Objective To investigate the clinical efficacy and application value of traditional Chinese medicine Shugan Jiangzhi decoction combined with L-ornithine-L-aspartate (LOLA) in the treatment of fatty liver after viral hepatitis.
Methods Patients with fatty liver after viral hepatitis who were diagnosed and treated in Hebei Chest Hospital from October 2018 to October 2020 were enrolled and randomly divided into control group and test group. The control group was treated with LOLA, and the test group was treated with Shugan Jiangzhi decoction on the basis of the treatment of the control group, and the changes of liver function, blood lipids and immune function before and after treatment in the two groups were observed and compared.
Results A total of 144 patients were included in the study, including 72 patients in the control group and 72 cases in the test group. After treatment, the total effective rate of the test group was 93.06%, which was higher than that of the control group (79.17%) (P<0.05). After treatment, the serum levels of ALT, AST, TBIL, DBIL, GGT, TC, LDL-C and TG in the two groups were significantly decreased (P<0.05), and the test group was lower than that in the control group (P<0.05). The ratio of HDL-C value to CD4+ T lymphocytes in the two groups was higher than that before treatment (P<0.05), and the test group was higher than that in the control group (P<0.05), but there was no significant change in the proportion of CD8+T lymphocytes (P>0.05). The ultrasound grade of fatty liver in the test group was better than that in the control group (P<0.05).
Conclusion Shugan Jiangzhi decoction combined with LOLA can improve the immune function and the liver function, balance the blood lipid level, and continuously improve the prognosis of patients with fatty liver after viral hepatitis.
1.Kwon D, Kim SM, Correia MA, et al. Cytochrome P450 endoplasmic reticulum-associated degradation (ERAD): therapeutic and pathophysiological implications[J]. Acta Pharm Sin B, 2020, 10(1): 42-60. DOI: 10.1016/j.apsb.2019.11.002.
2.Liu X, Xu J. Calling a stage-based treatment model for chronic liver diseases in China mainland[J]. Ann Hepatol, 2020, 19(6): 585-589. DOI: 10.1016/j.aohep.2019.09.007.
3.Milic J, Menozzi V, Schepis F, et al. Liver steatosis and nonalcoholic fatty liver disease with fibrosis are predictors of frailty in people living with HIV[J]. Aids, 2020, 34(13): 1915-1921. DOI: 10.1097/QAD.0000000000002650.
4.许梦丽, 徐琼, 崔翠, 等. 灵芝多糖对妊娠期糖尿病大鼠肝脏损伤的保护作用[J]. 中国临床药理学杂志, 2020, 36(20): 3242-3245. [Xu ML, Xu Q, Cui C, et al. Protective effect of Ganoderma lucidum polysaccharide on liver injury in pregnant diabetes rats[J]. Chinese Journal of Clinical Pharmacology, 2020, 36(20): 3242-3245.] DOI: 10.13699/j.cnki.1001-6821.2020.20.016.
5.张巍, 邵明亮, 苗同国, 等. 清热利湿方对脂肪肝细胞PI3K/Ark表达调节研究[J]. 天津中医药大学学报, 2020, 39(1): 76-81. [Zhang W, Shao ML, Miao TG, et al. Research on the regulation of PI3K/Ark expression in adipose liver cells by Qingre Lishi formula[J]. Journal of Tianjin University of Traditional Chinese Medicine, 2020, 39(1): 76-81.] DOI: 10.11656/j.issn.1673-9043. 2020.01.17.
6.李东浩, 刘玉婷, 郝书荣, 等. 小檗碱对非酒精性脂肪肝大鼠疗效及其机制的探讨[J]. 中华肝脏病杂志, 2020, 28(4): 338-344. [Li DH, Liu YT, Hao SR, et al. Exploration of the therapeutic effect and mechanism of berberine on non-alcoholic fatty liver in rats[J]. Chinese Journal of Hepatology, 2020, 28(4): 338-344.] DOI: 10.3760/cma.j.cn501113-20190519-0017
7.吴瑶, 宋囡, 贾连群, 等. 化瘀祛痰方对载脂蛋白E基因敲除小鼠肝脏脂质过氧化及p53、GPX4、xCT表达的影响[J]. 中医杂志, 2020, 61(18): 1633-1638. [Wu Y, Song N, Jia LQ, et al. The effect of Huayu Qutan formula on lipid peroxidation and expression of p53, GPX4, and xCT in the liver of apolipoprotein E gene knockout mice[J]. Journal of Traditional Chinese Medicine, 2020, 61(18): 1633-1638.] DOI: 10.13288/j.11-2166/r.2020.18.016.
8.鲍婷, 王振, 朱丽丽, 等. 菊粉增加非酒精性脂肪肝病小鼠外周血、肝脏及脾脏单核细胞型髓源性抑制细胞比例并调节炎症因子的分泌[J]. 细胞与分子免疫学杂志, 2020, 36(3): 228-235. [Bao T, Wang Z, Zhu LL, et al. Inulin increases the proportion of mononuclear myeloid suppressor cells in peripheral blood, liver, and spleen of non-alcoholic fatty liver disease mice and regulates the secretion of inflammatory factors[J]. Journal of Cellular and Molecular Immunology, 2020, 36(3): 228-235.] DOI: CNKI:SUN:XBFM.0.2020-03-007.
9.陈超.《内经》气机学说在脂肪肝辨证论治中的应用[J]. 中国中医基础医学杂志, 2010, 16(10): 855-856. [Chen C. The application of qi mechanism theory in the diagnosis and treatment of fatty liver in the internal classic[J]. Journal of Basic Chinese Medicine, 2010, 16(10): 855-856.] DOI: CNKI:SUN:ZYJC.0.2010-10-003.
10.戴加乐, 徐惠娟, 王剑, 等. 补充维生素D对非酒精性脂肪肝患者胰岛素抵抗及炎性因子水平的影响观察[J]. 中国药师, 2022, 25(3): 458-461. [Dai JL, Xu HJ, Wang J, et al. Observation on the effects of supplementing vitamin D on insulin resistance and inflammatory factor levels in non-alcoholic fatty liver patients[J] Chinese pharmacist, 2022-25(3): 458-461.] DOI: 10.19962/j.cnki.issn1008-049X.2022.03.013.
11.Ebrahimzadeh LH, Ghotaslou R. Non-alcoholic fatty liver diseases: from role of gut microbiota to microbial-based therapies[J]. Int J Mol Sci, 2020, 39(4): 613-627. DOI: 10.1007/s10096-019-03746-1.
12.He T, Li J, Ouyang Y, et al. FibroScan detection of fatty liver/liver fibrosis in 2266 cases of chronic hepatitis B[J]. J Clin Transl Hepatol, 2020, 8(2): 113-119. DOI: 10.14218/JCTH.2019.00053.
13.徐蔚, 费松柏, 田爱霞, 等. 热敏灸联合西药治疗非酒精性脂肪肝的疗效及对血清脂多糖、瘦素的影响[J]. 上海针灸杂志, 2020, 39(10): 1220-1224. [Xu W, Fei SB, Tian AX, et al. The therapeutic effect of heat sensitive moxibustion combined with western medicine on non-alcoholic fatty liver and its effect on serum lipopolysaccharide and leptin[J]. Shanghai Journal of acupuncture and moxibustion, 2020, 39(10): 1220-1224.] DOI: 10.13460/j.issn.1005-0957.2020.10.1220.
14.赵志敏, 黄恺, 沈丽, 等. 欧当归内酯A对实验性纤维化肝脏NO及内皮细胞功能的影响[J]. 世界中医药, 2020, 15(19): 2850-2856. [Zhao ZM, Huang K, Shen L, et al. The effect of Oudanggui lactone A on NO and endothelial cell function in experimental fibrotic liver[J]. World Traditional Chinese Medicine, 2020, 15 (19): 2850-2856.] DOI: 10.3969/j.issn.1673-7202.2020.19.004.
15.雷鹏, 田思聪, 滕春莹, 等. 莱菔硫烷对肝细胞的抗氧化能力和线粒体功能的影响[J]. 第三军医大学学报, 2020, 42(2): 141-147. [Lei P, Tian SC, Teng CY, et al. The effect of sulforaphane on the antioxidant capacity and mitochondrial function of liver cells[J]. Journal of the Third Military Medical University, 2020, 42(2): 141-147.] DOI: 10.16016/j.1000-5404.201908073.
16.吴迪, 杨晋翔, 谢春娥, 等. 茵陈苓桂剂对非酒精性脂肪肝病大鼠脂代谢及氧化—抗氧化系统的影响[J]. 环球中医药, 2020, 13(9): 1473-1478. [Wu D, Yang JX, Xie CE, et al. The effect of Yinchen Linggui decoction on lipid metabolism and oxidative antioxidant system in rats with non-alcoholic fatty liver disease[J]. Global Traditional Chinese Medicine, 2020, 13(9): 1473-1478.] DOI: 10.3969/j.issn.1674-1749.2020.09.002.
17.崔桂玉, 白剑, 苗兰英, 等. 枸杞子对非酒精性脂肪肝辅助性T细胞17和相关细胞因子的影响[J]. 中国临床药理学杂志, 2020, 36(3): 309-312. [Cui GY, Bai J, Miao LY, et al. The effect of goji berries on helper T cell 17 and related cytokines in non alcoholic fatty liver[J]. Chinese Journal of Clinical Pharmacology, 2020, 36(3): 309-312.] DOI: CNKI:SUN:GLYZ.0.2020-03-028.
18.Wong DK, Cheng SCY, Mak LL, et al. Among patients with undetectable hepatitis B surface antigen and hepatocellular carcinoma, a high proportion has integration of HBV DNA into hepatocyte DNA and no cirrhosis[J]. Clin Gastroenterol Hepatol, 2020, 18(2): 449-456. DOI: 10.1016/j.cgh.2019.06.029.
19.Yagi S, Hirata M, Miyachi Y, et al. Liver regeneration after hepatectomy and partial liver transplantation[J]. Int J Mol Sci, 2020, 21(21): 8414. DOI: 10.3390/ijms21218414.
20.谭婷, 何栋, 朱红梅, 等. 茵陈五苓散对非酒精性脂肪性肝病模型大鼠RBP4的影响[J]. 中医学报, 2020, 35(2): 344-347. [Tan T, He D, Zhu HM, et al. The effect of Yinchen Wuling powder on RBP4 in non alcoholic fatty liver disease model rats[J]. Journal of Traditional Chinese Medicine, 2020, 35(2): 344-347.] DOI: CNKI:SUN: HNZK.0.2020-02-029.
21.徐靖达, 杨公利, 杜井峰, 等. 双氢青蒿素通过调控PI3K/AKT通路增强肝癌H22细胞荷瘤小鼠放疗效果[J]. 中国病理生理杂志, 2020, 36(10): 1782-1788. [Xu JD, Yang GL, Du JF, et al. Dihydroartemisinin enhances the radiotherapy effect of H22 liver cancer cells in mice by regulating the PI3K/AKT pathway[J]. Chinese Journal of Pathophysiology, 2020, 36(10): 1782-1788.] DOI: 10.3969/j.issn.1000-4718.2020.10.008.
22.徐万鹏, 梁英琴, 韦秀桂, 等. 老鼠簕生物碱A对大鼠非酒精性脂肪肝的改善作用及其机制研究[J]. 中国药房, 2020, 31(16): 1955-1960. [Xu WP, Liang YQ, Wei XG, et al. Study on the improvement effect and mechanism of mouse acanthus alkaloid A on non-alcoholic fatty liver disease in rats[J]. China Pharmacy, 2020, 31(16): 1955-1960.] DOI: 10.6039/j.issn.1001-0408.2020.16.07.
23.Biquard L, Valla D, Rautou PE, et al. No evidence for an increased liver uptake of SARS-CoV-2 in metabolic-associated fatty liver disease[J]. Hepatol Commun, 2020, 73(3): 717-718. DOI: 10.1016/j.jhep.2020.04.035.
24.张瀚予, 罗娟, 缪应雷, 等. 缺血性肝炎[J]. 医学新知, 2023, 33(4): 295-302. [Zhang HY, Luo J, Miao YL, et al. Ischemic hepatitis[J]. Yixue Xinzhi Zazhi, 2023, 33(4): 295-302.] DOI: 10.12173/j.issn.1004-5511.202302040.
25.江莹, 张宁萍, 许青, 等. 65例程序性细胞死亡蛋白-1抑制药介导肝损伤患者的临床特点及预后分析[J]. 药物流行病学杂志, 2022, 31(10): 669-673,712. [Jiang Y, Zhang NP, Xu Q, et al. Clinical characteristics and prognosis analysis of 65 patients with programmed cell death protein-1 inhibitor mediated liver injury[J] Journal of Pharmacoepidemiology, 2022, 31(10): 669-673, 712. DOI: 10.19960/j.cnki.issn1005-0698.2022.10.004.]
26.Wahlang B, Appana S, Falkner KC, et al. Insecticide and metal exposures are associated with a surrogate biomarker for non-alcoholic fatty liver disease in the National Health and Nutrition Examination Survey 2003-2004[J]. HIV Med, 2020, 27(6): 6476-6487. DOI: 10.1007/s11356-019-07066-x.
27.王楚瑶, 蒋素素, 向德彪, 等. 姜黄素通过调节PCSK9促进肝细胞摄取血浆LDL-C[J]. 中国药理学通报, 2020, 36(10): 1415-1421. [Wang CY, Jiang SS, Xiang DB, et al. Curcumin promotes liver cell uptake of plasma LDL-C by regulating PCSK9[J]. Chinese Pharmacological Bulletin, 2020, 36(10): 1415-1421.] DOI: 10.3969/j.issn.1001-1978.2020.10.016.
28.唐海鸿, 魏春山, 郑颖俊, 等. 基于FibroScan技术评价疏肝消脂方加减治疗非酒精性脂肪性肝病的临床疗效[J]. 中医杂志, 2018, 59(7): 594-598. [Tang HH, Wei CS, Zheng YJ, et al. Evaluation of the clinical efficacy of modified Shugan Xiaozhi formula in the treatment of non-alcoholic fatty liver disease based on FibroScan technology[J]. Journal of Traditional Chinese Medicine, 2018, 59(7): 594-598.] DOI: CNKI:SUN:ZZYZ.0.2018- 07-014.
29.成扬, 袁莎莎, 王文健, 等. 王文健教授运用益气化聚方治疗非酒精性脂肪肝合并代谢综合征经验报道 [J]. 中国中西医结合杂志, 2019, 39(5): 624-625. [Cheng Y, Yuan SS, Wang WJ, et al. Professor Wang Wenjian's experience report on the treatment of non alcoholic fatty liver complicated with metabolic syndrome with Yiqi Huaju formula[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2019, 39(5): 624-625.] DOI: 10.7661/j.cjim.20180822.280.