Study On The Correlation Between Platelet Parameters And Alcoholic Liver Disease And Their Influence On The Distribution Of TCM Syndrome Type

Objective:By analyzing the correlation between platelet parameters and alcoholic liver disease(ALD),it provides a new serological index reference for ALD prediction and auxiliary diagnosis.To analyze the characteristics of platelet parameters among different TCM syndromes of ALD,study the influence of platelet parameters on the distribution of TCM syndromes,and introduce physical and chemical examination into the field of TCM syndrome identification,so as to provide new research ideas for the objectification and standardization of TCM syndrome differentiation and treatment of ALD.Methods:(1)This study included 130 patients who met the diagnostic criteria of ALD in Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine.The values of platelet parameters were collected and entered into the database.At the same time,the general information of all patients,including gender,age,past history,drinking history and so on,was entered into the database.A total of 130 subjects without recent drinking history and liver disease history were included as the control group,and the values of platelet parameters in the control group were collected.SPSS 20.0 software was used to analyze the data of the two groups to explore the correlation between platelet parameters and alcoholic liver disease.Multivariate logistic regression analysis was performed on the combination of parameters with significant differences between the ALD group and the healthy control group to study the most valuable parameters for predicting ALD.The ROC curve of this parameter was established to determine the optimal cutoff value and the prediction accuracy for predicting ALD.(2)The patients with ALD were divided into three groups:liver and gallbladder damp-heat syndrome,liver stagnation and spleen deficiency syndrome,liver and kidney yin deficiency syndrome.Statistical methods were used to analyze the differences of platelet parameters among different TCM syndromes,and to study the effect of platelet parameters on the distribution of TCM syndromes of ALD.Results:(1)A total of 130 patients with ALD were included in this study.There were significant differences in platelet count(PLT),mean platelet volume(MPV),plateletcrit(PCT)and mean platelet distribution width(PDW)between the ALD group and the control group(P<0.001).(2)ALD prediction results based on platelet parameters:①Logistic regression analysis results of PLT,MPV,PCT and PDW four platelet parameters combined to predict ALD:P values were 0.268,0.211,0.277 and<0.001,respectively.The P values of PLT,MPV and PCT were all greater than 0.05,which was not statistically significant.The P value of PDW was<0.001,which was statistically significant.And PDW index Logistic regression results suggest:B=1.176.②The results of ROC curve analysis of PDW parameters showed that the area under the curve(AUC)of PDW parameters for predicting ALD was 0.708,P<0.001,the optimal critical value for predicting ALD was 17.05,and the prediction accuracy was 70.8%.(3)TCM syndrome differentiation was performed on ALD patients,including 46 cases of liver and gallbladder damp-heat syndrome,69 cases of liver depression and spleen deficiency syndrome,and 15 cases of liver and kidney yin deficiency syndrome,The distribution of TCM syndromes was liver depression and spleen deficiency syndrome,liver and gallbladder damp heat syndrome,liver and kidney yin deficiency syndrome.The results of the difference analysis of platelet parameters between different TCM syndromes showed that there were statistically significant differences in PLT values between liver and gallbladder damp-heat syndrome,liver stagnation and spleen deficiency syndrome,liver and kidney yin deficiency syndrome(P<0.05).There was no significant difference in MPV,PCT and PDW values(P>0.05).The results of pairwise comparison of the three groups of syndromes showed that there was a statistically significant difference in PLT values between liver and gallbladder damp-heat syndrome and liver and kidney yin deficiency syndrome,liver stagnation and spleen deficiency syndrome and liver and kidney yin deficiency syndrome(P<0.05).The PLT values of liver and gallbladder damp-heat syndrome and liver stagnation and spleen deficiency syndrome were greater than those of liver and kidney yin deficiency syndrome.Conclusion:(1)Platelet parameters are correlated with ALD.Patients with ALD have abnormal platelet parameters,mainly manifested as decreased PLT,increased MPV,decreased PCT,and increased PDW.Platelet parameters can be used as serological indicators for ALD auxiliary diagnosis.(2)Among the platelet parameters,PDW had the highest value in predicting ALD,with a predictive critical value of 17.05 and an accuracy of 70.8%.PDW>17.05 is associated with the risk of ALD.Monitoring serum PDW levels is helpful for early detection and effective prevention of ALD and delaying the progression of ALD.(3)ALD TCM syndrome type is mainly liver depression and spleen deficiency syndrome,followed by liver and gallbladder damp heat syndrome,liver and kidney yin deficiency syndrome.PLT value in platelet parameters can affect the distribution of TCM syndromes of ALD,which has certain reference value for TCM syndrome differentiation of ALD,and can be used as an auxiliary reference index for TCM syndrome differentiation of ALD.