Relationship Between TCM Syndromes Of Nonalcoholic Fatty Liver And Ultrasonic Classification,Hcy And 1,25-（OH）₂D₃

Objective:To study the relationship between TCM syndrome type and ultrasonic classificati-on,serum homocysteine and 1,25-dihydroxyvitamin D3 in patients with non-alcoholic s-imple fatty liver,and to analyze and discuss the changing rule of indexes among dif-ferent syndrome types.To deepen the objective understanding of TCM syndrome diffe-rentiation of non-alcoholic simple fatty liver.Methods:From Feb.2018 to Feb.2019,the outpatient department and health management center of the second people’s Hospital affiliated to Fujian University of traditional Chi-nese Medicine were selected.The patients with fatty liver were examined by ultrasou-nd,and 200 cases were included in this study.At the same time,40 cases of physical examination patients in health management center were selected as control group.Cli-nical data of patients were recorded:name,sex,age,height,weight,body mass index,alcohol consumption,liver ultrasound classification,homocysteine,1,25-dihydroxy vita-min D₃,SPSS20.0 statistical software was used for statistical analysis of the data.Results:1.Ultrasonic classification:there was significant difference among different syndr-ome types（P<0.05）.Mild fatty liver（72.5%,62.5%,respectively）,moderate fatty liver（52.5%,55.0%）in phlegm-dampness internal obstruction group and damp-heat accumu-lation group,respectively,were found in liver stagnation and qi stagnation group,and liver stagnation and spleen deficiency group were mainly fatty liver（72.5%,62.5%,r-espectively）.Middle and severe fatty liver（45.0%,35.0%）was the main group of ph-legm and blood stasis.Non-alcoholic simple fatty liver was mainly mild and moderat-efatty liver（42.5%,40.5%respectively）.2.Homocysteine:there was significant difference among different syndrome types（P<0.05）.The highest level was in phlegm-stasis syndrome group（21.88±3.62）,follo-wed by damp-heat accumulation group（20.67±3.60）,phlegm-dampness internal obstru-ction group（16.66±2.66）,liver depression and spleen deficiency group（11.94±2.79）,liver stagnation and qi stagnation group（10.98±2.22）.Normal control group（8.54±1.92）.3.1,25-dihydroxyvitamin D₃:there was significant difference among different syn-drome types（P<0.05）.The decrease of phlegm-stasis syndrome group was the most o-bvious（11.09±3.20）,followed by damp-heat accumulation group（20.87±3.70）,phleg-mdampness internal obstruction group（20.44±3.89）,liver depression and spleen defici-ency group（29.67±4.32）,liver stagnation and qi stagnation group（29.44±3.69）.Nor-mal control group（29.61±3.29）.4.Pearson correlation analysis and grade data linerelated Kendall test showed that there was a negative correlation between homocysteine and 1,25-dihydroxyvitamin D₃（r=-0.549,P<0.05）.there was a active correlation between ultrasound and the levels of homocysteine,1,25-dihydroxyvitamin D₃（τ=0.544,-0.424,P<0.05）,respectively.The v-alue of 25-dihydroxyvitamin D₃ decreased.There was no correlation between homocyst-eine,1,25-dihydroxyvitamin D₃ and sex,BMI.Ultrasonic classification had no correla-tion with sex,but had positive correlation with BMI（τ=0.115,P<0.05）,suggesting that BMI increased with the aggravation of ultrasound.Conclusion:1.The ultrasonic classification of liver,homocysteine,1,25-dihydroxyvitamin D₃ in different TCM syndrome types of nonalcoholic simple fatty liver disease were different,and serum homocysteine showed an increasing trend with the aggravation of liver ultr-asonic classification.1,25-dihydroxyvitamin D₃ showed a downward trend.These three indexes can be used as auxiliary indexes to judge the severity of this disease,which can provide objective basis for TCM differentiation of symptoms and signs,and prov i-de a new way of thinking for the diagnosis of non-alcoholic simple fatty liver.