Distribution Characteristics Of TCM Syndrome Elements In Chronic Hepatitis B Combined With Non-alcoholic Fatty Liver Disease

Objective:By obtaining the distribution characteristics of TCM syndrome elements in patients with chronic hepatitis B(CHB)combined with non-alcoholic fatty liver disease(NAFLD),we analyzed the relationships between TCM syndrome elements and biochemical indexes,CAP value of this disease.To provide a reference basis for CHB combined with NAFLD TCM clinical syndrome differentiation and TCM syndrome type research,so as to provide a better solution for the clinical treatment of this disease with integrated traditional Chinese and Western medicine.Methods:The subjects of this study were 395 patients with CHB and NAFLD who met the diagnostic criteria from July 2020 to November 2021 in the Liver Disease Center of Xiamen Traditional Chinese Medicine Hospital.Collect the patient’s four diagnostic information and general information,biochemical indicators,and clinical data related to liver fibrosis CAP value,and use the "Traditional Chinese Medicine Health Status Identification System" developed by the Syndrome Base of Fujian University of Traditional Chinese Medicine to calculate the syndrome elements score.Using SPSS 25.0 software for statistical analysis,the clinical characteristics of TCM syndrome elements in CHB combined with NAFLD and their relationship with biochemical indexes and CAP values were summarized.Results:1.Among CHB patients with NAFLD,male patients(84.1%)> female patients(15.9%).Young patients(72.2%)> middle-aged patients(26.3%)> elderly patients(1.5%).The overweight population(49.1%)> the standard population(27.8%)> the obese population(22.8%)> the lean population(0.3%).2.Common clinical symptoms: fatigue(85.8%),thirst(27.6%),loose stools(24.3%).Common tongue symptoms: red tongue(50.6%),greasy coating(41.8%),yellow coating(37.7%),common pulse symptoms: stringed pulse(95.8%),slippery pulse(43.5%).3.Dampness,phlegm,heat,qi stagnation,blood stasis,qi deficiency,yin deficiency and yang deficiency are the main syndromes of disease.The frequency of dampness is the highest(90.1%),followed by phlegm(88.6%).The symptoms of disease location were sorted by frequency: spleen(82.0%)> liver(69.1%)> gallbladder(34.4%)> kidney(11.1%).In the combination of syndrome elements,the combination of three syndrome elements is the most common(24.8%),and the main syndrome is damp + heat + phlegm(13.9%).The combination of syndrome elements of two disease sites was the main type(35.0%),and the combination of liver and spleen accounted for the highest proportion(26.3%).4.The frequency of dampness,heat,stagnation of qi,deficiency of qi and deficiency of yang in different genders was statistically significant(P<0.05).5.The frequency of yang deficiency,heat,qi deficiency,phlegm and kidney in different age groups was significantly different(P<0.05).6.There are positive correlations between dampness,heat,phlegm,liver,gallbladder and ALT,AST.There has positive correlations between dampness,heat,phlegm,spleen,gallbladder and GGT(r>0,P<0.05).7.There are positive correlations between dampness,phlegm,spleen and TC.There are positive correlations between dampness,heat,phlegm,liver,spleen,gallbladder and TG(r>0,P<0.05),and a negative correlation with H-DLC(r < 0,P < 0.05).8.Blood stasis,dampness,phlegm,liver,and spleen had statistically significant differences in liver fibrosis CAP value grading(P<0.05).9.Using phylogenetic clustering(R-type clustering),the 12 syndrome elements were divided into four categories.The first category are dampness,heat,phlegm,spleen,the second category are qi stagnation,liver,gallbladder,the third category is qi deficiency,yang deficiency,and kidney,and the fourth category is blood stasis and yin deficiency.Conclusion:1.The syndrome elements of the disease are mainly dampness,phlegm,heat,qi stagnation,blood stasis,qi deficiency,yin deficiency and yang deficiency,and the syndrome elements of the disease location are mainly liver,spleen,gallbladder and kidney.The disease involves multiple syndrome elements,and the condition is more complicated.2.The distribution of syndrome elements was different in different ages and genders.There were correlations between syndrome elements and liver function,blood lipids and CAP.3.Through cluster analysis,the possible syndrome types of CHB combined with NAFLD were obtained: damp-heat phlegm obstruction,liver and gallbladder qi stagnation,kidney yang qi deficiency,blood stasis blocking collaterals,yin deficiency syndrome.