非酒精性脂肪肝中医证型分布及其与客观指标的相关性调查

发布时间：2018-01-30 02:28

  本文关键词： 非酒精性脂肪肝 中医证型 客观指标 相关性　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：调查非酒精性脂肪肝患者的中医证型分布,探索年龄、性别、BMI、肝功能、血糖、血脂指标与中医证型的相关性,为NAFLD患者的中医辨证治疗提供参考。方法：纳入就诊于成都中医药大学消化科、内分泌门诊及体检中心,符合诊断标准的单纯性非酒精性脂肪肝患者301例,采用统一的量化表格,进行流行病学调查问卷,采集中医四诊辨别证候,记录客观指标,使用SPSS19.0统计软件分析中医证型分布,比较各证型与年龄、性别、BMI、肝功、血脂、血糖等指标的相关性,并使用SAS9.3软件进行多重logistic回归分析。结果：1、301例NAFLD患者中,证型以肝郁脾虚证最多,占26.92%,其他依次为：痰湿内阻证(25.57%)、湿热蕴结证(22.92%)、肝郁气滞证(17.94%)、痰瘀互结证(5.65%)；2、性别与中医证型分布有统计学差异(P0.05),男性以湿热蕴结证及痰湿内阻证多见,女性以肝郁脾虚证及肝郁气滞证多见；3、不同年龄段中医证型分布有统计学差异(P0.05),青年组以湿热蕴结证多见,中年组以痰湿内阻证多见,老年组以肝郁脾虚及痰瘀互结证多见；4、脑力劳动者占59.14%,体力劳动者占40.86%,脑力劳动者发病率高于体力劳动者；5、病程与中医证型分布差异有统计学意义,其中病程1年者以痰湿内阻证最多见,病程1-5年者以湿热蕴结证最多见；6、BMI与中医证型分布有统计学差异(P0.05),痰湿内阻证BMI升高最明显；7、A/G、ALT、AST、FBG与中医证型分布有统计学差异(P0.05),以湿热蕴结证升高明显。TP、ALB、GLO、AKP、GGT、TBIL、DBIL、 IBIL、TC、TG、HDL-C、LDL-C与中医证型分布无统计学差异(P0.05)；8、血脂各指标与中医证型无统计学差异(P0.05); 9、logistic回归分析显示性别、年龄、BMI及FBG是NAFLD中医辨证分型的相关因素。结论：1、非酒精性脂肪肝患者中医辨证分型以肝郁脾虚证最多见；2、男性以湿热蕴结证及痰湿内阻证多见,女性以肝郁脾虚证及肝郁气滞证多见；青中年以湿热内蕴及痰湿内阻证最常见,老年人以肝郁脾虚证及痰瘀互结证最常见;痰湿内阻证BMI升高最明显；湿热蕴结证中A/G、ALT、AST、FBG普遍升高明显；3、logistic回归分析显示性别、年龄、BMI及FBG是NAFLD辨证分型的独立相关因素。
[Abstract]:Objective: TCM syndromes in patients with alcoholic fatty liver distribution, non investigation on age, gender, BMI, liver function, blood glucose, blood lipid indexes and the correlation between TCM syndrome type, provide a reference for TCM treatment of NAFLD patients. Methods: patients treated at the Chengdu University of Traditional Chinese Medicine Department of digestion, endocrine clinic and medical examination center, diagnosis the standard of simple nonalcoholic fatty liver patients with 301 cases, using the uniform quantization table, epidemiological survey questionnaire, collecting TCM Differentiation Syndromes, recording objective index, using SPSS19.0 statistical software to analyze the distribution of TCM syndromes, the syndrome type and age, gender, BMI, liver function, blood lipid, blood glucose and other correlation the index, and multiple logistic regression analysis using SAS9.3 software. Results: 1301 cases of patients with NAFLD syndrome, to stagnation and spleen deficiency, accounting for 26.92% of the other, according to the times: phlegm (25.57%) Rdhs (22.92%), (17.94%), qi stagnation, phlegm and blood stasis (5.65%); 2, gender and the distribution of TCM syndromes have significant difference (P0.05), male rdhs and phlegm dampness syndrome, women with stagnation of liver qi stagnation and spleen deficiency syndrome and see; 3, different age distribution of TCM syndromes have significant difference (P0.05) in the young group, rdhs rare, middle-aged group with phlegm dampness syndrome in the elderly group, liver stagnation and spleen deficiency and phlegm and blood stasis see; 4, mental workers accounted for 59.14%, manual workers accounted for 40.86%, the incidence of mental workers the rate is higher than that of manual workers; 5, the course of disease and TCM syndrome type distribution difference was statistically significant, the most common of which 1 years duration with phlegm, the most common course of 1-5 years to rdhs; 6, BMI with the distribution of TCM syndromes have significant difference (P0.05), phlegm BMI increased obviously; 7, A/G, ALT,AST,FBG涓庝腑鍖昏瘉鍨嬪垎甯冩湁缁熻�″�﹀樊寮，

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