incidences, could be added to provide objective reference indicator for clinical treatment and prognosis.2.The serum level of TNF-a concentration of the interaction of phlegm and stasis syndrome group and internal accumulation of damp-heat syndrome group were the highest. Then phlegm-dampness syndrome group was the second highest. Liver stagnation and spleen deficiency syndrome group was the third highest. Stagnation of liver qi syndrome group was the lowest. Evolution of the level of change and traditional Chinese medicine pathogenesis of patients with NAFLD, serum TNF-a concentration (stagnation of liver qi→liver stagnation and spleen deficiency→phlegm-dampness→internal accumulation of damp-heat→the interaction of phlegm and stasis) to the basic line.So it had reference value on TCM Syndrome Differentiation-Type of NAFLD.3. There was no statistical difference between the serum level of TNF-α concentration of phlegm-dampness syndrome group and no clinical symptom syndrome group. The patients of no clinical symptom syndrome may already exist in the phlegm of the evil block the pathogenesis of liver context.