Analysis Of The Syndrome Differentiation And Clinical Feature Of 69 Patients With Non-alcoholic Fatty Liver Disease

Background Non-alcoholic fatty liver disease (NAFLD) has its widespectrum, which ranges from fat in the liver—simple steatosis,Non-alcoholic steatohepatitis (NASH) and/or fibrosis to advancedfibrosis and cirrhosis when fat may no longer be present. NAFLD isassociated with obesity, diabetes, insulin resistance (IR), andhypertriglyceridemia. There is no established medical treatment for NASH,but moderate sustained weight loss is the mainstay of therapy. Treatmentsaimed at the various pathogenic mechanisms that lead to the developmentof NAFLD are sorely needed.Objectives To investigate the principles of non-alcoholic fatty liverdisease in etiology and therapeutics in Chinese Medicine (CM). And todocument the principle for syndrome differentiation in CM.Methods All the 69 eligible patients with NAFLD were recruited into thisclinical trail. All the necessary information was collected to build thedatabase. Analyze all the data as following: 1. Descriptive statistics.2. The difference of the syndrome differentiation between the NAFLD+DMgroup and NAFLD+DM group. 3. The difference of enzyme labeled compoundassay for liver function test among every syndrome differentiation groupin CM. 4. The difference of blood-fat assay among every syndromedifferentiation group in CM. 5. The difference of BMI and PLT among everysyndrome differentiation group in CM. 6. The difference of enzyme labeledcompound assay for liver function test and blood-fat assay among groupswith certain result of type-B ultrasonic examination. 7. The differenceof BMI and PLT among every group with certain result of type-B ultrasonicexamination.Results 1. The number of cases recruited in this trial is Phlegm Retentionand Blood-Stasis Syndrome＞Spleen Qi Deficiency and Retention of Body Fluid＞Spleen Qi Deficiency＞Liver and Kidney Yin Deficiency. 2. TheNAFLD+DM-group consist of 31 cases while NAFLD-DM-group consists of 38cases. 3. There was significant difference in the absolute ALP level inserum level among every syndrome differentiation group in CM, while therewere no significant differences in the other items for liver function testin serum level among every syndrome differentiation group in CM. 4. Therewere no significant differences in the all items for blood-fat test inserum level among every syndrome differentiation group in CM. 5. There wereno significant differences in BMI and PLT among every syndromedifferentiation group in CM. 6. There were significant differences in ALT,TB, HDL-C, and LDL-C among groups with certain result of type-B ultrasonicexamination while there were no significant differences in the other items,including ALP, AST, GGT, DB, IB, TP, ALB, GLO, TBA, BMI and PLT.Conclusions The proportion of the patients with Excess Syndrome is morethan that of the patients with Deficiency Syndrome and with coexistenceof Deficiency and Excess according to the theory of Chinese Medicine. Itseems that there is relevance between ALP and the Syndrome Differentiationin CM. It also seems that there is relevance between ALT and the resultsof the type-B ultrasonic examination. However, the elevation of the ALTlevel does not parallel with the results of the type-B ultrasonicexamination. NAFLD is a condition characterized by hepatomegaly, elevatedserum aminotransferase levels, and a histologic picture similar toalcoholic hepatitis in the absence of alcohol abuse. And many factorsmight be relevant to the onset of NAFLD. So the accurate diagnosis andthe evaluation of NAFLD should depend on the results of the biopsy of liver,the results of the type-B ultrasonic examination, the results of CT andthe liver function test together, other than on the single one.