Study On The Characteristics Of TCM Syndromes In Middle-Aged And Elderly Patients With Non-Alcoholic Fatty Liver Disease

ObjectiveThis study uses multivariate statistical mathematical analysis methods to simplify the dimensionality reduction of the four-diagnosis information(including tongue and pulse)of 263 middle-aged and elderly patients with NAFLD,objectively conduct TCM syndrome differentiation of the included patients,and further explore the various TCMs according to the type of syndrome.The differences in biochemical indexes,anthropological indexes and fatty liver Fibro Touch scores between syndrome groups are used to verify the feasibility and rationality of syndrome differentiation based on factor analysis and cluster analysis,and to provide an objective reference for NAFLD TCM syndrome differentiation.Establish an objective,standardized,and specialized standard for syndrome differentiation of the disease to provide an objective basis.MethodsThis project uses a cross-sectional research method to collect information on middle-aged and elderly NAFLD patients who attended the outpatient,inpatient ward and physical examination center of the Gastroenterology Department of Wuhan Hospital of Integrated Traditional Chinese and Western Medicine(Wuhan First Hospital)from November 2019 to January 2021,including General information,information on the four diagnostics of TCM,combined diseases,biochemical indicators,anthropological indicators and other information,common factors are obtained through factor analysis combined with the information of the four diagnostics,and the factor scores are used as variables for systematic clustering,and finally a clinically meaningful cluster is obtained.Class results,combined with professional knowledge to interpret the clustering results,and determine the TCM syndrome type.Further grouping by syndrome type,to explore the differences of biochemical indicators,anthropological indicators,comorbid diseases and Fibro Touch index among the various syndrome groups.Results(1)Analysis of information from the four diagnostics of traditional Chinese medicine: The main syndromes of NAFLD include: body obesity,fullness of the abdomen,fatigue,chlorosis,insomnia,sticky stool,dry mouth,irritability,loose stools,dry eyes,belching,Dizziness,tongue appearance is mainly seen in pale tongue,thin white coating,and tongue with teeth marks.The pulse condition is more common in pulse string and pulse number.(2)Distribution of TCM syndrome types: The results of factor analysis and cluster analysis show that NAFLD TCM syndrome types mainly include spleen and kidney yang deficiency syndrome,phlegm and blood stasis syndrome,damp-heat accumulation syndrome,liver depression and spleen deficiency syndrome,including liver depression and spleen deficiency syndrome and damp-heat The proportion of patients with accumulation syndrome accounted for the highest,reaching 59.70%.(3)Analysis of syndrome types and biochemical indicators:The difference between ALT and ?-GT groups is phlegm and blood stasis mutual syndrome> damp-heat accumulation syndrome> liver depression and spleen deficiency,spleen and kidney yang deficiency syndrome;comparison between AST groups,phlegm and blood stasis mutual syndrome,damp-heat Syndrome of accumulation> liver depression,spleen deficiency,spleen and kidney yang deficiency;comparison between TC groups,syndrome of mutual accumulation of phlegm and blood stasis,damp-heat accumulation syndrome>syndrome of yang deficiency of spleen and kidney,liver depression and spleen deficiency syndrome;comparison between TG groups,mutual accumulation of phlegm and blood stasis Syndrome,damp-heat accumulation syndrome>spleen and kidney yang deficiency syndrome;comparison between LDL-C groups,phlegm and stasis accumulation syndrome> damp-heat accumulation syndrome,spleen and kidney yang deficiency syndrome,liver depression and spleen deficiency syndrome;comparison between BUA groups,spleen and kidney yang syndrome Deficiency syndrome> Syndrome of mutual accumulation of phlegm and blood stasis,syndrome of liver depression and spleen deficiency(P<0.05).(4)Syndrome types and anthropological indicators: comparison between BMI groups,phlegm and blood stasis mutual accumulation syndrome,damp-heat accumulation syndrome> spleen and kidney yang deficiency syndrome,liver stagnation and spleen deficiency syndrome;comparison between WC,WHR,WHTR groups,damp-heat accumulation syndrome>phlegm Syndrome of mutual accumulation of blood stasis,syndrome of yang deficiency of spleen and kidney,syndrome of liver depression and spleen deficiency(P<0.05).(5)Analysis of syndrome types and combined diseases: combined with the proportion of atherosclerosis,phlegm and blood stasis syndrome> liver depression and spleen deficiency syndrome;combined with the proportion of hypertension,phlegm and blood stasis syndrome> spleen and kidney yang deficiency syndrome;obesity proportion,phlegm and blood stasis syndrome Syndrome,damp-heat accumulation syndrome> liver depression and spleen deficiency syndrome;hyperlipidemia,phlegm and blood stasis syndrome,spleen and kidney yang deficiency syndrome> liver depression and spleen deficiency syndrome(P<0.05);(6)syndrome type and Fibro Touch scale: mild Distribution of NAFLD syndrome types,liver depression and spleen deficiency syndrome> phlegm and blood stasis syndrome;severe ANFLD syndrome distribution,phlegm and blood stasis syndrome,damp-heat accumulation syndrome> liver depression and spleen deficiency syndrome(P<0.05).ConclusionAfter analyzing the four-diagnosis information,anthropological indicators,biochemical indicators and other related information of 263 middle-aged and elderly NAFLD patients collected by Wuhan First Hospital,it is found that: 1.The frequency of single clinical symptoms of NAFLD is relatively high,and the most frequent symptom is body shape.Obesity(67.68%),and the clinical symptoms of NAFLD have non-specific characteristics;2.The common syndromes of middle-aged and elderly patients with NAFLD are: liver stagnation and spleen deficiency syndrome,damp-heat accumulation syndrome,phlegm and blood stasis syndrome,and spleen and kidney yang deficiency syndrome.Liver stagnation and spleen deficiency syndrome and damp-heat accumulation syndrome are the most common;3.Liver inflammation of phlegm and blood stasis mutual accumulation syndrome and damp-heat accumulation syndrome is more obvious than other syndromes,blood lipid level is higher than other syndromes,and both syndromes are concentrated in severe Fatty liver suggests that the syndrome of phlegm and blood stasis and damp-heat accumulation is more severe than other syndrome types;4.The difference in clinical indicators between syndrome types shows that the syndrome differentiation based on factor and cluster analysis is reasonable.