Fan Xiao-fen, Deng Yin-quan, Wu Guo-lin
Department of Traditional Chinese Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2011 Oct;31(10):1332-6.
To supply evidence for establishing the standard for Chinese medicine (CM) syndrome differentiation by investigating the distribution and characteristics of CM syndromes in patients with nonalcoholic fatty liver disease (NAFLD).
928 NAFLD patients' symptoms, signs, tongue and pulse parameters were studied by clinical epidemiologic survey. And the results were analyzed by the cluster analysis and factor analysis.
The results of cluster analysis showed that the CM syndrome typings of fatty liver patients were mainly classified as dampness heat accumulation, Pi deficiency with dampness phlegm, Gan-qi stagnation and Pi deficiency, phlegm stasis accumulation, and Gan-Shen insufficiency, which were in accordance with clinical practice. The results of factor analysis indicated that overweight/obesity, abdominal distension, hypochondriac pain, discomfort in the hepatic region were common "condition factors" of fatty liver patients. The 5 "syndrome factors" such as dampness heat accumulation, Pi deficiency with dampness phlegm, Gan-qi stagnation and Pi deficiency, phlegm stasis accumulation, and Gan-Shen insufficiency showed identification significance in syndrome typing.
The basic CM syndrome typings of NAFLD were dampness heat accumulation, Pi deficiency with dampness phlegm, Gan-qi stagnation and Pi deficiency, phlegm stasis accumulation, and Gan-Shen insufficiency. The four parameters of fatty liver patients could be classified by statistical analysis as condition factors and syndrome factors (which could reflect CM syndrome characteristics), which could provide certain evidence for establishing CM syndrome differentiation standards.
通过调查非酒精性脂肪性肝病(NAFLD)患者中医证候的分布及特点,为制定中医辨证标准提供依据。
采用临床流行病学调查方法,对928例NAFLD患者的症状、体征、舌象和脉象参数进行研究,并通过聚类分析和因子分析对结果进行分析。
聚类分析结果显示,脂肪肝患者的中医证候类型主要分为湿热蕴结、脾虚痰湿、肝郁脾虚、痰瘀互结、肝肾不足,与临床实际相符。因子分析结果表明,超重/肥胖、腹胀、胁肋疼痛、肝区不适是脂肪肝患者常见的“病情因素”。湿热蕴结、脾虚痰湿、肝郁脾虚、痰瘀互结、肝肾不足等5个“证候因素”在证候分型中具有鉴别意义。
NAFLD的基本中医证候类型为湿热蕴结、脾虚痰湿、肝郁脾虚、痰瘀互结、肝肾不足。通过统计分析可将脂肪肝患者的四个参数分为病情因素和证候因素(可反映中医证候特点),可为制定中医辨证标准提供一定依据。