【摘要】 目的 探讨胆汁酸谱与非酒精性脂肪性肝病（Non-alcoholic Fatty Liver Disease,NAFLD）生化学及中医证型的关系。方法 回顾性选取2020年11月至2023年5月厦门市中医院门诊及病房收治的95例非酒精性脂肪性肝病患者，采用色谱-质谱分析法检测血清胆汁酸谱，进行生化指标及中医证型与胆汁酸谱的相关统计分析。结果 胆汁酸谱系与生化指标的相关性：牛磺鹅脱氧胆酸（TCDCA）、牛磺胆酸（TCA）与体质量指数（BMI）水平呈正相关，甘氨胆酸（GCA）、TCDCA、TCA、鼠胆酸（MCA）与丙氨酸转氨酶（ALT）水平呈正相关，猪脱氧胆酸（HDCA）、GCA、TCDCA、TCA、别胆酸（ApoCA）、MCA与门冬氨酸转氨酶（AST）水平呈正相关，ApoCA、MCA与甘油三酯（TG）呈正相关。胆汁酸谱系在各中医证型的比较：HDCA、甘氨脱氧胆酸（GDCA）、甘氨石胆酸（GLCA）差异有统计学意义（P<0.05）。结论 非酒精性脂肪性肝病患者血清胆汁酸谱会发生明显改变，胆汁酸与脂代谢异常在NAFLD的发生发展中起着重要作用。中医药，特别是针对痰湿证的治疗，可能为NAFLD的临床管理提供新的治疗方向。更多还原

【Abstract】 Objective To explore the relationship between bile acid profiles, biochemical indicators,and Traditional Chinese Medicine(TCM) syndrome patterns in patients with non-alcoholic fatty liver disease(NAFLD). Methods This study included 95 patients with NAFLD who were admitted to the outpatient and inpatient departments of Xiamen Traditional Chinese Medicine Hospital between November 2020 and May 2023.Serum bile acid profiles were analyzed using chromatography-mass spectrometry, and statistical analyses were conducted to examine the correlation between bile acid profiles, biochemical indicators, and TCM syndrome patterns. Results Correlation between bile acid profiles and biochemical indicators: TCDCA and TCA levels were positively correlated with body mass index(BMI); GCA, TCDCA, TCA, and MCA levels were positively correlated with alanine aminotransferase(ALT) levels; HDCA, GCA, TCDCA, TCA, ApoCA, and MCA levels were positively correlated with aspartate aminotransferase(AST) levels; ApoCA and MCA levels were positively correlated with triglycerides(TG). Comparison of bile acid profiles across different TCM syndrome patterns showed statistically significant differences in HDCA, GDCA, and GLCA levels(P<0.05). Conclusion Serum bile acid profiles in patients with NAFLD exhibit significant alterations. Bile acids, along with lipid metabolism abnormalities, play a critical role in the pathogenesis and progression of NAFLD. Traditional Chinese Medicine, particularly treatments targeting phlegm-dampness syndrome, may offer new therapeutic approaches for the clinical management of NAFLD.更多还原