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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (5): 411-417.doi: 10.3736/jcim20090503

• Original Clinical Research • Previous Articles     Next Articles

Distribution pattern of traditional Chinese medicine syndromes in 793 patients with fatty liver disease

 Hua-feng Weia,Tao Liua,Lian-jun Xinga,Pei-yong Zhenga,Guang Jia,b   

  1. a Institute of Digestive Diseases and Department of Gastroenterology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
    b E-institute of Traditional Chinese Medicine Internal Medicine,Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
  • Received:2008-10-13 Accepted:2009-02-17 Online:2009-05-20 Published:2009-05-15

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Objective

To study the distribution pattern of traditional Chinese medicine (TCM) syndromes in fatty liver disease.
Methods

A multicenter and large sample survey was carried out by adopting the model of "combining disease with syndrome". A TCM syndrome information database was established by EPidata 3.1 software. The distribution pattern of TCM syndromes in fatty liver was studied by factor analysis and cluster analysis methods with SPSS 13.0 software.
Results

The basic syndromes of fatty liver included insufficiency of liver and kidney, flaring fire due to yin deficiency, liver-qi stagnation and spleen deficiency, spleen deficiency, spleen deficiency and dampness stagnation, mild syndrome of internal accumulation of damp-heat, blood stasis, severe syndrome of internal accumulation of damp-heat, and internal stagnation of phlegm-dampness. Single syndrome and combination of two to four basic syndromes were common in fatty liver disease. The syndrome of spleen deficiency and dampness stagnation was the most frequent one when its pathogenesis was simple, while the syndrome of insufficiency of liver and kidney was most frequent one when the pathogenesis was complicated. A total of 108 patients (13.6%) had no obvious symptoms, 46 patients (5.8%) were classified into the pattern of non-categorization, and the other patients were classified into five syndromes including phlegm accumulating with stagnation due to spleen deficiency (11.5%, 91/793), yin deficiency of liver and kidney (18.5%, 147/793), retention of phlegmatic dampness due to spleen deficiency (32.0%, 254/793), internal accumulation of damp-heat due to spleen deficiency (10.2%, 81/793), and damp obstruction due to liver-qi stagnation and spleen deficiency (8.3%, 66/793).
Conclusion

Multi-element analysis reveals the distribution pattern of TCM syndromes in fatty liver disease, which is worthy of further study. The basic pathogenesis is spleen deficiency, and has a close correlation with the liver and kidney. The main pathogenesis factors are phlegm, dampness, blood stasis, heat and liver-qi stagnation. Yin deficiency of liver and kidney is a typical syndrome in fatty liver disease.

Key words: Fatty liver, Syndrome, Epidemiological method, Multivariate analysis

Figure 1

Scree plot of the initial factor analysis"

Table 1

Main symptoms of load values over 0.4 in the 10 common factors extracted from the second factor analysis"

Symptom Component
1 2 3 4 5 6 7 8 9 10
Afternoon fever 0.744
Hectic fever and tidal fever 0.851
Night sweats 0.577
Yellowish body and eyes 0.873
Tinnitus and deafness 0.678
Distending pain in hypochondrium 0.545
Dull pain of hypochondrium 0.420
Wandering pain 0.659
Fixed pain 0.909
Abdominal pain 0.880
Fullness of stomach and abdomen 0.475 0.568
Abdominal distension 0.623
Nausea and vomiting 0.642
Sour regurgitation 0.871
Belching 0.893
Anorexia 0.707
Tired of grease 0.434
Fatigue and weakness 0.459 0.520
Expectoration 0.823
Aching and weakness of waist and knees 0.729
Heel pain 0.732
Reddish swollen and painful eyes 0.885
Blurred vision 0.775
Dryness of eyes 0.762
Depression and sighing 0.695
Surprise and fear readily 0.616
Forgetfulness 0.715
Yellow urine 0.797
Frequent urination 0.585 0.404
Loose stools 0.436 0.441
Constipation 0.738
Halitosis 0.792
Pale-grayish complexion 0.538 0.534
Red face 0.570
Sallow complexion 0.740
Tongue with ecchymoses 0.865
Thin, whitish and greasy tongue fur 0.416 0.495
Thin, yellowish and greasy tongue fur 0.513 0.445
Yellow greasy fur 0.563
Scanty fur 0.517 0.600
Tongue with scanty fluid 0.401
Corpulent and tender tongue 0.836
Teeth-marked tongue 0.873
Prickled tongue 0.767
Thin tongue 0.668

Table 2

Combination of the basic syndrome factors in 631 cases"

Syndrome factor combination Factor 1 Factor 2 Factor 3 Factor 4 Factor 5 Factor 6 Factor 7 Factor 8 Factor 9
One factor 16 12 8 19 37 6 18 8 12
Two factors 64 40 45 26 84 37 34 33 29
Three factors 83 65 68 29 75 53 29 40 44
Four factors 79 48 54 20 48 45 46 48 48
Five factors 20 19 18 3 13 18 16 7 11
Six factors 3 3 3 0 1 3 3 0 2
Total 265 187 196 97 258 162 146 136 146

Table 3

Last cluster center after 25-time iteration"

Cluster Regression factor score
1 2 3 4 5
Regression factor score 1 for analysis 1 0.41 1.07 0.33 0.14 0.59
Regression factor score 2 for analysis 1 0.33 0.77 0.15 0.31 0.36
Regression factor score 3 for analysis 1 0.15 0.19 0.21 0.51 2.32
Regression factor score 4 for analysis 1 0.31 0.22 0.46 0.83 0.61
Regression factor score 5 for analysis 1 0.70 0.35 0.22 1.94 0.73
Regression factor score 6 for analysis 1 0.35 0.27 0.32 0.69 0.30
Regression factor score 7 for analysis 1 2.25 0.12 0.09 0.02 0.20
Regression factor score 8 for analysis 1 0.36 0.49 0.28 0.56 0.29
Regression factor score 9 for analysis 1 0.69 0.53 0.47 0.78 0.36
Regression factor score 10 for analysis 1 0.47 1.39 0.20 0.64 0.59
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