Investigations And Researches On Liver Fibrosis Treated By The Coordination Of Lower He Sea Acupoint, Back-shu Acupoint And The Eight Confluent Acupoint

Liver fibrosis was caused by the pathological process of paraplasm in hepatic fibrous connective tissue when hepatocellular inflammation and necrosis occurred. The slight one was called fibrosis, while the serious one, which including the restitution of hepatic lobule and the formation of pseudo-lobule and nodule, was called cirrhosis. Researches have found that hepatitis might be reversed. Thus, interception and reversion of liver fibrosis were regarded as key points of prevention and therapy for chronic liver disease and cirrhosis. Till now, there were few effective medicines for liver fibrosis. The medicines were commonly restricted in clinical therapy because of serious side effects. However, the traditional acupuncture therapy was found to have exact effects for liver fibrosis.Objectives:In this study, firstly, archaic traditional documents and neoteric references of acupuncture for liver disease accumulation were analyzed retrospectively. Archaic recognition and point selection of liver disease accumulation were summarized, especially focused on those randomized controlled trial (RCT) studies of acupuncture for liver fibrosis or cirrhosis, and the quality of the RCT reference were analyzed. Regularity of point selection on the disease was summarized clinically from the forthcoming researches. Secondly, animal model of liver fibrosis was established by CC14 abdominal capacity injection in rats. Colchicin injection in abdominal capacity was selected as positive control group. Catgut embedment was subsequently performed in Zusanli(ST36), Ganshu(BL18), Geshu(BL17) of the rats. By detecting HA, LN, PCIII, IVC and ALT in serum and pathological changes of hepatic tissue, animal experiment based on the above clinical results was fibrosis, and to provide theoretical evidence for clinical therapy.Methods:Part of documents:For the ancient documents:To summarize the symptoms, pathogenesis, acupoints and therapy methods of concretions, conglomerations, accumulations, and gatherings. For the modern times documents:With the methods of evidence-based medicine, retrieve the clinical research documents of liver fibrosis treated by acupuncture and moxibustion, from 1994 to 2009(16years), to evaluate the 36 RCT documents, and summarize the law of acupoints. Part of experiment:To divide the healthy, adult 70 SD rats randomly into 4 groups. They are normal group (10 rats), model group (20 rats), colchicines group(20 rats) and catgut embedding group(20 rats). Peritoneal injection was done on the last 3 groups of rats with 40%CC14 peanut oils twice a week, and continues 8 weeks. Each rat was injected oils 0.3ml/Kg. The colchicines group:From the ninth week, intragastric administration was done on the rats with 0.0025% colchicines suspensions 1 ml/kg once a day, and last for 8weeks. The catgut embedding group:From the ninth week, catgut embedding was done on the rats' acupoints of Zusanli(ST36), Ganshu(BL18), Geshu(BL17) every two weeks, and last for 8weeks. After the treatment finished, the rats were anesthetized and withdraw blood 3～5 ml from inferior vena cava to detect the ALT, HA, LA, PCIII & IVC. The right liver lobe was taken and put into the formalin immediately at the same time. Slicing the liver lobe after embedded with paraffin, HE and Masson staining. The Pathological changes and histopathological semi-quantitative scores in rats'liver were observed.Results:Part of reference summarization:In archaic acupuncture for liver fibrosis, points on the abdominal Conception Channel and liver, spleen, renal and stomach meridians were commonly used to invigorating Qi and promoting Blood circulation and to activating blood and resolving stasis. Bladder meridians on back and Back-shu point were used to adjust the function of Viscera and Bowels. Moxibustion, especially tactic high-dose moxibustion was proposed. Supplementation and draining was performed by acupuncture based on syndrome differentiation, time selecting were remarkable in acupuncture technique. In neoteric RCT references, acupoint application and acupoint injection were frequently used. Danshen Injection was the most commonly used medicine. The most frequently used points in acupoint application were Shenque(CV8), Qimen(LR14) and Zhangmen(LR13). Moreover, zusanli(ST36), Ganshu(BL18) and Qimen(LR14) were most generally used points, which especially, been used as Meridian ana Ken (?)hanne(?) were most constantly used in the cnosen meridian.Part of animal experiment:Compared with Colchicin injection group, the ascending of ALT, HA, LN, PCIII & IVC in catgut embedment group, which were evoked by CC14, were statistically lower (p<0.05). Catgut embedment group have an obvious degrading in infiltration of inflammatory cell and hyperplasia of collagen fiber tissue, the pathological appearance of liver fibrosis were changed obviously, the improvement of liver function and the degrading of fibrosis were statistically.Conclusions:The coordination of lower He Sea acupoint and Back-shu acupoint were used frequently, also the coordination of lower He Sea acupoint, Back-shu acupoint and the Eight Confluent acupoint. The coordination of the three kinds of special points can decrease ALT, HA, LA, PCIII & IVC. And also can improve the pathological appearance in rats'liver.