非酒精性脂肪肝肝纤维化指标与中医证型的关系

目的 :探讨非酒精性脂肪肝肝纤维化指标与中医证型的关系 ,为中医辨证提供有益参数。方法 :符合B超诊断的非酒精性脂肪肝患者 (79例 ) ,经中医辨证后作肝纤维化指标检测 ,并以不嗜酒的健康人作为对照。结果 :脂肪肝组肝纤维化指标明显高于对照组 (P <0 0 5 ,P <0 0 1) ;各证型间 ,痰瘀互结型Ⅲ型前胶原 (PCⅢ )、Ⅳ型胶原 (CⅣ )、层粘连蛋白 (LN)明显高于脾虚痰湿、湿热内蕴两型 (P <0 0 5 ,P <0 0 1) ,而透明质酸 (HA)无明显差异 (P >0 0 5 )。结论 :脂肪肝患者存在不同程度的肝纤维化趋向 ,提示痰瘀互结可能是非酒精性脂肪肝肝纤维化指标升高的中医主要病理因素。

英文摘要:

Objective: To explore the relationship between the liver fibrosis criteria and TCM Syndrome type in the patients suffering from non alcoholic fatty liver. Methods: Seventy nine patients with non alcoholic fatty liver diagnosed by B ultrasonography were classified by TCM Syndrome Differentiation and their liver fibrosis criteria was determined and compared with those of the healthy subjects as control. Results: Levels of procollagen Ⅲ (PCⅢ), hyaluronic acid (HA), collagen Ⅳ(CⅣ) and laminin (LN) in the fatty liver group were significantly higher than those in the control group (P<0 05, P<0 01). In respect to the TCM Syndrome types, PCⅢ, CⅣ and LN in patients of Phlegm stasis combined type were significantly higher than those in patients of other two Syndrome types (P<0 05, P<0 01), while HA was insignificantly different (P>0 05). Conclusion: There was trend of liver fibrosis in fatty liver patients. It was indicated that the Phlegm stasis combined Syndrome type possibly was the main TCM pathologic factor of the increasing of fibrosis criteria for non alcoholic fatty liver.

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