Objective

2

To explore the pathogenesis of metabolism-dysfunction-associated fatty liver disease (MAFLD) in traditional Chinese medicine (TCM).

Methods

2

In this cross-sectional study

data were collected among the MAFLD patients admitted to the 23 hospitals in the East China

South China

Central China

North China

Northwest and Southwest China from 2020 June to 2021 February. The “questionnaire for the clinical epidemiology of MAFLD” was used

and information on 14 kinds of symptoms and signs including abdominal palpation

inspection of the complexion

diet

sleep

abdominal inquiry

sweating

limbs

stomach cavity

chest and rib-side

stool and urine

cold-heat

thirst-drinking water and taste

head discomfort

and emotions were collected. Excel software was used to establish a MAFLD information database

and the symptoms and signs with a frequency of ≥10% were selected as the variables for statistical analysis. The principal component analysis was used for factor extraction

by initially identifying common factors and then analyzing the disease location

disease nature

pathological and syndrome elements of the common factors

so as to summarize them into several TCM syndromes and calculate the frequency. MAFLD patients were divided into juvenile group

youth group

middle-aged group and elderly group

and to observe the distribution of TCM syndromes in different age groups.

Results

2

All the 2

287 questionnaires were responded

of which 2261 were valid. There were 48 symptom variables with a frequency ≥10%. Taking each symptom and sign variable as a factor

a total of 15 factors with an initial eigenvalue ＞ 1 were extracted

and the cumulative contribution rate reached 51%. The disease location

disease nature

and pathogenic factors of the common factors were analyzed

showing that the syndrome elements regarding the disease location were mainly involved with the liver

spleen

and kidney

while that relating to disease nature were mainly excess heat

yang

deficiency and

qi

deficiency

and that relating to pathogenesis were mainly dampness

heat and blood stasis. The most common syndromes of MAFLD patients were spleen deficiency and phlegm-damp syndrome (34.1%)

stomach heat and spleen deficiency syndrome (16.1%)

binding of phlegm and stasis syndrome (14.1%)

spleen and kidney deficiency syndrome (12.9%)

liver constraint and spleen deficiency syndrome (7.3%)

liver-kidney

yin

deficiency syndrome (6.5%)

and damp-heat accumulation syndrome (4.4%). Compared with other age groups

stomach heat and spleen deficiency syndrome was higher in youth group

while spleen and kidney deficiency syndrome was lower.

Conclusion

2

For MAFLD patients

the disease location is mainly involved with the liver

spleen

and kidney

and the nature is deficiency-excess complex. The main syndrome is spleen deficiency and phlegm-damp syndrome

accompanied by stomach heat

phlegm stasis

yang

deficiency and

yin

deficiency. Stomach heat and spleen deficiency syndrome is common in youg patients.