Study On The Mechanism Of Gallstone Combined With Non-alcoholic Fatty Liver Disease And Its Tcm Constitution

Objective: Through the analysis of differences of metabolic indexes between patients with gallstone(GD)combined non-alcoholic fatty liver disease(NAFLD)and other control groups,the possible mechanism of their comorbidity was discussed;and through the analysis of the relationship between the common traditional Chinese Medicine(TCM)Constitution Types and the metabolism indexes of the comorbidity patients,the possible pathogenic mechanism of TCM constitution was discussed.Methods: Randomly selected total 350 subjects from General surgery of Anhui Armed Police Corps Hospital on January 2019 to June 2019.98 patients with gallstone and non-alcoholic fatty liver disease were divided into GD combined NAFLD group,60 patients with non-alcoholic fatty liver disease were divided into NAFLD group,132 patients with gallstone were divided into GD group and 60 healthy persons were divided into Normal Group.First,the questionnaire survey was used to collect objective data such as gender,age,height,weight and TCM constitution.Second,the main indicators of subjects were collected and organized,including: BMI,blood lipid(TG,TC),glycometabolism(FPG,FINS,HOMA-IR),liver function(ALT,AST)and pro-inflammatory factors(TNF-α,IL-6).Then,we used SPSS 24 analysis software for data statistics and analysis,the main conclusions were drawn,with P<0.05 as the significant difference.Results: 1.The levels of BMI,TG,ALT,FINS,HOMA-IR,TNF-α and IL-6 in GD combined NAFLD group are significantly higher than those in other groups(P <0.01);2.BMI is positively correlated with TG(r = 0.71,P <0.01),TNF-α(r = 0.75,P <0.01),IL-6(r = 0.73,P <0.01),HOMA-IR(r = 0.65,P <0.01)in GD combined NAFLD group;3.The top three TCM constitution types in patients with GD combined NAFLD are phlegm dampness(21.4%),qi deficiency(17.4%),dampness heat(14.3%);4.The BMI and IR of phlegm dampness,qi deficiency and dampness heat were higher than those of yang deficiency.(P<0.05).Conclutions: 1.GD combined NAFLD may be related to the increased of BMI,TG,ALT,FINS,HOMA-IR,TNF-α and IL-6.2.The comorbidity mechanism of GD combined NAFLD may be based on the increase of BMI and TG,which then leads to the formation of a large amount of adipose tissue,then adipose tissue necrosis stimulates the release of pro-inflammatory factors(TNF-α,IL-6),increase IR levels,and causes liver Cell damage,which is manifested by an increase in serum(ALT,AST).3.Common types of TCM constitutions in patients with GD combined NAFLD are Phlegm dampness,Qi deficiency and Dampness heat.4.The phlegm dampness,qi deficiency and dampness heat may lead to the occurrence of their comorbidity by increasing BMI and IR levels.