942例绝经后女性患代谢相关脂肪性肝病中医体质特征分析  

Analysis of TCM constitution characteristics in the 942 postmenopausal women with metabolic associated fatty liver disease

作　　者：杨明 王科举 熊壮[2] 刘铁军[2] 冷炎[2] YANG Ming;WANG Keju;XIONG Zhuang;LIU Tiejun;LING Yan(School of Traditional Chinese Medicine,Changchun University of Chinese Medicine,Changchun 130117,China;Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130021,China)

机构地区：[1]长春中医药大学中医学院,长春130117 [2]长春中医药大学附属医院,长春130021

出　　处：《吉林中医药》2024年第10期1186-1189,共4页Jilin Journal of Chinese Medicine

基　　金：吉林省卫生健康科技能力提升项目(2023LC034);吉林省自然科学基金项目(YDZJ202201ZYTS263)。

摘　　要：目的通过对绝经后女性中医体质及危险因素研究,探讨代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)的中医发病机制。方法采用横断面调查方法,纳入长春中医药大学附属医院就诊的942名绝经女性,分析MAFLD的中医发病特征。结果根据诊断标准,共有313名绝经后女性诊断为MAFLD,发病率为33.23%,且随着年龄增长发病率呈上升趋势;绝经后女性人群中占比最高的是气郁质(25.48%)、阳虚质(17.52%)、湿热质(14.65%)、阴虚质(11.36%);绝经后MAFLD人群中占比最高的是湿热质(19.81%)、气郁质(18.85%)、痰湿质(14.38%);按体质分层统计,肥胖/超重、高血压病、高脂血症等危险因素在MAFLD组与非MAFLD组间存在特异性统计学差异。结论血亏是绝经女性体质变化的基础,精血同源、且后天之精无法濡养先天之精,引起肾精不足而至“天癸竭”;肝失条达,疏泄运化失司,水谷精微困于中焦,陈化为浊,引起的一系列体质改变是绝经后MAFLD高发的可能机制。Objective To explore the pathogenesis of metabolic associated fatty liver disease(MAFLD)in traditional Chinese medicine(TCM)by investigating the TCM constitutions and risk factors in postmenopausal women.Methods Using a cross-sectional survey,the 942 postmenopausal women admitted to the Affiliated Hospital of Changchun University of Chinese Medicine were included to analyze the TCM characteristics of MAFLD.Results According to the diagnostic criteria,a total of 313 postmenopausal women were diagnosed with MAFLD,with an incidence of 33.23%,which showed an increasing trend with age.Among the postmenopausal women,the qi-stagnation constitution(25.48%),yang-deficiency constitution(17.52%),damp-heat constitution(14.65%),and yin-deficiency constitution(11.36%)had a higher proportion.While in the postmenopausal women with MAFLD,the damp-heat constitution(19.81%),qi-stagnation constitution(18.85%),and phlegm-dampness constitution(14.38%)constituted the more common ones.According to a hierarchical statistics of the physical constitutions,specific statistical differences were found in risk factors including obesity/overweight,hypertension and hyperlipidemia between the MAFLD group and the non-MAFLD group.Conclusion Hemophthisis is the basis of constitutional changes in postmenopausal women.The facts that essence and blood come from the same origin and that the acquired essence cannot nourish the innate essence may usually lead to a kidney-essence deficiency,and consequently to menopause.In addition,a series of constitutional changes caused by the dysfunction of the liver in maintaining the smooth movement of qi,failure in its conveyance-dispersion and transportation-transformation functions,retention of water and grain essence in the middle jiao,and its sedimentation into turbidity may all count as possible pathogeneses for the higher incidence of MAFLD in postmenopausal women.

关 键 词：绝经 代谢相关脂肪性肝病 中医体质 血虚 

分 类 号：R256.4[医药卫生—中医内科学]