Study On Prevention And Treatment Of Non-alcoholic Fatty Liver Disease By TCM Health Management Model Based On The Theory Of Differentiation

Study one:Preliminary study on evaluation of patients with Non-Alcoholic Fatty Liver Disease based on CAP valueObjective:Through the analysis of difference of different degree of steatosis in patients with NAFLD between Controlled Attenuation Parameter(CAP value), the correlation between Controlled Attenuation Parameter(CAP value) and body mass index(BMI)、 liver function(ALT, AST)、 blood lipids(TG, TC, HDL, LDL)、 blood glucose(GLU),preliminary study the value of Controlled Attenuation Parameter(CAP value) assessment of Non-Alcoholic Fatty Liver Disease patients,determined the optimal cut-off value of NAFLD patients with Controlled Attenuation Parameter(CAP value) to judge the degree of different disease.Method:Select 103 cases of patients with mild、moderate and severe NAFLD and 32 cases of healthy control group confirmed by abdominal ultrasound, calculation body mass index(BMI),detection liver function(ALT、AST)、blood lipids(TG、TC、HDL、LDL)、blood glucose(GLU),using Transient Elastography(TE) Fibro Touch diagnostic apparatus measured Controlled Attenuation Parametter(CAP)values,comparing the difference between the groups of patients with CAP values,analysis the correlation among CAP value with the degree of liver steatosis、the clinical index,and using the receiver-operating characteristic(ROC) curve analysis the accuracy of classification diagnosis NAFLD by Transient Elastography(TE) measured Controlled Attenuation Parametter(CAP) values.CAP value of each groups:healthy control groups:242.8±6.91db/m,mild NAFLD groups:246.90±6.49db/m,moderate NAFLD groups:277.71±8.43db/m, severe NAFLD groups:309.74±11.46db/m,the difference was statistically significant(P<0.05);between groups were statistically significant(P<0.01),except for control group and mild NAFLD group;CAP value was positively correlated with the degree of liver steatosis by ultrasound diagnosis,R=0.819;CAP value was positively correlated with BMI、TG、TC and GLU,R Spearman were 0.528, 0.420, 0.327,0.258;CAP value diagnosis of mild NAFLD groups、moderate NAFLD groups and severe NAFLD groups Area Under Receiver Operating Characteristic ROC were 0.798、0.722、0.739,95% Confidence Interval were(0.683,0.894)、(0.588,0.855)、(0.617,0.861);the best cut-off value respectively: 247.4db/m、256.7db/m、293.8db/m。Conclusion:Transient Elastography(TE) has a significant correlation with CAP value and ultrasound in the diagnosis of NAFLD,Transient Elastography(TE) in the diagnosis of different degree of steatosis in patients with NAFLD ROC is different,it can be used for the noninvasive, quantitative diagnosis of NAFLD, with a high value of classification diagnosis。The doctor can given priority to CAP values,and comprehensive analysis of the liver ultrasound、BMI、TG、TC、GLU and other high risk factors when clinical evaluation of patients with NAFLD condition。Study two:Observation the curative effect by TCM health management model based on body constitution identification in prevention and treatment of Non-Alcoholic Fatty Liver DiseaseObjective:Through the comprehensive intervention、analysis and evaluation of the patients with Non-Alcoholic Fatty Liver Disease,observation the Traditional Chinese Medicine health management mode relies on the combination of body differentiation and syndrome differentiation to Result: improve conditions in patients with NAFLD,such as body mass index(BMI)、liver function(ALT, AST)、blood lipids(TG, TC, HDL and LDL)、glucose(GLU)、Controlled Attenuation Parameter values(CAP)、constitution and syndrome integral,etc. definite the curative effect of prevention and treatment of Non-Alcoholic Fatty Liver Disease by the health management mode based on the theory of differentiation.Methods:Using randomized controlled trials,collection of 118 cases of moderate and severe NAFLD patients met the inclusion criteria,randomly divided into TCM health management group(67cases,management group)and modern medicine treatment based on disease group(51 cases,control group).Two groups were given diet and exercise guidance of basic health mission education,management group given the body differentiation and syndrome differentiation of TCM treatment,the control group only give general protect liver and lipid-lowering therapy,the course of treatment was 3 months。Compared two groups of baseline data before into the group, after 3 months, observe two groups of patients changes with body mass index(BMI)、liver function(ALT, AST)、blood lipid(TG, TC, HDL and LDL)、 glucose(GLU)、Controlled Attenuation Parameter(CAP)、constitution and syndrome score changes.Result:100 patients were followed.Two groups had no significant difference in sex ratio、the types of ultrasound dividing、constitution, BMI、age、liver function(ALT, AST)、blood lipid(TG, TC, HDL and LDL)、 blood glucose(GLU)、CAP、constitution and syndrome integra,comparability between groups。The total effective rate of control group was 91.22%, and the total effective rate of control group was 93.02%,there was no significant difference in the curative effect of the 2 health management methods(P>0.05);comparison of the management group before and after its own test,BMI、 ALT、AST、 TG、TC、 LDL、 blood glucose、CAP、physical points all decreased,the difference was statistically significant(P<0.01);HDL、the syndrome score all increased,the difference was statistically significant(P<0.01).Comparison of the control group before and after their own test,BMI、 ALT、AST、 TG、 TC、 LDL、 blood glucose、 CAP、 physical points all decreased,the difference was statistically significant(P<0.01);HDL increased,the difference was statistically significant(P<0.01); syndrome score decreased, but the difference was not statistically significant(P>0.05)。Comparison between the two groups after the test,management group of BMI、AST、TG、HDL、blood glucose、 constitution points were lower than the control group,but there was no statistically significant difference(P>0.05); management group CAP values higher than the control group, but there was no statistically significant difference(P>0.05);the syndrome score of management group was higher than that of control group,and the difference was statistically significant(P<0.01);management group TC、ALT lower than the control group, the difference was statistically significant(P<0.05).Conclusion:TCM health management mode based on body differentiation and modern medicine based on disease differentiation and treatment have a significant effect on improving the liver function、blood lipid and physical condition of patients with Non-Alcoholic Fatty Liver Disease,but the effects of TCM health management mode which distinguishes the body differentiation was more obvious than modern medicine treatment based on disease, more promotion value。...