最新刊期
期 2 ， 2023
- 摘要：The incidence of obesity and its related metabolic diseases is increasing year by year， causing a global public health problem. More and more studies have found that the occurrence and development of obesity are closely related to the structural and functional changes of gut microbiota， and the imbalance of the relationship between the two is considered one of the hallmarks of metabolic disorders. Traditional Chinese medicine in our country has accumulated rich experience in the treatment of many chronic diseases， including diseases caused by disorders of glucose and lipid metabolism， and it has shown significant effects on weight loss and improvement of glucose and lipid metabolism. However， the oral bioavailability of the active ingredients of traditional Chinese medicines and formulas is low， and it is difficult to reach the effective concentration in target organs while the intestine may be the main organ of action. Focusing on the interaction between obesity and its related metabolic diseases and gut microbiota， we summarized the current research progress of traditional Chinese medicine in improving metabolic diseases such as obesity， type Ⅱ diabetes， and metabolic associated fatty liver disease by regulating gut microbiota in this review， aiming to provide a theoretical basis for the traditional Chinese medicine prevention and treatment of obesity and other metabolic diseases， and provide a reference strategy for the development of drugs targeting gut microbiota against obesity and its complications.关键词：obesity;metabolic disease;traditional Chinese herbal medicine;gut microbiota;glucolipid metabolism;type Ⅱ diabetes;metabolism associated fatty liver disease
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发布时间：2023-02-24 - 摘要：Metabolism associated fatty liver disease （MAFLD） is an important cause of chronic liver disease in the world， which ranges from simple hepatic steatosis to steatohepatitis， potential cirrhosis and hepatocellular carcinoma. MAFLD is also an independent risk factor for type 2 diabetes and cardiovascular diseases. At present， no officially approved potent drugs are available for the clinical treatment of MAFLD. In the context of the rapid development in modern medical science and technology， the research on the mechanism of action of traditional Chinese herbal medicines for treating MAFLD is advancing， continues to make breakthroughs， and has received wide attention and recognition. Therefore， with a view to providing guidance for the clinical treatment of MAFLD， we reviewed the research progress on the mechanism of action of traditional Chinese herbal medicines for treating MAFLD.关键词：metabolic associated fatty liver disease;traditional Chinese herbal medicine;insulin resistance;lipid metabolism;intestinal microflora;mechanism of action;research progress
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发布时间：2023-02-24 - 摘要：The research progress of traditional Chinese medicine in improving hyperuricemia by regulating uric acid transporter was reviewed. Studies had found that the traditional Chinese medicine monomers， active components and compounds could reduce the level of serum uric acid by affecting the expression of uric acid reabsorption transporters and uric acid secretion transporters.关键词：hyperuricemia;gout;traditional Chinese herbal medicine;uric acid transporter;mechanism of action;research progress
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发布时间：2023-02-24 - 摘要：This paper reviews the experimental research progress of Dendrobium nobile Lindl. in the treatment of diabetes and its related lesions（complications）. Dendrobium nobile Lindl. can improve blood glucose and islet function， diabetic nephropathy， diabetic cardiopathy， diabetic hepatopathy， diabetic ophthalmopathy and so on.Its effects are mainly concentrated in reducing blood glucose， lowering blood fat， protecting liver and kidney function， protecting cardiomyocytes， delaying the development of cataract， anti-inflammation， anti-oxidation， anti-apoptosis and so on.关键词：diabetes;complications;Dendrobium nobile Lindl.;traditional Chinese herbal medicine;mechanism of action;research progress
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发布时间：2023-02-24 - 摘要：ObjectiveTo systematically evaluate the efficacy and safety of Chinese herbal formulas （CHFs） for obesity.MethodsLiterature related to the treatment of obesity with Chinese herbal formulas （randomized controlled trials） was included by searches conducted on China National Knowledge Infrastructure （CNKI）， VIP Journal Integration Platform （VIP）， Wanfang Data Knowledge Service Platform （WanFang Data）， China Biomedical Literature Service System （CBM）， PubMed， Cochrane， AMED， CINAHL， ClinicalTrials， Embase， Informit， ProQuest， SciFinder， Scopus， Web of Science and other Chinese and English databases， and the literature was published from the establishment of databases to July 30th， 2022. Quality of studies was assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials and meta-analysis was performed with RevMan v5.4.Results①A total of 25 Random Clinical Trials （RCTs） involving 2，472 patients were included， 1，225 patients in the CHF group and 1，217 in the control group. ②Meta-analysis results showed that the CHF group had a better effect on lowering body weight ［MD=-3.05， 95% CI（-4.64， -1.46）， P<0.05］ and body mass index （BMI） ［MD=-1.19， 95% CI （-1.55， -0.82）， P<0.05］ of patients than the control group. ③According to the further analysis， the CHM had a more significant effect on reducing body weight ［MD=-3.05， 95% CI （-4.64， -1.46）］ and BMI ［MD=-1.02，95% CI（-1.73， -0.31）］ of patients than the placebo； The CHM had a more significant effect on reducing body weight ［MD=-3.91， 95% CI（-5.49， -2.32）］ and BMI ［MD=-1.52， 95% CI（-1.99， -1.05）］ of patients than the lifestyle intervention； The CHM had a more significant effect on reducing body weight ［MD=-2.89， 95% CI（-6.47， 0.69）］ and BMI ［MD=-1.18， 95% CI（-1.68， -0.68）］ of patients than western drugs； and all of the above differences were statistically significant （P<0.05）. ④Subgroup analysis revealed that the classical formulas had better efficacy on obesity than the self-formulated formulas ［classical formulas subgroup body weight MD=-4.74， 95% CI（-5.11， -4.36）， self-formulated formulas subgroup body weight MD=-2.19， 95% CI（-4.63， 0.25）］； Syndrome differentiation-based treatment of obesity was more effective than the disease identification-based treatment of obesity ［syndrome differentiation-based treatment subgroup body weight MD=-4.99， 95% CI（-7.13， -2.85）， disease identification-based treatment subgroup body weight MD=-1.21， 95% CI（-4.12， 1.69）］. All the above differences were statistically significant （P<0.05 ）. ⑤No serious adverse events were reported in any of the 25 included papers.ConclusionChinese herbal formulas are effective and safe for the treatment of obesity， and the preferred application mode is prescriptions based on classical formulas and syndrome differentiation-based treatment.关键词：obesity;Chinese herbal formula;syndrome differentiation-based treatment;classical formula;randomized controlled trial;Meta-analysis
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发布时间：2023-02-24 - 摘要：ObjectiveTo investigate the clinical efficacy of Jiangzhi Granule combined with lifestyle intervention in treating non-alcoholic fatty liver disease （NAFLD） patients with damp-heat accumulation syndrome and the effect on bile acid metabolism.MethodsNinety NAFLD patients with damp-heat accumulation syndrome were randomized into a treatment group （n=45） and a control group （n=45）. The lifestyle intervention was implemented to the control group， while the treatment group received Jiangzhi Granule plus lifestyle intervention. The clinical efficacy was evaluated after 16 weeks of continuous treatment through the liver ultrasound imaging， as well as comparative analysis of body weight， body mass index （BMI）， TCM syndrome scores， blood lipids profiles （TC， TG， HDL-C， and LDL-C）， and bile acids metabolome in serum and urine （TBA， CA， GCA， HCA， UDCA， GUDCA， GCDCA， CDCA， α-MCA， GHCA， TCA， DCA， LCA， GDCA， GLCA and T-β-MCA） before and after intervention. The treatment safety was assessed simultaneously.Results①There were 84 cases that finally completed the trial， including 43 cases in the treatment group and 41 cases in the control group. ②According to the liver ultrasound imaging， the total effective rate of the treatment group （62.8%） was significantly higher than that of the control group （36.6%） after intervention （P<0.05）. ③After intervention， the TCM syndrome scores， body weight， BMI and serum TC and TG levels decreased in the treatment group （P<0.05）， and the TCM syndrome scores and serum TG levels also decreased in the control group （P<0.05）； The TCM syndrome scores and BMI in the treatment group were lower than those in the control group （P<0.05）. ④In the treatment group， the levels of serum total bile acids （TBA）， primary bile acids （CA， GCA， HCA， UDCA， GUDCA， GCDCA， CDCA） and secondary bile acids （DCA， GDCA） decreased significantly after intervention （P<0.05）， and the levels of urinary TBA， primary bile acids （CA， α-MCA， T-β-MCA， CDCA， UDCA） and secondary bile acids （DCA， GDCA） increased significantly after intervention （P<0.05）； In the control group， the levels of serum TBA， primary bile acids （CA， GCA， UDCA， GCDCA， CDCA） and secondary bile acids （DCA， GDCA） decreased significantly after intervention （P<0.05）， and the levels of urinary primary bile acids （CA， α-MCA， T-β-MCA， CDCA） and secondary bile acids （DCA， GDCA） increased significantly after intervention （P<0.05）. After intervention， the levels of serum TBA， primary bile acids （CA， HCA， UDCA， GUDCA， GCDCA） and secondary bile acids （DCA， GDCA） in the treatment group were lower than those in the control group （P<0.05）， and the levels of urinary TBA， primary bile acids （CA， T-β-MCA， CDCA， UDCA） and secondary bile acids （DCA， GDCA） in the treatment group were higher than those in the control group （P<0.05）. ⑤There was no statistically significant difference in the incidence of adverse reactions between the two groups （P>0.05）.ConclusionsThe combination of Jiangzhi Granule and lifestyle intervention was effective in treating NAFLD patients with damp-heat accumulation syndrome， which could significantly improve the clinical symptoms and regulate blood lipid levels of patients. The mechanism may be related to lowering the serum levels of bile acids， promoting the urinary excretion of bile acids， and maintaining the homeostasis of bile acid metabolism.关键词：non-alcoholic fatty liver disease;metabolic associated fatty liver disease;Jiangzhi Granule;bile acid metabolism;damp-heat accumulation;traditional Chinese herbal medicine research;clinical trial
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发布时间：2023-02-24 - 摘要：ObjectiveTo explore the mechanism of Huazhi Rougan Granule （HZRG） in improving non-alcoholic steatohepatitis （NASH）-related fibrosis by network pharmacology methods.MethodsPotential targets of HZRG for NASH were investigated through the analysis of network pharmacology. Male C57BL/6 mice were randomly divided into control group， model group and HZRG low dose group and HZRG high dose group， and 8 mice were allocated per group. The mice in each group were given a methionine choline-deficient diet （MCD） to induce NASH-related fibrosis model except those in the control group， and the corresponding pharmacological interventions were given at the same time of modeling for 4 consecutive weeks. HE staining was used to observe the pathological changes of liver tissues， and the non-alcoholic fatty liver disease activity score （NAS） was used in parallel； Sirius red staining and Masson’s trichrome staining were used to observe the liver collagen deposition； immunohistochemistry was used to detect the expressions of α-smooth muscle actin （α-SMA） and type I collagen α1 chain （Col1a1） in liver tissues， and the area of positive expression was analyzed by ImageJ. The reagent kit was used to detect TC and TG levels in liver tissues. Biochemical analyzer was used to measure the blood alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， lactate dehydrogenase （LDH） and alkaline phosphatase （ALP） levels of mice in each group， and ELISA kits was used to measure the level of serum tumor necrosis factor-α （TNF-α）. The expressions of fibrosis parameters α-SMA， Col1a1 and p53 were detected by western blot and immunofluorescence， respectively； and the expression of p53 mRNA was detected by RT-qPCR. LX2 cells were treated with different concentrations of TGF-β1 and/or Tenovin-6 for 24 hours， and related indicators were detected.Results①The results of network pharmacology suggested that p53 was a potential target for HZRG to exert its effect on. ②The results of HE， Sirius red and Masson’s trichrome staining showed hepatic lipid accumulation， inflammatory cell infiltration and fibrosis formation in mice of the model group， and the mice in the model group had larger area of positive expression of α-SMA and Col1a1 （P<0.05） and higher NAS score （P<0.05） than those in the control group. HZRG low and high dose groups of mice had reduced intra-hepatocellular lipid droplets and significantly reduced liver steatosis and inflammatory cell infiltration. The mice in the HZRG low and high dose groups had smaller area of positive expression of α-SMA and Col1a1 （P<0.05） and lower NAS score （P<0.05） than those in the model group. ③The serum levels of ALT， AST， LDH， ALP were higher in mice of the model group than those in mice of the control group （P<0.05）. The serum levels of ALT， AST， LDH and TNF-α were lower in mice of the HZRG low and high dose groups than those in mice of the control group （P<0.05）. The serum levels of ALP were lower in mice of the HZRG low dose groups than those in mice of the control group （P<0.05）.④The TG and α-SMA protein expression in liver tissues of mice in the model group were higher than that in the control group （P<0.05）. The α-SMA protein expression in liver tissues of mice in the HZRG high dose group was lower than that in the model group （P<0.05）， and the TG and Col1a1 protein expression in liver tissues of mice in the HZRG low and high dose groups was lower than that in the model group （P<0.05）. ⑤The difference in p53 mRNA expression in liver tissues of mice among each group was not statistically significant （P>0.05）. ⑥The expression of p53 decreased in liver tissues of NASH mice and activated LX2 cells， and its expression could be up-regulated by HZRG and Tenovin-6； The elevated expression of p53 might alleviate the progression of liver fibrosis in NASH mice and inhibit LX2 cell activation.ConclusionThe mechanism by which HZRG alleviates NASH-related fibrosis may be related to the upregulation of p53 expression.关键词：non-alcoholic steatohepatitis;hepatic fibrosis;Huazhi Rougan Granule;traditional Chinese medicine therapy;network pharmacology;mechanism of action
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发布时间：2023-02-24 - 摘要：ObjectiveTo explore the mechanism of Shenge Recipe on inhibiting oxidative stress and mitochondrial function of steatosis hepatocytes.Methods①Thirty male C57BL/6J mice were divided into normal group， model group and Shenge Recipe group （the dosage of 15.75 g·kg-1·d-1）， with 10 mice in each group. The fatty liver model was induced by methionine and choline deficiency （MCD） diet for 16 weeks， while the mice in the Shenge Recipe group was given intragastric administration of traditional Chinese medicine since the 13th week. The levels of liver inflammation， lipid deposition and peroxidation were observed. ②Human hepatoma cells （HepG2 cells） were pretreated with palmitic acid （PA，0.2 mmol/L） for 24 h to induce hepatic steatosis model. Then the cells were treated with silencing information regulatory protein 3 （SIRT3） inhibitor （3-TYP）， adenylate activated protein kinase （AMPK） inhibitor （Compound C）， Shenge Recipe drug serum and normal mouse serum and were divided into 7 groups： Control group （Control）， model group （PA）， Shenge Recipe group （PA+SGF）， SIRT3 inhibition group （PA+3-TYP）， AMPK inhibition group （PA+CMC）， Shenge Recipe+SIRT3 inhibition group （PA+3-TYP+SGF） and Shenge Recipe+AMPK inhibition group （PA+CMC+SGF）. The levels of oxidative stress including cellular reactive oxygen species （ROS）， malondialdehyde（MDA）， mitochondrial function including adenosine triphosphate （ATP） and their effects on the contents of SIRT3， p-AMPK/AMPK and oxisome proliferator activated receptor γ coactivator-1α （PGC-1α） were observed. The structure of mitochondria was observed under electron microscope.Results①Compared with PA， the levels of lipid deposition and peroxide in PA+SGF were all reduced. ②Compared with PA group， the levels of TG， TNF-α and IL-6 in PA+SGF group were decreased significantly （P<0.05）. And the levels of ROS and MDA were decreased as well（P<0.01）， while PGC-1α and ATP levels showed the increase in PA+SGF group （P<0.05）. The damage of mitochondria was alleviated under electron microscope. However， the above effects were weakened after treatment with 3-TYP and Compound C.ConclusionShenge Recipe can inhibit oxidative stress injury， improve mitochondrial function and reduce hepatocyte steatosis， and its mechanism may be related to up-regulating the expression of SIRT3 and AMPK.关键词：nonalcoholic steatohepatitis;metabolic associated fatty liver disease;Shenge Recipe;oxidative stress;mitochondria;mouse model;traditional Chinese herbal medicine research
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发布时间：2023-02-24 - 摘要：ObjectiveTo observe the effects and mechanism of Shugan Huatan Jiangzhi Decoction （SHJD） on inflammatory injury in mice with non-alcoholic fatty liver disease （NAFLD） in order to provide experimental basis for the SHJD clinical application.MethodsFifty C57BL/6 male mice were randomly divided into 5 groups： normal control group （normal saline）， model group （normal saline）， low-dose SHJD group （8.32 g/kg）， medium-dose SHJD group （16.65 g/kg） and high-dose SHJD group （33.29 g/kg）， with 10 mice in each group. The NAFLD mouse model was constructed by feeding with high-fat diet， and sacrificed at 12 weeks after administration. The histopathological morphological changes of the mouse liver were observed； the expression levels of inflammatory factors including interleukin-1β （IL-1β）， IL-6 and tumor necrosis factor-α （TNF-α） were detected in the serum of the mice in each group； the protein and mRNA expressions of Toll-like receptor 4 （TLR4）， myeloid differentiation factor 88 （MyD88） and nuclear factor kappa B p65 （NF-κB p65） in mouse liver were detected.ResultsCompared with the normal control group， the liver tissue of the mice in the model group was severely damaged by inflammation. After the intervention of different SHJD doses， the degree of liver tissue damage and the inflammatory lesions were significantly reduced in the mice. Compared with the normal control group， the expression levels of serum IL-1β， IL-6 and TNF-α and the expressions of TLR4， MyD88， p-NF-κB p65 protein and TLR4， MyD88 and NF-κB p65 mRNA in the liver tissue of the mice in the model group were significantly increased （P<0.05）； Compared with the model group， the serum levels of IL-1β， IL-6 and TNF-α and the expression of TLR4， MyD88， p-NF-κB p65 protein and TLR4， MyD88 and NF-κB p65 mRNA in the liver tissue of the mice treated with SHJD were significantly decreased （P<0.05）.ConclusionSHJD may reduce the inflammatory injury in NAFLD mice by inhibiting the activation of TLR4/MyD88/NF-κB signaling pathway.关键词：non-alcoholic fatty liver disease;Shugan Huatan Jiangzhi Decoction;inflammatory response;mouse model;traditional Chinese herbal medicine research
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发布时间：2023-02-24 - 摘要：ObjectiveTo investigate the regulation and mechanism of Nelumbinis Folium on aquaporins （AQPs） and water metabolism in hyperlipidemia （HLP） model rats.MethodsA hyperlipidemic SD rat model was established with high-fat diet feeding. The rats were randomly divided into normal group， model group， ezetimibe group and Nelumbinis Folium group， with 7 rats in each group. Rats in normal group and model group were given intragastric administration of pure water， and rats in other two groups were given intragastric administration of ezetimibe or Nelumbinis Folium water extract in respective doses， once a day for 6 consecutive weeks. Serum triacylglycerol （TG） samples were detected by automatic biochemical analyzer； Serum gastrin （GAS）， motilin （MTL） and Na+-K+-ATPase levels were determined by ELISA； The mRNA expression of AQP3， AQP8 and AQP9 in colon tissue were detected by RT-qPCR； and Hmatoxylin-Eosin （HE） staining and oil red O staining were applied to observe the pathological changes of liver tissues.ResultsCompared with the model group， Nelumbinis Folium group showed decreased serum TG and MTL levels， significantly increased GAS and Na+-K+-ATPase content， down-regulated mRNA expression of AQP8 and AQP9 in colon tissues， and significantly reduced lipid deposition in liver cells of HLP model rats.ConclusionNelumbinis Folium has a regulatory effect on TG levels in HLP model rats， and the mechanism may be related to regulating the expression of aquaporins， improving the transportation and transformation function of the spleen and water metabolism.关键词：hyperlipidemia;metabolic diseases;Nelumbinis Folium;AQPs;rat model;traditional Chinese herbal medicine research
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发布时间：2023-02-24 - 摘要：ObjectiveTo investigate the effect of Peibu Qingli Decoction （PBQLD） on rats with polycystic ovary syndrome（PCOS） with insulin resistance （IR） based on a new target of gut microbiota.MethodsThe 3-week-old female SD rats were randomized into a control group of 8 rats and a model group of 18 rats. The rats in the model group were given trazole CMC suspension by gavage every day and continuous feeding of a high-fat diet， while the rats in the control group were given CMC by gavage every day and a normal diet. The rats in both groups received gavage continuously for 13 weeks. After modeling， 15 successfully modeled rats were randomly divided into model group （n=7） and treatment group （n=8）. The treatment group was given PBQLD concentrated solution by gavage， while the control group and the model group were given distilled water by gavage. The treatment lasted for 42 days. The body weight of rats in each group was weighed， HE staining was used to observe the morphological changes of ovaries， the oral glucose tolerance test was used to observe the changes of blood glucose of rats， the enzyme-linked immunosorbent assay （ELISA） was used to detect the fasting serum insulin （FINS） level and insulin resistance index （HOMA-IR）， the changes of gut microbiota were observed and the functions of gut microorganisms were predicted and analyzed.ResultsThe rats in the treatment group had improved ovarian morphology and reduced ovarian mass compared with rats in the model group. The data of 120 min postprandial blood glucose （PBG 120'）， and the concentrations of FINS and HOMA-IR of rats in the treatment group were lower than those in the model group （P<0.05）； There was a change in the relative abundance of gut microbiota （P<0.05） and a decrease in the F/B ratio （P<0.05）. PICRUSt2 functionally predicted that the abnormal gut microbiota structure in PCOS-IR rats was associated with amino sugar metabolism， citric acid cycle， lipid metabolism， and pentose phosphate pathway， etc. The gene abundance of fatty acid biosynthesis， citric acid cycle， and glycolysis in rats was down-regulated after PBQLD intervention.ConclusionsPBQLD can reduce the number of opportunistic pathogens， increase beneficial bacteria， better the abnormal structure of gut microbiota， and improve IR and PCOS phenotypes. The mechanism may be related to mediating glycolytic pathway and tricarboxylic acid cycle， and reducing lipid fatty acid biosynthesis.关键词：polycystic ovary syndrome;insulin resistance;Peibu Qingli Decoction;gut microbiota;rat model;traditional Chinese herbal medicine research
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发布时间：2023-02-24 - 摘要：In recent years， the prevalence of obesity in China is rapidly increasing， which can lead to a variety of complications. Traditional Chinese medicine has unique clinical advantages for the treatment of obesity because it has “simple diagnosis， convenient medication， low cost and good efficacy”. The purpose of the article is to investigate the pathogenesis of obesity from multiple syndrome differentiation approaches including the eight-principle syndrome differentiation， qi-blood-fluid syndrome differentiation， zangfu-organ syndrome differentiation， and sanjiao syndrome differentiation， etc. By doing so， it is helpful to treat obese patients with different syndromes.关键词：obesity;treatment based on syndrome differentiation;etiology and pathogenesis;traditional Chinese medicine classics;traditional Chinese medicine therapy
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发布时间：2023-02-24 - 摘要：Based on the perspective of “yang transforming qi， while yin constituting form”， we re-understood the causes of obesity. Meanwhile， we combined modern molecular biology mechanism and traditional Chinese medicine theory to discuss the application of “transforming static into dynamic and form into qi” in the obesity treatment. The connotation of traditional Chinese medicine prescriptions guided by form-qi theory could be explained from 3 aspects： replenishing qi and transforming blood to make the essential substance transforming into the normal pattern， boosting source of fire for eliminating abundance of yin， and resolving the hard mass with bitter-pungent medicines to adjust qi and blood circulation. All of them played a role in improving obesity by revolving the core mechanism of activating fat thermogenesis.关键词：obesity;metabolic diseases;yin and yang;form-qi theory;fat tissue;traditional Chinese medicine treatment
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发布时间：2023-02-24 -
Discussion on treating diabetic kidney disease by pungent moistening and dredging collaterals method
摘要：The clinical treatment of diabetic kidney disease（DKD）based on Ye Tianshi’s “pungent moistening and dredging collaterals method” is discussed. According to traditional Chinese medicine， DKD is a syndrome of deficiency of origin and excess of signs. It is based on kidney deficiency， with blood stasis as the main pathological factor. The disease location is in the kidney， with “kidney collaterals” as essentials and “kidney deficiency and blood stasis” as the core pathogenesis throughout the whole process of disease. In the treatment， pungent moistening and dredging collaterals method aims to use the characteristics of pungent drugs， such as warming， channeling and moistening， so as to play the functions of pungent expediting qi activity， pungent helping yang， steaming body fluid， promoting blood circulation and dredging collaterals， pungent moistening and tonifying， which is consistent with the pathogenesis of DKD.关键词：diabetic kidney disease;collateral disease;pungent moistening and dredging collaterals method;traditional Chinese medicine therapy- 17
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发布时间：2023-02-24 - 摘要：ObjectiveTo provide an objective basis for visual diagnosis theory of traditional Chinese medicine （TCM） and classification of liver disease syndromes and symptoms by analyzing the changes of fundus vascular images with the machine learning method in patients with non-alcoholic fatty liver disease （NAFLD） of common TCM syndromes （internal accumulation of damp-heat syndrome， liver depression and spleen deficiency syndrome）.MethodsGeneral data such as gender and age， as well as clinical symptoms were collected from NAFLD patients and healthy controls， and their fundus vascular images were collected with professional fundus cameras. The fundus vessels were segmented by the improved U-Net model， and the color， morphology and Haralick texture features were extracted by computer vision technology. A decision tree model was used to develop a disease prediction model with healthy people as controls. The fundus image features of NAFLD patients with internal accumulation of damp-heat syndrome and liver depression spleen deficiency syndrome， as well as the correlation between the fundus image features and influencing factors such as general data， clinical symptoms and so on were analyzed by SPSS 26.0 and R language.Results①A total of 126 NAFLD patients with different syndromes were included （61 cases with internal accumulation of damp-heat syndrome， 44 cases with liver depression and spleen deficiency syndrome， and 21 cases with nontypical syndrome）， and were divided into different groups accordingly. The healthy group included 110 healthy individuals as controls. ②The diagnosis model of NAFLD disease was established based on the decision tree model， with an accuracy of 0.972， a sensitivity of 0.970， a specificity of 0.975， and an AUC of 0.995， which can be effectively used for the analysis of fundus vascular features of NAFLD patients. ③In terms of vessel morphology and color， the internal accumulation of damp-heat syndrome group and liver depression and spleen deficiency syndrome group had smaller area， and higher small rate， curved and small curved than the nontypical syndrome group （P<0.05）. In terms of vascular texture， the internal accumulation of damp-heat syndrome group had higher value of asm and lower value of den than the nontypical syndrome group （P<0.05）， and the liver depression and spleen deficiency syndrome group had lower values of dva and den， and higher value of idm than the nontypical syndrome group （P<0.05）. ④A total of 6 common symptoms of NAFLD were obtained by screening， which were fatigue， dry mouth， lack of sleep at night， thin and unformed stools， dry eyes and sleepiness and desire to sleep during the day. ⑤The results of correlation analysis showed that the age of NAFLD patients was positively correlated with asm， curved and idm （P<0.05）， and negatively correlated with area， width， bsd， den， cor， ent， sen and f13 （P<0.05）， and gender was negatively correlated with small curved （P<0.05）. Dry eyes were negatively correlated with area， width and f13 （P<0.05）； thin and unformed stools were positively correlated with curved， con and dva （P<0.05）， and negatively correlated with idm （P<0.05）.ConclusionThe presence of specific changes in the vascular texture of fundus images of NAFLD patients with internal accumulation of damp-heat syndrome and liver depression and spleen deficiency syndrome may provide data support for the study of the TCM syndrome and symptom classification of NAFLD based on fundus vascular features.关键词：non-alcoholic fatty liver disease;traditional Chinese medicine syndrome and symptom;TCM diagnosis;machine learning;computer visual technology;fundus vascular image
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发布时间：2023-02-24
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