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代谢相关脂肪性肝病中医证型分布规律及其与生辰运气的关系

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目的:收集代谢相关脂肪性肝病(MAFLD)患者的临床资料,分析MAFLD常见中医证型,初步探讨MAFLD中医证型分布规律与生辰运气的关系.方法:共收集MAFLD患者 200 例,通过问卷调查采集患者的基本资料,如性别、年龄、出生时间、身高、体重、合并疾病等,以及症状、舌脉等中医四诊资料.采用因子分析法总结出MAFLD常见中医证型,探索证型与生辰运气的关系.结果:①MAFLD有5 种常见证型,频率由高到低依次为脾虚痰湿证、湿热蕴结证、肝郁脾虚证、脾肾亏虚证及痰瘀互结证.②MAFLD患者出生岁运与证型分布差异有统计学意义(P=0.001),岁运为火运、土运时证型分布差异有统计学意义(P<0.05),岁运为火运时湿热蕴结证最常见,岁运为土运时脾虚痰湿证最常见;MAFLD患者出生司天在泉之气与证型分布差异有统计学意义(P<0.001),司天在泉为少阴君火/阳明燥金、太阴湿土/太阳寒水、阳明燥金/少阴君火时证型分布差异有统计学意义(P<0.05),司天在泉为少阴君火/阳明燥金时湿热蕴结证最常见,司天在泉为太阴湿土/太阳寒水时脾虚痰湿证最常见,司天在泉为阳明燥金/少阴君火时肝郁脾虚证最常见;MAFLD患者出生主气、客气、主运、客运与证型分布差异无统计学意义(P>0.05).结论:MAFLD中医证型主要有脾虚痰湿证、湿热蕴结证、肝郁脾虚证、脾肾亏虚证及痰瘀互结证,MAFLD患者出生时岁运为火运、或少阴君火司天可能与湿热蕴结证的形成有关,岁运为土运、或太阴湿土司天可能与脾虚痰湿证的形成有关,阳明燥金司天可能与肝郁脾虚证的形成有关.
The distribution of traditional Chinese medicine syndrome types in metabolic associated fatty liver disease and its relationship with congenital fortune
Objective:To analyze the collected clinical data of patients with metabolic associated fatty liver disease,obtain the main common syndrome types of MAFLD,and preliminarily explore the relationship between the distribution of traditional Chinese medicine syndrome types of MAFLD and congenital fortune.Methods:A total of 200 patients with metabolic associated fatty liver disease were collected in this study.Basic data such as gender,age,time of birth,height,weight and complicated diseases were collected through questionnaire survey,as well as four TCM diagnosis data such as symptoms,tongue and pulse.Factor analysis was used to summarize the common TCM syndrome types of MAFLD,and statistical methods were used to explore the relationship between the syndrome types and congenital fortune.Results:①MAFLD has five commonly syndrome types,and the frequency from high to low is successively spleen deficiency and phlegm-dampness syndrome,damp-heat accumulation syndrome,liver stagnation and spleen deficiency syndrome,spleen and kidney deficiency syndrome and phlegm-stasis interjunction syndrome.②There were statistically significant differences in the distribution of yearly phase at birth and syndrome types in MAFLD patients(P=0.001).Among them,there were statistical differences in the distribution of syndrome types in the yearly phase of fire and earth(P<0.05).The syndrome of damp-heat accumulation is the most common when the yearly phase is fire,and the syndrome of spleen deficiency and phlegm-dampness is the most common when the yearly phase is earth.There were statistical differences in the distribution of Sitian Zaiquan and syndrome types in MAFLD patients(P<0.001).Among them,there were statistical differences in syndrome type distribution when Sitian Zaiquan was Shaoyin Junhuo/Yangming Zaojin,Taiyin Shitu/Taiyang Hanshui,Yangming Zaojin/Shaoyin Junhuo(P<0.05).The syndrome of dampness-heat accumulation is the most common when Sitian Zaiquan is Shaoyin Junhuo/Yangming Zaojin;the syndrome of spleen deficiency and phlegm-dampness is the most common when Sitian Zaiquan is Taiyin Shitu/Taiyang Hanshui;the syndrome of liver depression and spleen deficiency is the most common when Sitian Zaiquan is Yangming Zaojin/Shaoyin Junhuo.There were no significant differences in the distribution of host climatic qi,guest climatic qi,host evolutive phase,guest evolutive phase of birth and syndrome types in MAFLD patients(P>0.05).Conclusion:First,the TCM syndrome types of MAFLD mainly include spleen deficiency and phlegm-dampness syndrome,dampness-heat accumulation syndrome,liver stagnation and spleen deficiency syndrome,spleen and kidney deficiency syndrome and phlegm-stasis interjunction syndrome.Secondly,the relationship between TCM syndrome types of MAFLD and congenital fortune of birthday was analyzed.The yearly phase of fire or celestial manager qi of Shaoyin Junhuo at birth may be related to the formation of syndrome of dampness-heat accumulation.The yearly phase of earth or celestial manager qi of Taiyin Shitu may be related to the formation of syndrome of spleen deficiency and phlegm-dampness.The celestial manager qi of Yangming Zaojin may be related to the formation of syndrome of liver stagnation and spleen deficiency.

metabolic associated fatty liver diseaseTCM syndrome typefive Yun and six Qi

刘元宣、茹清静

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襄阳市中医医院肝胆科(湖北 襄阳,441099)

浙江中医药大学附属第二医院

代谢相关脂肪性肝病 中医证型 五运六气

2024

中西医结合肝病杂志
中国中西医结合学会,湖北中医学院

中西医结合肝病杂志

CSTPCD
影响因子:0.908
ISSN:1005-0264
年,卷(期):2024.34(10)