Research in Related Etiological Causes and Syndrome Differentiation of Fatty Liver

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Fatty liver is a kind of fatty degeneration resulting from various diseases and factors. This research is mainly concerned about chronic fatty liver caused by alcoholism and obesity. As a common disease in western countries, whose clinical manifestation varies and basic treatment lies in abstinence and improvement of nourishment, the incidence of fatty liver is now growing in China. It could be an independent disease, yet it is more commonly viewed as pathogenic process manifested in the liver in many systematic diseases, such as obesity, poisoning, malnutrition, diabetes, pregnancy, infection by hepatic viruses or other pathogens and hereditary defects of metabolism, etc. And though it used to be considered benigh, the incidence of hepathic fibrosis resulting from it can be up to 25% and about 1.5% - 8.0% of the patients can later progress to hepatocirrhosis.

This article reviews the early inducement, pathogenesis and clinical classification of fatty liver in the Chinese medical field, and summarizes views of TCM in understanding the disease and research in its pathogenesis. The four main inducements are alcoholism, obesity, malnutrition and hepatargia, and the pathogenesis is related to many factors such as abnormal metabolism of fat and lipoprotein, oxygen stress and immunoreaction, all leading to fat accumulation in hepatocytes as a result. Fatty liver is a kind of fatty degeneration resulting from various diseases and factors and those caused by alcoholism and obesity are studied mainly in epidemiology.

The purpose of the study was to discover the common types of fatty liver and proportion of each type based on the body examination results in our hospital, so as to make a retrospective discussion about the causality between each etiological agent and the disease. With the statistical software of spps 11.5 processing and analyzing the data, we could induce the syndrome groups of Chinese Traditional Medicine from the analytical results' main component and grouping the same item. Besides, analysis of a single item is also helpful in studying the correlation between each syndrome and etiological agent. Based on our research results, we conclude as below.

Drinking and obesity are two important factors in causing fatty liver, while factors like smoking, overstress at work, coronary disease and viral hepatitis have no statistical meaning in this research. And among all the cases with fatty liver, all collected from the body examination results in our hospital, only 28 of them were complicated with diabetes, the incidence of which is 13.33%. Considering the few case records as well as the relatively small range of patients, we suggest further study should be based on a clear picture of the correlation between diabetes and fatty liver, which requires a larger and wider inclusion of case records.

Differences lie in the constitutive rate of each age group and syndrome in the study, which indicates that the incidence of fatty liver increases as age grows. Meanwhile, the result that the incidence of the disease in male is higher than female is not accorded with other related reports. This could result from the rather small range of cases included in the research and thus could not demonstrate any correlation between sex and the incidence of fatty liver.

Comparing each process of the disease and its correspondent syndrome differentiation, we find that in mild fatty liver, the incidence of the syndrome of accumulated damp and restrained heat in liver is the highest. And as the disease progresses without proper treatment, retention of phlegm and blood stasis are sequentially observed and finally can progress to the syndrome of retention of damp, phlegm and blood stasis. Thus in progressive fatty liver, syndrome of retention of phlegm and blood stasis is the most common type. In the course of the disease, syndrome of TCM varies, and corresponding syndrome differentiation of TCM offers proper methods in treating the disease.

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By Bong Yee Yang, (Malaysia)

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