体检人群脂肪肝中医证型特点及相关因素分析

目的:探索体检人群脂肪肝中医证型与临床因素的相互关系及中医证候的演变规律。方法:对所有病例进行辨证分型,并分析各证型与年龄、性别、肥胖、生活习性、相关疾病、生化指标等危险因素的相关性。结果:脂肪肝无症状或轻微症状者占总数的66.6%,痰浊壅阻证(34.1%)和肝郁脾虚证(27.7%)在5个证型中占主导地位,男性患者痰浊壅阻证所占比例最大(36.2%),而女性患者则以肝郁脾虚(39.4%)及肝肾不足证(27.3%)多见。痰瘀互结证多见于饮酒人群中。伴有高血压或糖尿病者以肝肾不足证最多见,伴有高脂血症或胆囊改变者以痰浊壅阻证及肝郁脾虚证为常见证型。结论:痰浊壅阻证和肝郁脾虚证为常见证型。不同年龄、性别、饮酒习惯及伴随疾病间中医证型分布有差异。病机为本虚标实,本虚以脾肾为主,标实主要与气滞、痰湿、血瘀有关。

Epidemic Survey on TCM Syndrome Typing and Analysis in Related Causes of Fatty Liver in Examinationers

Objective：To investigate the correlation between TCM syndrome typing and clinical factorsbased on the body examination results with fatty liver and the tendency of TCM syndrome, in order to directclinical diagnose and therapy. Method ： Syndromes of fatty liver could be typed into the different TCM types,and then the correlations of related data （ age, sex, fat, habits and customs, related dieases, liver function,blood lipids ）were analyzed among these groups. Result： The patients with no symptoms were 66.6% inthis research. Phlegm-dampness conglomeration group was 34.1%. Liver-depression and spleen deficiencygroup was 27.7%, which was the main types among the five groups. Phlegm-dampness conglomeration wasthe main type among men （ 36.2% ）, but liver-depression and spleen deficiency group （ 39.4% ） and liver-kidney deficiency group （ 27.3% ）were much more among women. Phlegm and blood-stasis in collateralswere common among men who were fond of liquor. Liver-kidney deficiency group was the main type amongthe people with hypertension or diabetes, but phlegm-dampness conglomeration and liver-depressionand spleen deficiency were the main types among the people with hyperlipidemia or change of cholecyst.Conclusion： Phlegm-dampness conglomeration and liver-depression and spleen deficiency were the maintypies among the people with fatty liver diease. TCM types differ in different ages, sexes, habits and customsand related dieases. The pathogenesis iv root deficiency and branch excess. The deficiency is mainly kidneyand spleen deficiency and the excess is mainly qi stagnation, phlegm-dampness and blood stasis.