Experimental And Clinical Research On The Treatment Of Non-alcoholic Steatohepatitis With The Method Of Promoting Blood Circulation And Removing Dampness

Purpose Professor Lu Bingjiu a famous Chinese medicine practitioner in Liaoning province,specializes in the treatment of various liver diseases,especially for non-alcoholic steatohepatitis(NASH).Based on his 35 years of clinical experience,he summed up the method of promoting blood circulation and dampness.It is intended to promote blood circulation and dampness(here in after referred to as self-prepared side).Using experimental methods,we discussed the therapeutic efficacy and mechanism of self-made Huoxue Qushi Decoction in the treatment of established NASH model rats.Using clinical research methods,we explored the clinical efficacy of self-made prescriptions in the treatment of 80 patients with NASH,and assess its security.Material and method The materials used in the animal experiment were used in 60 wistar experimental rats,which were randomly divided into control group,model group,high-dose self-prepared group,medium-dose self-prepared group,low-dose self-prepared group and Qianggan capsule group.The control group was fed with normal feed.The model group was fed with purified high-fat diet(containing 45% fat)and fed for 12 weeks.The other groups were given corresponding drug intervention.By examining the changes of serum biochemistry,liver pathology,inflammatory factors and oxidative stress in all experimental rats,the effects of the above treatment on PPARα,SREBP-1 c and Toll-nuclear factor κB protein signal transduction pathway were determined,and then the prescription was studied the mechanism of liver protection function in model rats.The clinical study was used to observe the efficacy and safety of the self-made prescription.Results Experiment(1)Exploration of hepatocellular functions and blood lipid conditioning function of experimental rats in NASH model group 1.1 General conditions and pathological morphology No animals died during the experiment.Compared with the normal group,the experimental group of rats generally showed greasy contamination of the fur,increased wet weight and yellow staining of the liver.HE staining showed that the liver tissue was rich in fat vacuoles,and a large amount of central can be seen around the central vein.Inflammatory cell infiltration,NAS histological pathology score > 5 points,NASH model was successful;liver weight of each intervention group was reduced,the difference was statistically significant(P <0.05),self-prepared high dose group and Qianggan capsule group was more obvious in optimizing liver pathology than the other four groups,and the difference was statistically significant(P<0.05).1.2 Liver functions and blood lipids The serum biochemical parameters such as alanine aminotransferase(ALT),aspartate aminotransferase(AST),triglyceride(TG)and very low density lipoprotein(VLDL)in the model group were higher than those in the normal group,while high-density lipoprotein cholesterol(HDL-C)was lower than the normal group;serum biochemical parameters such as alanine aminotransferase(ALT),aspartate aminotransferase(AST),triglyceride(TG)and very low density lipoprotein(VLDL)were lower in the experimental group.All were significantly reduced(P<0.05),and the self-prepared high-dose group and Qianggan capsule group were more obvious than the other four groups,the difference was statistically significant(P<0.05).Experiment(2)Exploring the Antioxidant function of experimental rats in NASH model group 2.1 Liver SOD,MDA In the model group,the liver of the experimental rats was reduced compared with the superoxide dismutase(SOD),and the MDA content was increased(P<0.05).After intervention,the activity of SOD enzymes in each group increased,and the amount of MDA decreased(P<0.05).The effect of Qianggan capsule group and self-prepared middle and high dose groups was obvious,and the difference was statistically significant(P<0.05).2.2 PPARα m RNA expression in liver tissue Compared with the normal group,the integrated optical density(IOD)of PPARα m RNA in the model group was significantly different(P<0.05).After the intervention,all the rats were compared with the normal group.The IOD of PPARα m RNA was increased(P<0.05),and the effect of Qianggan capsule group and self-prepared high dose group was obvious(P<0.05).2.3 Expression and distribution of SREBP-1c in liver tissues Compared with the normal model group,the SREBP-1c m RNA in the liver of the experimental group,the integrated optical density(IOD)and the Western-blot protein gray value decreased,the difference was statistically significant(p<0.05);The ratio of IOD and Western-blot protein gray value of SREBP-1c m RNA in liver tissue of all experimental rats was decreased(p<0.05).The effect of Qianggan capsule group and self-prepared high and medium dose group was the most obvious(P< 0.05).The results of immunohistochemistry showed that the brown-yellow particles of the proximal central vein of the model group increased obviously and dispersed to the surrounding tissues.The brown-yellow particles near the central vein of each intervention group decreased,and the self-prepared high-dose group and Qianggan capsule group optimization is most obvious.Experiment(3)The function of intervention on the Toll-NF-κB protein signal transduction pathway in the NASH model group The expressions of TNF-ɑ,TLR3 and nuclear factor-κB protein p65 m RNA and protein in the liver tissue of the model group were significantly increased compared with the normal group(P<0.05).TNF-ɑ,TLR3 and nuclear factor-κB in the liver tissues of the rats in each intervention group.The expression of p65 m RNA and protein was significantly decreased(P<0.05).The effect of the high-dose group and the Qianggan capsule group was more obvious than other groups(P<0.05).Experiment(4)Clinical study of self-made prescription for treatment of NASH Eighty patients with NASH were randomly divided into two groups.Compared with Qianggan capsule treatment group,the efficacy of self-prepared prescription in optimizing BMI,liver function,blood lipids,liver B-ultrasound was more obvious(P<0.05),and the safety rating is 2 levels.Conclusion 1 Purified high-fat diet(containing 45% fat)for 12 weeks to produce the Wistar experimental rats NASH model.All intervention groups can reduce liver wet weight,protect liver function,regulate blood lipids,optimize liver pathology,and improve liver antioxidant capacity.The mechanism may be related to the regulation of hepatic fat synthesis by regulation of PPARα down-regulation of the target gene SREBP-1c.2 Self-made formulas can inhibit liver inflammatory reaction and enhance liver tissue anti-inflammatory ability.There are two possible mechanisms: 1 inhibits the expression of inflammatory factors in the liver;2 regulate the Toll-NF-κB signal transduction pathway.3 The indicators are more visible to each other,and the effect of the high-dose self-prepared group is more obvious.4 Oral Qianggan capsule and self-prepared clinical treatment of NASH patients are effective,the self-prepared side effect is more obvious,and the safety is level 2.