| Objective:1.To investigate the correlation between the factors of syndrome type of syndrome and the level of serum NPY in patients with different degree of hepatitis and cirrhosis; 2.To observe the effect of traditional Chinese medicine intervention on serum NPY level in patients with compensated cirrhosis.Methods:1.Correlation between serum NPY level and disease type syndrome elements in patients with hepatitis and cirrhosis:this research based on the 973 "syndromes of liver cirrhosis and micro indicators relevance" of "syndrome and law mechanism of action and research on the Treatment of Liver Cirrhosis", which collected 801 cases of investigation, observed relevance between syndrome factors and NPY.(1)using a unified "hepatitis cirrhosis clinical information collection list", which was formulated by this team, to do a national multi center cross-sectional epidemiological survey, to collect the general condition of patients, symptoms and other information, and to collect blood samples and unify detection index;(2)based on the expert consensus, "hepatitis cirrhosis often witness syndromes identification standard" formed to make the common determination in patients with the syndrome elements;(3)precluded the use of data entry task unified management platform established a database, and complete the double, dual independent entry, applicated SPSS20.0 statistical package for statistical data analysis;(4)observed syndromes distribution of liver cirrhosis patients with different severity;(5) analysis serum levels of NPY in patients with liver cirrhosis of different severity grade 2.Effect of traditional Chinese medicine intervention on serum NPY levels in patients with compensated hepatitis B cirrhosis:this study based on the 973 "medical interventions for decompensated cirrhosis" of "syndrome and law mechanism of action and research on the Treatment of Liver Cirrhosis", which collected 144 patients who were treated for six months.(1) Using a unified "hepatitis cirrhosis clinical information collection list", which was formulated by this team, the use of block randomized, controlled, blinded in principle to do a clinical intervention research in three research centers, which followed the general condition of patients, symptoms and other information, and to collect 144 cases in line with decompensated liver cirrhosis diagnostic criteria and common syndrome factors determining patient criteria, all included patients were randomly divided into a, B, C three groups, respectively, treatment principles, "Qi and spleen, liver qi, Ruanjian meridians", " Qi and spleen, liver qi, Ruanjian meridians, yin nourishing the liver, "the recipe grain simulation agent administered intervention,1 bag each time,2 times a day, respectively, in the morning, after dinner water transfer service;(2) Observation points were baseline and six months, respectively, detected serum NPY levels;(3) In this study, by a group of 973 project (project number:2011CB505100) unified management, the establishment of a database platform-"like syndromes and liver stores Research information system "data entry and database management, data entry using the machine back to back double entry, and by the second entry to be checked, applicated SPSS20.0 statistical package for statistical data analysis;(4) analysis changes of NPY levels in three groups after intervention, the rate of changes of NPY levels in three groups after interventionResults:1.Correlation between serum NPY level and disease type syndrome elements in patients with hepatitis and cirrhosis:801 cases of patients with liver cirrhosis collected in this study, the measured value of NPY were 714 cases. Child-Pugh classification, A grade 278 cases, including 38 males, female 85 cases, mean age (48.00 ± 14) years of age; B grade 286 cases, male 210 cases, female 76 cases, mean age (53.00 ± 13) years; C grade 150 cases,105 cases were male,45 females, mean age (49.00±14) years. The average age is higher than Class A Class B and Class C, and there is significant difference (P <0.05); three sex constitutes no significant difference (P> 0.05). Decompensated 272 cases,188 cases were male, female 320 cases, mean age (48.73 ± 9.28) years; decompensated 442 cases,84 cases were male, female 122 cases, mean age (50.18 ± 9.35) years. Decompensated average age is higher than compensated, and there is significant difference (P<0.05); two sex constitutes no significant difference (P> 0.05). Activities of the 565 cases,403 cases were male, female 162 cases, mean age (51.00 ± 14) years; resting 149 cases,105 cases were male,44 females, mean age (48.00 ± 14) years. Two age no significant difference (P> 0.05), two sex constitutes no significant difference (P> 0.05).(1) compared the severity of different levels in patients with liver cirrhosis NPY:NPY levels of child-Pugh A stage patients was significantly higher than B and C grade (P<0.05), NPY levels of decompensated patients was significantly lower than compensated (P<0.05), no significant difference NPY levels in patients with active and quiescent(P> 0.05).(2) common syndrome elements distribution in patients with liver cirrhosis:seven kinds of disease frequency distribution of elements in varying degrees of disease, in addition to Yin Deficiency and Qi Stagnation determination group, the remaining elements of the frequency distribution of various diseases are Child-Pugh B level significantly higher than A and C; except Yin Deficiency, Qi Stagnation, Damp Heat determination group, the remaining elements of the frequency distribution of various diseases were significantly higher than the compensatory determination; in addition to Damp Heat and Qi Stagnation determination group, the remaining elements of the frequency distribution of various diseases are significantly higher than the activity of the stationary phase;(3) NPY levels between the two groups of determination and non-determination of the disease syndrome elements:expect Qi Deficiency, NPY levels of the rest determined group are lower than the non-determination group, NPY levels of Yin Deficiency, Damp Heat, Qi Deficiency, Yang Deficiency determination and non-determination group were significantly different in comparison groups; men, in addition to Blood Stasis and Qi Deficiency, NPY levels of the rest determined group are lower than the non-determination group, NPY levels of Yin Deficiency, Damp Heat, Qi Deficiency, Yang Deficiency determination and non-determination group were significantly different in comparison groups; women, in addition to Blood Stasis and Qi Deficiency, water retention, NPY levels of the rest determination group are lower than the non-determination group, NPY levels of Yin Deficiency, Qi Stagnation, Yang Deficiency determination and non-determination group were significantly different in comparison groups.(4)NPY level comparison in syndrome elements of determination and non-determination group with different severity:serum NPY levels of Child-Pugh A grade in Yin Deficiency, Qi Stagnation, Yang Deficiency determination group were significantly lower than the rest of the elements of various diseases; serum NPY levels of Child-Pugh B grade in Yin Deficiency determination group were significantly lower than the rest of the elements of various diseases, however, Qi Deficiency was vice versa; serum NPY levels of Child-pugh C grade in Qi Deficiency determination group were significantly lower than the rest of the elements of various diseases; serum NPY levels of compensation in Yin Deficiency, Qi Stagnation, Yang Deficiency determination group were significantly lower than the rest of the elements of various diseases; serum NPY levels of decompensated in Yin Deficiency, Qi Deficiency determination group were significantly higher than the rest of the elements of various diseases, however, Blood Stasis was vice versa; serum NPY levels of activity period in Yin Deficiency, Yang Deficiency determination group were significantly lower than the rest of the elements of various diseases, Qi Deficiency is the opposite; serum NPY levels of stationary phase in Yin Deficiency, Qi Stagnation, Yang Deficiency determination group were significantly higher than the rest of the elements of various diseases.Above differences were statistically significant (P<0.05).2. Effect of traditional Chinese medicine intervention on serum NPY levels in patients with compensated hepatitis B cirrhosis:This study collected 144 cases of patients with decompensated cirrhosis, the measured value of NPY were 127 cases. A group of 40 cases, including 28 males and 12 females, mean age (49.70 ± 7.07) years, mean disease duration (3.00 ± 5.00), the average NPY levels (249.53 ± 11.81); group B 43 cases, including 28 males, 15 women, mean age (48.77 ± 9.91) years, mean disease duration (2.00 ± 5.00), the average NPY levels (268.51 ± 10.58); group C 44 cases,35 males and 9 females, mean age (47.02 ± 8.43) years, mean disease duration (3.00 ± 4.00), the average NPY levels (245.23 ± 10.07). Among the three groups was no significant difference in mean age (P> 0.05) among the three groups no significant difference in the gender composition (P> 0.05) than that, there was no significant difference (P> 0.05) among the three groups course, among the three groups There was no significant difference (P> 0.05) NPY levels.(1) Comparison of serum NPY levels:serum NPY levels of A group, B group, C group in the six months were significantly higher than baseline (P<0.05); gender stratification, in men, except for group A and group B, serum NPY levels of C group in six months were significantly higher than baseline (P<0.05); in women, serum NPY levels of A group, B group, C group in the six months were significantly higher than baseline (P<0.05); stratified by age,20 to 29 years, serum NPY levels of group C in six months were higher than baseline (P> 0.05); 30-39 years, serum NPY levels of B group in the six months were significantly higher than baseline (P<0.05); 40 to 49 years, serum NPY levels of A group, B group, C group in the six months were significantly higher than baseline (P<0.05); 50-59 years,60 to 69 years, serum NPY levels of all groups in six months were higher than baseline (P> 0.05).(2) Comparison of serum NPY levels among groups:among the three groups after the intervention the comparison of serum NPY levels had no significant difference (P> 0.05), three groups of NPY in descending order were B group, C group, A group; men and women stratified, among the three groups after the intervention the comparison of serum NPY levels had no significant difference (P> 0.05), the three groups in descending order of NPY comparison were B group, C group, A group; stratified by age, between 30 to 39 years old, among the three groups after the intervention the comparison of serum NPY levels had no significant difference (P> 0.05), the three groups in descending order of NPY comparison were B group, C group, A group, multiple comparisons among groups showed that, serum NPY levels of group B in six months was significantly higher than other groups (P<0.05); between 40 to 49 years, among the three groups after the intervention the comparison of serum NPY levels had no significant difference (P> 0.05), the three groups in descending order of NPY comparison were B group, A group, C group; between 50 to 59 years, after the intervention group among the three levels of NPY compare the difference was not significant (P> 0.05), the three groups in descending order of NPY comparison were B group, C group, A group.(3) the rate of serum NPY change in each group:the rate of serum NPY changes after the intervention in each group were positive, there were no statistical difference (P> 0.05) among the three groups, the rate of change of serum NPY were B group> A group> C group; stratification factors in men and women, in men, the rate of serum NPY changes after the intervention in each group were positive, there were no statistical difference (P> 0.05) among the three groups, the rate of change of serum NPY were B group> C group> A group; in women, the rate of serum NPY changes after the intervention in each group were positive, there was no statistical difference among the three groups (P> 0.05), the rate of change of serum NPY were group B> a group> C group.Conclusions:1.Correlation between serum NPY level and disease type syndrome elements in patients with hepatitis and cirrhosis(1) With the increase of the severity in liver cirrhosis, serum NPY levels tended to decrease;(2) serum NPY levels in patients with different syndromes of certain elements are different, serum NPY levels in patients with Yang Deficiency and Qi Deficiency are significantly lower than other syndromes patients. Serum levels of NPY reflect the severity of the patient to a certain extent, and have some correlation with common class syndrome factor.2.Effect of traditional Chinese medicine intervention on serum NPY levels in patients with compensated hepatitis B cirrhosis(1) The clinical intervention show, group B in the principles of "Qi and spleen, liver qi, Ruanjian meridians, nourishing yin" to guide the formulation particles may increase serum levels of NPY to a certain extent;(2) between 30 to 39 years old female patient in the principles of "Qi and spleen, liver qi, Ruanjian meridians, nourishing yin" to guide the formulation particles may increase serum levels of NPY improvement is better. |
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