Clinical Study Of The Therapy Of Soothing Liver And Strengthening Spleen And Removing Dampness And Activating Blood To Fatty Liver

BackgroundThe first medical awareness of fatty liver reported from the study of W. Bowman, 1842. Subsequent studies mainly base on liver biopsy pathology reports. 1986 F. Schaffner has proposed fatty liver disease (FLD) concept. FLD refers to the main lesion to liver cells in acini hepatis bullous steatosis and fat storage-based broad-spectrum. When the liver cells of liver lipid accumulation were more than 5% of the wet weight, or histology see on each unit area 1/3 or more liver cell lipid changes, known as fatty liver, including three main types such as simple fatty liver, steatohepatitis, and of fatty liver cirrhosis.As China's socio-economic development and improvement of people's living standards, The incidence of fatty liver showed an upward trend year after year, tending to younger age at onset, with an average population incidence of approximately 5%～10%. For obesity, diabetes and alcohol abuse , the incidence of the people were 25%～75%, a serious threat to human health, the diagnosis and treatment of fatty liver have become an increasing concern to public health problems.In Western Europe, Japan and the United States , the general adult detection rate of the chronic fatty liver diseaseis about 25%. FLD has become the largest causes of chronic liver disease and abnormal liver enzymes in Western Europe, the United States, Australia, Japan. General adult incidence of non-alcoholic fatty liver disease (NAFLD) has gone up to 20%～33%, of which at least 10% to 15% is non-alcoholic steatohepatitis (NASH). In 10 years, 15% to 25% of these people will become the cirrhosis. The probability of recurrencefor fatty liver sclerosis in patients with primary hepatocellular carcinoma, liver failure and liver transplantation has risen up to 30%～40%; for the simple fatty liver in obese (60%～90%); for NASH (20%～25%) and cirrhosis (2%～8%) and the incidence is even higher.15 years ago, the incidence of fatty liver in China was low. Based on the statistics of Luidezhen at Zhongshan Hospital, Shanghai Medical University, in 1991-1992. He studied 40 factories and institutes which have 10,923 individuals, and found 220 cases of fatty liver in factories and institutes, with the average incidence of 2%. In recent years, the people's living standards have gradually improved .With the changes in the structure of people's diet people lack physical activities, an average weight gaining,the incidence of fatty liver continues to rise. At present, the incidence of fatty liver has increased 5 times than five years ago. The people of some city, such as Beijing, Nanjing, Shanghai and other places in the healthy census, we found that the incidence of fatty liver reached 10% -15%. In Nanjing, the incidence of fatty liver was from 8.99% in 1998 to 12.33% in 2002.ObjectiveThe objective of the theme is studying and assessing the effection of the "Jianpi Huoxue Shugan", which is based on the method of soothing Liver and Strengthening Spleen and Removing Dampness and Activating Blood to treat fatty liver, and further discuss the mechanism of the method, and lay a solid foundation for exploring a new and effective treatment of liver fatty. Study methodFrom May, 2007 to March, 2009, in Jiangsu Province Hospital of Chinese Medicine and Wuxi lazaret Hospital in Jiangsu Province, China have 120 cases infection with liver fatty. And divide into group such as treatment group and control group using the same basic treatment such as rest, nutrition, and exercise and control diet. General symptomatic has been treatment by Baogan Jiangmei. Using the Traditional Chinese medicine "Ganzhixiao" for the treatment group of one day 1 package divide into 2 times during one month, in general treatment time in two months; For control group used Shu Jiangzhi,10mg/d in two months. The observations of general information of the patient are gender, age, etc. In the safety of medicine are blood, urine, stool routine, electrocardiogram, and renal function. In the effect of treatment including clinical symptoms (such as body weight, fatigue, abdominal distension and anorexia, etc); the function of liver (such as Cholesterol (TC), Triglyceride (TG), Low-density lipoprotein (VDL-C), High-density lipoprotein (HDL-C); Liver function: ALT, AST, ALP, GGT, etc,..), in some cases have to test by CT examination, ultrasonic).Achieved resultAfter 2 months treatment, the results as following:- Treatment group have 9cases recover from an illness that has 15% recovered, 16 cases have markedly effective (26.6%), and 26 cases have effective (43.3%). The total effective rate is 85%;- Control group have7 cases of the basic recover from an illness (11.6%), 12 cases of markedly effective (20%), and 23 cases of effective (38.3%). The total effective rate is 70%.- Clinical symptoms of treatment group (such as body weight, fatigue, abdominal distension and anorexia, hypochondriac pain, etc) have markedly improved compared with pre-treatment (P<0.01), and tongue, hepatomegaly have to reduce, (P<0.05).- The control group after treatment (such as hypochondriac pain, abdominal distension, anorexia, fatigue, tongue, etc) has improved in symptoms of hepatomegaly.- For fatigue, abdominal distension and anorexia, hypochondriac pain, etc the treatment group have improvement more than control group (P<0.01).- Other symptoms such as tongue, hepatomegaly, ultrasonic, etc the treatment group have improvement more than control group (P<0.05).- The two groups before and after treatment in patients with cholesterol(TC) Triglyceride (TG) Low-density lipoprotein (VDL-C), High-density lipoprotein (HDL-C); Liver function: ALT, AST, ALP, GGT, etc, also have markedly improvement and significant in statistical.- Comparison of two groups of patient treatment group used the Ganzhixiao liver has improved more than control group. There were significant differences (P<0.05 and P<0.01). In the evaluation of liver function has improved the situation and the parameters ALT, AST, ALP, GGT were decreased in varying degrees. In particular, the treatment group is moderate fatty liver to improve the most obvious.- Safety of the medicine before and after treatment in blood, urine, stool routine, electrocardiogram, renal function showed that the Ganzhixiao liver without adverse reactions, better safety. ConclusionGanzhixiao liver of fatty liver has a highly effective such as improvement in clinicalsymptoms, liver function, lipid levels, changing in ultrasonic image. Especial, for the patientshave medium and low disease level.