Tone The Liver Lipi Side To Improve The Clinical Trials Of Alcoholic Liver Fibrosis With The In Vitro Study

Alcoholic liver desease(ALD) is a commonly encountered disease. Alcoholicliver fibrosis(ALF)is the intermediary from minor alcoholic liver disease,alcoholic fatty, alcoholic hepatitis to alcoholic liver cirrhosis. It has beenone of the hot spots in the present studies for its reversibility. The formingmechanisms of Alcoholic liver fibrosis base on the activation of hepatic stellatecell(HSC), and is the reversible dynamic pathologic process of the increasedsynthesis and the relatively decreased degradation of ECM impelled by the livereffect cells through the reciprocity between the pathogenic genes and nosotropicgenes. Traditional Chinese medicine(TCM) has the predominance and satisfactoryeffectiveness in prevention and treatment for ALF.The research objective was the syndrome of liver stagnation with spleendeficiency and stagnation due to phlegm and blood stasis of ALF. The observationof the Tiaoganlipi Decoction (TD) was to be deepen; the extracorporeal experimentwas to creat multicellular environment as imitated ALF and to observe theinfluence of TD on the cells.Clinical research: Strictly, according to the Guideline Principle of ClinicalResearch on New Drug of Traditional Chinese Medicine and the requirement ofclinical epidemiology. In order to observe the clinical curative effect of TDtreating the syndrome of liver stagnation with spleen deficiency and stagnationdue to phlegm and blood stasis of ALF, the clinical trial was adopted randomparallel control multicenter method with Capsule of Fufangbiejiaruanganpian ( COF)as the control drug.Extracorporeal experiment: the proliferation of HSC with the TD–intervened-serum mixing with supernant of kupffer cell (KC) or hepatic cell(HC) wereobserved with MTT method; the content of TP and AST of HC with the TD–intervened-serum mixing with supernant of KC or HSC were observed; the content of NO ofHC with the TD–intervened -serum mixing with supernant of KC and of KC withthe TD–intervened -serum mixing with supernant of HC were observed.Clinical research :Results: The 73 cases were involved during this period of the trial, and amongthem the 37 cases were in treatment group, 36 cases were in control group. Therewas no significant difference between the 2 groups in the age, weight, height,ill period and type of disease distribution, either the safety index beforetreatment. So they were comparative. The clinical curative effect shows as follows:After 4 weeks treatment, the total effective percentage of the treatment groupwas 86.5%,of the control group 72.2%. There were significant differences between the two groups (P<0.05). The effect of treatment group was more advanced thanof the control group for relieving the syndrome of hypochondriac pain, poorappetite, fatigue,having significant difference(P < 0.05). The effect oftreatment group was superior to the one of the control group for improving themanifestation of the tongue and the pulse,but having no significant difference(P>0.05). The effect of treatment group was inferior to the one of the controlgroup for relieving the syndrome of diarrhea, but having no significant difference(P>0.05). Both the two groups had no significant effect on relieving the syndromeof numb of limbs and amnisia. Both the two groups could decrease the content ofAST and GGT(P<0.05), but there was no significant difference between them(P>0.05).Both the two groups could increase the rate of A/G significantly(P<0.01), theeffect of treatment group superior to the one of the control group(P<0.05).Forthe liver fibrosis index, both the two groups could decrease the content of LNsignificantly(P<0.01), the effect of treatment group superior to the one ofthe control group(P<0.05). Both the two groups could decrease the content ofPIIINP,CGIV and HA(P<0.05) but having no significant differences between thetwo groups(P>0.05).Conclusions: On the whole, both TD and COF have good effect on improving thesyndrome of liver stagnation with spleen deficiency and stagnation due to phlegmand blood stasis of ALF. The effect of TD is superior to the one of COF in theshort term.Extracorporeal experiment:Results: 1.The model of ALF within multicellular environment was built. 2.Thesupernant of KC and of KC with HC could increase the proliferation of HSC, whilethe supernant of HC could not.3. The supernant of KC could decrease the contentof TP in HC, while the supernant of HSC could not. The supernant of KC or HSCcould not decrease the content of AST in HC. 4. The supernant of KC or HC couldincrease the content of NO. 5. in the model of ALF within multicellular environment,both Tiaoganlipi Decoction and Fufangbiejiaruanganpian could decrease theproliferation of HSC, increase the content of TP, decrease the content of AST ,decrease the content of NO. The effect of treatment group superior to the oneof the control group slightly, but having no significant differences between thetwo groups.Conclusions: The mechanism of TD may be direct action or through cytokinenet for improving the lesion of liver in the model of ALF within multicellularenvironment.