[1]程亚伟,王婷,王珊,等.中医湿证与非酒精性脂肪肝程度关联性分析[J].西部中医药,2020,33(05):102-105.[doi:10.12174/j.issn.1004-6852.2020.05.29]
　CHENG Yawei,WANG Ting,WANG Shan,et al.The Correlation Analysis between TCM Dampness Syndrome and the Degrees of NAFLD[J].Western Journal of Traditional Chinese Medicine,2020,33(05):102-105.[doi:10.12174/j.issn.1004-6852.2020.05.29]
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中医湿证与非酒精性脂肪肝程度关联性分析
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
33
期数:
2020年05期
页码:
102-105
栏目:
出版日期:
2020-05-15

文章信息/Info

Title:
The Correlation Analysis between TCM Dampness Syndrome and the Degrees of NAFLD
文章编号:
1004-6852(2020)05-0102-04
作者:
程亚伟，王婷，王珊，丁一，蔡媛媛，薛兰霞，蔡敏
海南省中医院，海南 海口 201203
Author(s):
CHENG Yawei, WANG Ting, WANG Shan, DING Yi, CAI Yuanyuan, XUE Lanxia, CAI Min△
Hainan Provincial Hospital of TCM, Haikou 201203, China
关键词:
非酒精性脂肪肝; 中医湿证; FibroScan-CAP; 脂肪肝程度
Keywords:
NAFLD;  TCM dampness syndrome;  FibroScan-CAP;  the degrees of fatty liver
分类号:
R575
DOI:
10.12174/j.issn.1004-6852.2020.05.29
文献标志码:
B
摘要:
目的：探讨非酒精性脂肪肝病(nonalcoholic fatty liver disease，NAFLD)中医湿证与脂肪肝程度的关联性。方法：将NAFLD患者110例按照中医辨证分为中医湿证组90例(湿浊证组41例、湿热证组33例、痰瘀证组16例)及非湿证组20例(气滞证组)，另外招募正常对照组30例。用肝纤维化脂肪肝一体化诊断检查仪(FibroScan-CAP，502B)检测各组患者血脂、肝功能等，比较中医湿证(湿浊证、湿热证、痰瘀证)、非湿证(气滞证)与血脂、肝功能等的关系。结果：1)110例NAFLD患者中非湿证组(气滞证组)20例(18.2%)，湿证组90例(81.8%)，湿证患者比例大于非湿证患者，提示NAFLD的发生发展与中医湿证关系密切。2)中度脂肪肝非湿证组(气滞证组)占比最大，为75.0%(15/20)，与湿证各组比较差异有统计学意义(P＜0.05)；重度脂肪肝中非湿证组(气滞证组)与湿证各组比较，差异有统计学意义(P＜0.05)，且痰瘀证组占比最大，为68.7%(11/16)，与非湿证组、湿浊证组比较差异有统计学意义(P＜0.05)，提示各组脂肪肝程度从轻到重依次为：非湿证(气滞证)＜湿浊证/湿热证＜痰瘀证。3)与非湿证组比较，湿证各组谷草转氨酶(glutamic-oxalacetic transaminease，AST)、谷丙转氨酶(glutamic-pyruvic transaminase，ALT)、甘油三酯(triglyceride，TG)、谷氨酰转移酶(gamma-glutamyl transferase，GGT)水平高于非湿证组，差异具有统计学意义(P＜0.05)；痰瘀组总胆固醇(total cholesterol，TC)、TG、AST、ALT、碱性磷酸酶(alkaline phosphatase，ALP)、GGT水平升高最显著，痰瘀组与TC(R=0.446，P=0.003)、TG(R=0.377，P=0.014)、AST(R=0.403，P=0.008)、ALT(R=0.449，P=0.003)、ALP(R=0.408，P=0.007)有较强相关性。结论：非酒精性脂肪肝的发生和发展与中医湿证密切相关，且湿证与脂肪肝程度、血脂、肝功能等指标呈正相关，为中医“聚湿成痰、痰瘀互结”理论提供了数据支持，为NAFLD的早诊断、早干预及制定更合理化的管理及诊治方案提供了数据支持。
Abstract:
Objective: To explore the correlation between TCM dampness syndrome of NAFLD and the degrees of fatty liver. Methods: All 110 NAFLD patients were allocated to 90 cases of TCM dampness syndrome group (41 cases of dampness-turbidity syndrome group, 33 cases of dampness-heat syndrome group and 16 cases of phlegm stasis syndrome group) and 20 cases of non-dampness syndrome group (Qi stagnation syndrome group), another 30 cases were recruited as normal control group. FibroScan-CAP, 502B was used to detect blood lipid, liver function and others of the patients in different groups, compare the connections between TCM dampness syndrome (dampness-turbidity syndrome, dampness-heat syndrome and phlegm stasis syndrome), non-dampness syndrome (Qi stagnation syndrome) and blood lipid, liver function and others. Results: 1)Among 110 NAFLD patients, 20 cases of non-dampness syndrome group (Qi stagnation syndrome group) (18.2%), and 90 cases of dampness syndrome group (81.8%), the ratio of patients of dampness syndrome was greater than that of the ones of non-dampness syndrome, it suggeted that the incidence and development of NAFLD was closely related to TCM dampness syndrome. 2) The proportion of non-dampness syndrome group (Qi stagnation syndrome group) suffering moderate fatty liver was the largest, and 75.0%(15/20), the difference showed statistical meaning when it was compared with different groups of dampness syndrome(P＜0.05); when non-dampness syndrome group (Qi stagnation syndrome group) with severe fatty liver was compared with different groups of dampness syndrome, the difference was statistically significant (P＜0.05), the proportion of phlegm stasis syndrome group was the largest, and 68.7%(11/16), the difference had statistical meaning when it was compared with non-dampness syndrome group and dampness-turbidity syndrome group, which suggested that the groups ranked from light to severe according to the degrees of fatty liver: non-dampness syndrome (Qi stagnation syndrome)-dampness turbidity syndrome/dampness-heat syndrome-phlegm stasis syndrome. 3) The levels of AST, ALT, TG and GGT of different groups of dampness syndrome were higher than these of non-dampness group, and there were the significant differences(P＜0.05); the improvements of the levels of TC, TG, AST, ALT, ALP and GGT of phlegm stasis group were the most notable, phlegm stasis syndrome showed stronger connections with TC (R=0.446, P=0.003), TG (R=0.377, P=0.014), AST (R=0.403, P=0.008), ALT (R=0.449, P=0.003) and ALP (R=0.408, P=0.007). Conclusion: The incidence and development of NAFLD is closely related to TCM dampness syndrome, and dampness syndrome is positively related to the degrees of fatty liver, blood lipid, liver function and other indexes, it could provide data support for TCM theory of "dampness gathering to form phlegm, phlegm mixed with blood stasis", early diagnosis, early intervenion of NAFLD, establishing more rational management, diagnostic and therapeutic regimen.

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备注/Memo

备注/Memo:
收稿日期：2019-09-25*基金项目：海南省基础与应用基础研究计划（自然科学领域）高层次人才项目（2019RC383）；海南省省级中医治未病中心能力建设项目（琼卫中医函〔2020〕17号）；国家中医药管理局第六批全国老中医药专家学术经验继承项目（国中医药人教发〔2017〕29号）。作者简介：程亚伟(1982—)，女，硕士学位，副主任医师。研究方向：脾胃肝病的中医临床研究。△通讯作者：蔡敏(1966—)，男，主任医师。研究方向：脾胃肝病的中医临床研究。
更新日期/Last Update: 2020-05-15