Study On The Distribution Characteristics Of TCM Syndromes Of Non-alcoholic Fatty Liver Disease With Gallstone Disease

Research objective:To study and analyze the TCM syndrome distribution of nonalcoholic fatty liver with cholelithiasis,so as to provide basis for clinical treatment.Research method:1.According to the method of cross-sectional investigation,questionnaire was designed.The First Affiliated Hospital of Yunnan University of traditional Chinese medicine was selected as the research object,from December 2017 to November 2019,285 patients with NAFLD and Gd were collected,276 cases were actually effective,and 276 samples were finally included in the study.Collect the basic information,life style,four diagnostic information,physical examination,blood lipid,liver function and other biochemical indicators of patients.2.Using spss23.0 to analyze the data collected,Using spss23.0 statistical analysis of data collected by factor analysis method to study the non-linear dimensionality reduction of NAFLD combined with Gd patients,in order to analyze the characteristics of NAFLD combined with Gd patients.3.The measurement data is expressed by X±s,the relationship between the distribution of TCM syndromes and sex,age,blood lipid,liver function in patients with NAFLD and Gd was analyzed by variance analysis.The test standard P < 0.05 was significant difference.Research results:The general clinical data of NAFLD patients with Gd are as follows:1.There were 129 males and 147 females,the age of male is mainly 40-49,and that of female is 50-59;The main diet of NAFLD patients with Gd was high fat diet(63.4%),93.5% of patients with NAFLD and Gd lacked exercise;Among 276 patients with NAFLD and Gd,55.08% had BMI≥24.The mean BMI of male and female was 24.69±3.47 and 24.30 ±3.29 respectively,There was no significant difference in BMI between men and women(P > 0.05).2.In this study,73.55% of the patients were single syndrome type,26.45% of the patients had complex syndrome type.According to the frequency and proportion of syndrome types,Damp turbid internal stop syndrome(110cases)>Damp heat syndrome of liver and gallbladder(90cases)> Syndrome of liver depression and spleen deficiency(57cases)>Syndrome of stagnation of liver Qi(29cases)>Deficiency of liver yin(28cases)>Syndrome of phlegm and blood stasis(19cases)>Deficiency of spleen and kidney(13cases).In addition,1 case of spleen and stomach weakness,1 case of Qi and blood deficiency,and 1 case of kidney yang deficiency.The main manifestation of the complex syndrome type is Damp turbid internal stop syndrome with Syndrome of liver depression and spleen deficiency,Damp heat syndrome of liver and gallbladder with Syndrome of stagnation of liver Qi,Damp heat syndrome of liver and gallbladder with Syndrome of liver depression and spleen deficiency,they accounted for 5.80%,3.26% and2.54% of the total samples.The distribution characteristics of NAFLD combined with Gd and the relationship between them:1.The symptoms and pulse of tongue with frequency more than 10% were statistically analyzed.Among 276 patients,the symptoms were right flank fullness,obesity,chest and epigastric fullness,tiredness,stomachache and dizziness,The tongue veins are mostly thick and greasy with smooth veins.By factor analysis,it can be concluded that the syndrome types of TCM are mainly Damp turbid internal stop syndrome,Damp heat syndrome of liver and gallbladder,Syndrome of liver depression and spleen deficiency,Syndrome of stagnation of liver Qi,among which the most is stagnation of Damp turbid internal stop syndrome,which is consistent with the frequency of syndrome types.2.Before 30 years old,there were few syndrome types,after 30 years old,the syndrome types increased,the peak of syndrome types was mainly 40-69 years old.Only in Damp turbid internal stop syndrome,more male patients than female patients,Other syndromes,more women than men.3.TG of each syndrome type was generally increased;Compared with deficiency of liver yin,TC and LDL-C were significantly higher and HDL-C was significantly lower in patients with Damp turbid internal stop syndrome and Damp heat syndrome of liver and gallbladder(P < 0.05);The ALT of the patients with Damp turbid internal stop syndrome and Damp heat syndrome of liver and gallbladder was significantly higher than that of the patients with Syndrome of liver depression and spleen deficiency,Syndrome of stagnation of liver Qi and Deficiency of liver yin(P < 0.05);The AST of the patients with Damp turbid internal stop syndrome was significantly higher than that of the patients with Deficiency of liver yin(P < 0.05);The GGT of the patients with Damp heat syndrome of liver and gallbladder was significantly higher than that of the patients with Damp turbid internal stop syndrome,Syndrome of liver depression and spleen deficiency and Deficiency of liver yin(P < 0.05);The CHE of the patients with Damp turbid internal stop syndrome and Damp heat syndrome of liver and gallbladder was significantly higher than that of the patients with Syndrome of stagnation of liver Qi(P < 0.05).Research conclusions:1.The distribution characteristics of 276 cases of NAFLD combined with Gd are as follows:Damp turbid internal stop syndrome > Damp heat syndrome of liver and gallbladder > Syndrome of liver depression and spleen deficiency > Syndrome of stagnation of liver Qi>Deficiency of liver yin>Syndrome of phlegm and blood stasis>Deficiency of spleen and kidney.Among them,damp turbid internal stop syndrome,Damp heat syndrome of liver and gallbladder,Syndrome of liver depression and spleen deficiency and liver stagnation and Syndrome of stagnation of liver Qi are the main ones.2.The basic pathogenesis of NAFLD combined with Gd is that the spleen is not healthy,the liver is not dredged,and the gallbladder is not unblocked,damp evil was the main pathological factor.3.The patients with Damp turbid internal stop syndrome and Damp heat syndrome of liver and gallbladder are often accompanied with dyslipidemia and liver function damage,in other syndrome types,except for the general increase of TG,other blood lipid indexes and liver function were not significantly abnormal.The dyslipidemia of the patients with Damp turbid internal stop syndrom E and Damp heat syndrome of liver and gallbladder mainly manifested as the increase of TG,TC,LDL-C and the decrease of HDL-C;The main manifestations of liver function damage in patients with Damp turbid internal stop syndrome were ALT,AST and CHE;The main manifestations of liver function damage in patients with hepatobiliary Damp heat syndrome of liver and gallbladder are ALT,GGT and CHE.